Third party insurance claim in India

This article provides a brief introduction of the Insurance claims under the Insurance Act, including insurance of first and third parties. Different accidents attract different insurance claims with documents required for both. The article also discusses the procedure for filing an insurance claim, relief sought, and the appeal mechanism from MACT.

Fri Jul 22 2022 | Govt. Agencies and Taxation | Comments (0)

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Under the provisions of the Insurance Act, the concept of insurance claim is categorized into two parts:

  1. First Party Insurance
  2. Third party Insurance ( often known as liability insurance)

Under first party Insurance Claim, one can file with his own insurance company but in third party insurance, the Insurance Company indemnifies the insured person, if he is liable for any injury or damage caused to the third party. In the above explanation  the first party is the insured party, the  second party is the Insurance Company and the third party is the party who suffered damages or injuries.

WHEN A THIRD PARTY CLAIM CAN BE FILED

There are certain conditions which are to be followed for claiming  damages by the third party:

  • The person should suffer bodily injury in an accident
  • The property of the person must be damaged because of the accident
  • There is a loss of life

WHO CAN FILE A THIRD PARTY CLAIM

The claims can be made by the person himself who has sustained any damage or injury or by the agent duly authorized by the person who suffered any loss or the owner of the damaged property or any heir or legal representative of the deceased whose life is lost in an accident.

HOW TO FILE A THIRD PARTY CLAIM

The insurance details of the vehicle involved in an accident with due intimation to the insurer of the vehicle.

Filing an FIR stating the details of the accident occurred, information about the vehicle involved in the accident and its driver and the details of the person who has witnessed the accident.

As per the provision of the Motor Vehicle Act, for the purpose of deciding the claims for compensation with respect to any loss or injury or damage to any life or property in an accident, cases are filed before the Motor Accident Claim Tribunals (MACT)

The MACT issues a notice upon the Application to the insured person and gives  reasonable opportunity of being heard and holds the inquiry for the claim.

The award is made by MACT upon the merits of the case.

DOCUMENTS REQUIRED TO FILE A CLAIM BEFORE MACT

The party files the case before MACT with all the supporting  documents. The list of documents is given as under:

Documents relating to the Identity of the Claimants who suffered loss or the deceased person.

Copy of the FIR filed before the Police Authorities and the surveyor report in case the property is damaged.

The treatment record and the expenses incurred for the   person injured.

The Income proof of the Injured or deceased person

The age proof of the injured or deceased person

Other documents as instructed by the Tribunal

RELIEFS SOUGHT

The compensation sought for  damages caused before the MACT are as follows:

General Damages for the pain and suffering caused to the person;

If the loss is caused  to a person  who is deprived  of earning then the past and  future income to be given;

All the past and future medical expenses of the person injured;

Rehabilitation expenses, if any;

Damages - if there are any out of pocket expenses.

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