Accident insurance compensation denied as the rider was on a 150+cc bike

tilt · 22nd October 2021, 18:48

Quote:

Originally Posted by UtkarshC

Thanks to Roni Simon for sending this information in. Heartfelt gratitude for sharing it with other enthusiasts via this Team-BHP share page!

HDFC Ergo denied compensation as the rider was on a bike whose displacement was greater than 150cc. This is as per their fine print. It is mentioned in clause 8, under General Exclusions.

The following details are as per the company’s Personal Accident Insurance Policy:
There is yet another clause that says, if you are met with an accident on the way to a hospital even for a routine check-up, they can refute the claim.

The following details are as per the company’s Personal Accident Insurance Policy:

Ther problem with this (and this is true of all insurance companies I have spoken with at various times), they do not send you the detailed terms and conditions of the policy before you buy. They only send you scant information and it is only after you pay and buy the policy that this entire legalese is sent to you, by which time it is too late to change any terms.

I have asked them for detailed policy wordings at the quotation stage and all of them have said they will send it along with the policy.

Cheers

Gansan · 22nd October 2021, 19:12

I think this will not be for the PA policy sold with bike insurance policy. If that be the case, they expose themseves to litigation because they already know what bike the person has.

I suspect this will be the PA policy they sell bundled with health insurance. I have a policy for 25 lacs alongwith my health cover. The insurer is New India. My renewed policy should reach me in a few days. I will go through it in detail.

Sran · 22nd October 2021, 20:36

New insurance ombudsman act, 2021 has included insurance agent and malpractices done by them in the ombudsman list. The amended rules have enlarged the scope of complaints to Ombudsmen from only disputes earlier to deficiencies in service on the part of insurers, agents, brokers and other intermediaries. Further, insurance brokers have been brought within the ambit of the Ombudsman mechanism, by empowering the Ombudsmen to pass awards against insurance brokers as well.

Ironhide · 23rd October 2021, 18:10

Accident insurance compensation denied as the rider was on a 150+cc bike-screenshot_202110231800242.png

According to Pt No 15, those in the uniform are not covered against any bodily injury, whether on active service or otherwise.

Does this sound like an unfair practice?

Just thinking aloud.

Gansan · 23rd October 2021, 18:22

Armed forces personnel can't buy normal insurance policies, be it life insurance or PA insurance because of the high risks involved. Their insurance needs will usually be taken care of by their own services. I have heard it forms part of their pay or the premium is deducted from their pay.

Fx14 · 23rd October 2021, 18:41

My 2p basis personal purchases of PA policies.

There are different variants on offer :
1. The bundled PA add on with your vehicle insurance, mandated by the MV Act. This can be avoided if the vehicle owner already has a standalone PA cover.

2.Standalone PA policy which is customisable and premium varies basis the facts and exclusions. Eg. For the same coverage amount a person in an administrative job pays lowest premium, whereas a driver pays the highest.

Possibly some specific exclusions were in play in this specific case / policy.

Gansan · 27th October 2021, 15:55

Quote:

Originally Posted by Gansan

I think this will not be for the PA policy sold with bike insurance policy. If that be the case, they expose themseves to litigation because they already know what bike the person has.

I suspect this will be the PA policy they sell bundled with health insurance. I have a policy for 25 lacs alongwith my health cover. The insurer is New India. My renewed policy should reach me in a few days. I will go through it in detail.

I have received the renewed PA and health insurance policies. I find no such engine cc reference. It only mentions about racing, adventure sports etc.

So the policy posted by the OP must be bundled with bike insurance. In which case they were aware of the engine capacity at the time of issuing the policy, and are very much liable. Better write to the insurance ombudsman with all particulars.

