MISCELLANEOUS INSURANCE

Transcription

1 MISCELLANEOUS INSURANCE The accident or miscellaneous department covers those types of risk which are not covered either under Fire or Marine Departments. Its scope is therefore, very vide and extensive and includes such a wide range of contingencies as may not be included in the strict interpretation of the term Accident. The Accident or the miscellaneous insurance includes many sub-sections under which different classes of business are transacted. A special feature of this department is that it covers many branches which are grouped together in it which are apparently unrelated to each other. However in practise, unrelated risks are grouped together for the convenience of the insured. Marine cum Erection / Storage cum Erection Policy: This is a comprehensive policy covering all physical risks which a project is exposed to. Highlights This is a comprehensive policy covering all physical risks which a project is exposed to right from the warehouse of the supplier of equipments - whether imported or indigenous - to its erection, testing and commissioning at the site. In case the supplier has arranged transit insurance upto the site, a Storage cum erection policy can be issued limiting coverage to risks that the project is exposed to at the site only. In case the policy period exceeds 12 months, the premium can be paid in quarterly installments with the first installment being more by 5% and the last installment being paid 6 months before expiry of the policy. For project value exceeding Rs.1500crs, specially designed policies are available. Scope The policy comprises of 2 Sections : Section I-Material Damage-covering physical loss, damage or destruction of the property insured by any cause, other than those specifically excluded in the policy. Section II-Third Party Liability-covering the legal liability falling on the insured contractor as a result of bodily injury or property damage belonging to a third party. The policy covers all risk of physical loss or damage of insured property other than those specifically excluded, including :- marine voyage for imports offloading / storage at port inland transit to site storage, handling, erection at site testing and commissioning at site The main exclusions are :- a. Loss or damage due to faulty design, defective material or casting, bad workmanship other than faults in erection. This exclusion is limited to the items

2 immediately affected and does not apply to any consequential loss to correctly executed items. b. Cost necessary for rectification or correction of any error during erection unless resulting in physical loss or damage. c. Loss or damage due to gradual deterioration, atmospheric condition, rusting etc. d. Loss discovered only at the time of taking inventory. e. Loss arising out of penalty for delay, non-fulfilment of terms of contract. Add on covers The policy can be extended to cover the following on payment of additional premium. clearance and removal of debris damage to owner's surrounding property maintenance visit / extended maintenance cover additional customs duty civil works express freight air freight deletion of duration clause under marine Who can take the policy The policy can be taken by the principal, contractor or sub contractor, jointly or separately. How to select the sum insured The sum insured selected under section I should not be less than the completely erected value of the property inclusive of estimated freights, customs duty, erection cost etc. In case of long term contracts, there is bound to be escalation in prices i.e.prime cost. The basic policy will pay only as per the original cost and prices. However escalation clause can be opted for, under which escalation upto 50%, can be selected to take care of such increase in prices during the policy period. The sum insured shall be adjustable on completion of the erection, on the basis of actual values incurred by the insured in respect of freights, handling charges, customs dues, cost of erection etc. and premium adjusted accordingly. The sum insured under section II should represent the per accident limit (the maximum legal liability that may fall on the insured as a result of an accident in the insured's site). The limit per policy period should be fixed taking into account the maximum number of such accidents which can reasonably be expected to occur. How to claim In the event of any loss or damage giving rise to a claim under the policy, the

3 following steps should be taken :- Take necessary steps to minimise the loss. Inform insurance company immediately. Inform fire brigade in case of fire and police authorities in case of theft. Extend full cooperation to the surveyor deputed by the company. Submit duly filled in claim form along with necessary documents to substantiate the financial loss suffered as a result of the accident. Period of Insurance The period of insurance should not be less than the period of contract and should commence from the date of unloading of the first consignment at the site of the erection and shall continue upto the conclusion of the first test operation or test loading subject to a maximum of 4weeks from the date trial running is made and / or readiness for work is declared by the erectors. If a part of the plant or one or several machines are tested and put into the operation, the coverage under the policy for that particular part of the plant or machine will cease, whereas the coverage will continue for the remaining parts which are not yet ready. In case approval of the plant or any part thereof is not given by the concerned authorities even after expiry of 4weeks of trial running, the policy can be extended and the extra premium to be arranged beforehand. Key Documents required for settlement of claim for Engineering (a) Marine cum Erection (b) Storage cum Erection. A Claim form containing the following information. 1. Date, time, cause of loss 2. Details of damaged property. 3. Amount of loss claimed. 4. Sound value of the property at the time of loss 5. Other insurance, if any. B. Certified True copy of the policy along with schedule and Endorsements/clauses. C. Payment details of premium amount. D. Newspaper reports on the incident, if any. E. Photographs. F. Estimate of repair from repairer. G. Bills of repair/replacement with proof of payment. H. Survey Report is very important where claim amount is over Rs.20,000/- as per provisions of the Insurance Act I. Discharge voucher. J. Letter of Undertaking where applicable.

