Motor Insurance Case Studies.
Determination of nonearning Member- To determine the compensation for a nonearning member like a child who has no income is quite difficult for courts to judge what should be justified compensation, but still based on intelligent guesswork, the amount can be ascertained.
How to calculate where there is no income proof- A minimum of 15000 must be taken into consideration. In case of simple injuries lump sum is given and no separate amount for medical expenses is considered. In Sushma Thomas’s case, the maximum multiplier was 16 but now courts are considering maximum multiplier 18 and minimum 5. The multiplier is to be applied on the age of the deceased or dependent whichever is higher. Section 163 A has the concept of no-fault liability but if the award is obtained under 163 A then it is full and final and no further scope to file a case in 166. Under 163 An additional 2000 for funeral expenses, 5000 for consortium, 2400 for loss of estate, and 15000 for medical expenses.
Meaning of Fraud -Section 2 (23-25) of IPC- gain by unlawful means of property to which the person so gaining is not legally entitled. Dishonesty– if any person with the wrong intention of causing wrongful gain is said to be doing the act of dishonesty. If a person does anything fraudulently then he is guilty of a fraudulent act, Fraud is explained in section 463 of IPC this is an intention to deceive for any expectation or advantage to the party himself. or for others. Forgery- 463 making false documents.
types of fraud- conversion of nonroad accidents into road accidents like snake bite death is shown as death by running over by the vehicle. conversion of medical cases as accidental cases, fraud in road accidents (substitution of insured vehicles in place of uninsured vehicles), the addition of names of persons in accidents, false FIR, medical documents, etc. Multiple cases (forum shopping)
Underwriting frauds- issuance of cover notes after accidents, issuing bogus cover notes policies, wrong dates, acceptance of back-dated premium cheques. Wrong Medical Certificates, We must do an effective investigation of all third-party cases. Seizure Memo, FIR, 64VB confirmation, may throw some light on frauds. Initiation of criminal action is suggested for preventing fraud.
Orphan Claims- where policy is not confirmed, the insurers keep one-third provision as the claim amount.
Say Report and No Say report in WS (written statement) where after the search policy is not found advocate of the insurance company will file no say report to the court.
MV Act is a social act and hence under section 158, a police officer is required to submit an investigation report of an accident within 30 days.
Fitness of the vehicle- As per section 56 of MV Act 1988, if fitness is expired, it is deemed that the registration of the vehicle is automatically canceled.
Commencement of date: if a particular time and date are mentioned in the policy then no problem otherwise the policy will commence from 00 hours of the date mentioned in the policy. Public Policy v/s Cancellation of policy- The insurer might have canceled the policy, but then public interest will prevail over the interest of the insurance company, which please note. Section 147 of MV act obligates the owner of the vehicle to get the vehicle insured.
