Receipt of summons: The common processing defect at the time of service of summons to the insurer is that no date stamp is affixed by the insurers office on the face of summons received, which can be vital evidence of late service of summons. The summons are neither filed with file number, case number and claim number on the same day, nor entered in TP claims register or Genysis same day, resulting in misplaced summons.
Scope and purport of tribunal: As regards the scope and purport of Section 168 of the Motor Vehicles Act, 1988, the Claims Tribunal is not only entitled to determine the amount of claim from the insurer, owner or driver of the vehicle jointly or severally, but also adjudicate on the dispute between the insurer and the owner or driver of the vehicle involved in the accident, in so far as it can be resolved by the Claims Tribunal in such proceedings.
Internal Audit Issues in Third Party Claims Settlement: Some important issues in third party claims settlement are listed below: i. Whether the method of computing outstanding provision is incorrect? ii. Why some of the files are incomplete; iii. Claims paid through inter office accounts are not reflected in TP claims paid / intimation register in the year of payment affecting correctness of incentive payments to development officers due to paid claims being shown as inadequate outstanding provisions; iv. Attachment orders need be examined as to the causes which led to the serious situation. System deficiency should be identified and panel advocate should be asked to explain; v. Number of TP claims registered is too large vis--vis personnel earmarked to handle claims effectively. vi. Quality assurance teams must examine large claims and claims outstanding for over three years to initiate appropriate action in order to expedite settlement.
Treatment of Orphan Claims: These are third party claims where no policy details are available. Sometimes, Claims Tribunals serve notice only on the Insurance Company and no claim petition is received, then such cases are registered as Orphan Claims and a separate list is kept of such claims.
Whoever does anything with the intention of causing wrongful gain to one person or wrongful loss to another person is said to do that thing dishonestly.
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