SAMUDRA · 30th October 2021, 11:33

Guys, who are all working in private sector, please do check your companies employee insurance policy or Insurance co-ordinator wrt
1. will the insurance cover, if you are injured / in extreme case demise, while riding a >150cc bike.
2. will the insurance cover, if you are injured / in extreme case demise, While travelling in private car or taxi as a passenger or as a pillion on a bike and the driver happens to be intoxicated at the time of accident.

I was in for a rude shock, when I came to know that I'd not be covered while riding my bike's as both of them are 350cc bikes.

22nd October 2021, 19:12	#17
Gansan Senior - BHPian Join Date: May 2009 Location: Chennai Posts: 4,623 Thanked: 5,917 Times	Re: Accident insurance compensation denied as the rider was on a 150+cc bike I think this will not be for the PA policy sold with bike insurance policy. If that be the case, they expose themseves to litigation because they already know what bike the person has. I suspect this will be the PA policy they sell bundled with health insurance. I have a policy for 25 lacs alongwith my health cover. The insurer is New India. My renewed policy should reach me in a few days. I will go through it in detail.
	(1) Thanks

22nd October 2021, 20:36	#18
Sran BHPian Join Date: Jun 2019 Location: Patna Posts: 416 Thanked: 2,254 Times	Re: Accident insurance compensation denied as the rider was on a 150+cc bike New insurance ombudsman act, 2021 has included insurance agent and malpractices done by them in the ombudsman list. The amended rules have enlarged the scope of complaints to Ombudsmen from only disputes earlier to deficiencies in service on the part of insurers, agents, brokers and other intermediaries. Further, insurance brokers have been brought within the ambit of the Ombudsman mechanism, by empowering the Ombudsmen to pass awards against insurance brokers as well.
	(3) Thanks

23rd October 2021, 18:10	#19
Ironhide BHPian Join Date: May 2012 Location: UK-07 Posts: 482 Thanked: 1,160 Times	Re: Accident insurance compensation denied as the rider was on a 150+cc bike According to Pt No 15, those in the uniform are not covered against any bodily injury, whether on active service or otherwise. Does this sound like an unfair practice? Just thinking aloud.
	() Thanks

23rd October 2021, 18:22	#20
Gansan Senior - BHPian Join Date: May 2009 Location: Chennai Posts: 4,623 Thanked: 5,917 Times	Re: Accident insurance compensation denied as the rider was on a 150+cc bike Armed forces personnel can't buy normal insurance policies, be it life insurance or PA insurance because of the high risks involved. Their insurance needs will usually be taken care of by their own services. I have heard it forms part of their pay or the premium is deducted from their pay.
	() Thanks

23rd October 2021, 18:41	#21
Fx14 BHPian Join Date: Mar 2014 Location: Mumbai Posts: 208 Thanked: 635 Times	Re: Accident insurance compensation denied as the rider was on a 150+cc bike My 2p basis personal purchases of PA policies. There are different variants on offer : 1. The bundled PA add on with your vehicle insurance, mandated by the MV Act. This can be avoided if the vehicle owner already has a standalone PA cover. 2.Standalone PA policy which is customisable and premium varies basis the facts and exclusions. Eg. For the same coverage amount a person in an administrative job pays lowest premium, whereas a driver pays the highest. Possibly some specific exclusions were in play in this specific case / policy.
	() Thanks

30th October 2021, 11:33	#23
SAMUDRA BHPian Join Date: Feb 2009 Location: Bangalore Posts: 94 Thanked: 82 Times	Re: Accident insurance compensation denied as the rider was on a 150+cc bike Guys, who are all working in private sector, please do check your companies employee insurance policy or Insurance co-ordinator wrt 1. will the insurance cover, if you are injured / in extreme case demise, while riding a >150cc bike. 2. will the insurance cover, if you are injured / in extreme case demise, While travelling in private car or taxi as a passenger or as a pillion on a bike and the driver happens to be intoxicated at the time of accident. I was in for a rude shock, when I came to know that I'd not be covered while riding my bike's as both of them are 350cc bikes.
	() Thanks