4 N.B. Waiver of requirement of any claim documents can be made on the merit of each claim case by the claim sanctioning authority with the approval of the Head of the Department. Machinery Breakdown policy: This is a policy which covers financial loss incurred by the insured due to loss or damage to machinery as a result of accidental electrical and mechanical breakdown. Highlights This is a policy which covers financial loss incurred by the insured due to loss or damage to machinery as a result of sudden accidental electrical and mechanical breakdown. It reimburses the insured for the cost of repairs or replacement of machinery of like nature. Who can take this Insurance: This insurance can be taken by the individual owner of the machine or a person or company having financial interest in the machine. What kind of machines can be covered: All types of industrial machinery like compressors, pumps, turbine etc. as also electrical machines like transformer, electrical motor, generator etc. can be covered under this policy. What is the sum insured or value for which policy is to be taken: It is a requirement of this policy that the sum insured or value for which the particular machine is insured should represent the present day purchase value of a similar new machine including all incidental expenses like custom duties, taxes, excise, freight, insurance charges, handling charges etc. In case the sum insured under the policy is less than as per the above requirement the claim will be paid only in such proportion as the sum insured bears to the current replacement cost of similar new machinery. Scope The policy covers all kinds of electrical and mechanical breakdown resulting from the following incidents: a. Faulty material/workmanship of the machine b. Action of centrifugal forces contributing to disruption of the rotating parts c. Failure of lubrication due to malfunctioning of lubricating oil pumps or its breakdown. d. Malfunctioning or failure of safety devices. e. Electrical short-circuiting including electrical fire originating from failure of insulation and or over voltage or under voltage conditions. f. Abrupt and sudden stoppage of other connected machinery. g. Entry of foreign bodies into running machine. h. Inexperienced operations causing damage due to error of judgment or error in

5 operation. Add on covers The policy can be extended to include the following risks on payment of additional premium. 1. Damage to foundation of machinery 2. Damage to oil in electrical apparatus 3. Express freight (excluding air freight), holiday rates, overtime charges 4. Air freight 5. Additional custom duty i.e. the additional percentage of duty payable at the time of reimport for replacement over and above the percentage of duty included in the original sum insured. 6. Own surrounding property i.e. damage to the insured s own existing property or property in his custody or control (not included in the sum insured of the policy) due to any damage to the insured machines which is covered under the policy. 7. Third party liability i.e. liability falling on the insured for bodily injury to any other party other than those covered by the policy or for property damage belonging to such other party. How to claim In case of any such incident which falls under the scope of the policy, the following steps should be followed: 1. Please inform the insuring office by phone, letter or fax. 2. Take all necessary steps to minimise the loss. 3. Obtain estimate of repair from repairer of your choice. 4. Submit this repair estimate and claim form to the surveyor deputed by the insurance company. 5. After getting clearance from the surveyor, proceed for repairing machine or ordering for replacement as the case may be. 6. Submit actual bills of repair/replacement with proof of payment to the surveyor. Key Documents required for settlement of claim for Machinery Breakdown A. Claim form containing the following information. a. Date, time, cause of loss b. Details of damaged property. c. Amount of loss claimed. d. Sound value of the property at the time of loss e. Other insurance, if any. B. Certified True copy of the policy along with schedule and Endorsements/clauses. C. Payment details of premium amount. D. Newspaper reports on the incident, if any. E. Photographs.

6 F. Estimate of repair from repairer G. Bills of repair/replacement with proof of payment H. Survey Report is very important where claim amount is over Rs.20,000/- as per provisions of the Insurance Act I. Discharge voucher. J. Letter of Undertaking where applicable. N.B. Waiver of requirement of any claim documents can be made on the merit of each claim case by the claim sanctioning authority with the approval of the Head of the Department. Electronics Equipment Policy: This is a specially designed policy which covers accidental loss or damage to electronic equipment. Highlights This is a specially designed policy which covers accidental loss or damage to electronic equipment. What equipment can be covered under this policy: The policy covers the following types of equipments: 1. Electronic data processing machine. 2. Telecommunication equipment. 3. Transmitting and receiving installations (including Radio, TV, Cinema Sound Reproduction and Studio Equipment). 4. Material testing and research equipment. 5. Electro-Medical Installations. 6. Signal and transmitting units. 7. Office calculators, duplicating machines and Reproduction machines. 8. Control and supervisory units. Note: The above items should not be portable and mobile Who can take this policy: This policy can be taken by the owner, lessor or hirer of electronic equipment. Scope The policy covers sudden and unforeseen physical damage including breakdown to the electronic equipment covered under the policy due to any reason not specifically excluded. Thus it covers damage caused by the following perils:- 1. Smoke, soot, dust, corrosive gases etc. 2. Water and Humidity. 3. Short circuit and Electrical fire risk.

7 4. Faulty operations, lack of skill. 5. Falling object and entry of foreign bodies 6. Fire, lightning, explosion. 7. Riot and strike and malicious damage and terrorism. 8. Theft and burglary. 9. Natural calamities flood, inundation, storm, cyclone and earthquake 10. Subsidence, landslide, rockslide. Loss of damage caused by the following perils are specifically excluded from the scope of the policy. 1. Normal wear and tear and corrosion of parts arising from use and continuous operation (limited to parts immediately affected, subsequent damage to other parts of the unit covered). 2. War, wilful acts, gross negligence. 3. Faults for which third party is responsible by law or contract. 4. Failure due to interruption of gas, water or power supply. 5. Aesthetic defects. 6. Consequential loss of any kind. 7. Loss to consumables and operating media etc. Add on covers The sum insured or value of the policy should be equivalent to the present day purchase price of a similar new electronic equipment including all incidental expenses like cost of installation, duty, freight, taxes etc. If the sum insured is less than required as stated above then the claim will only be paid in such proportion as the sum insured bears to the amount required to be insured. How to select the sum insured The policy can be extended to include the following risks on payment of additional premium. 1. Damage to external data media for example punch cards, tapes, discs etc. as also the cost of reconstruction of data on this external media caused by a peril covered under the policy. 2. The additional expenditure incurred due to use of a substitute computer system as a result of an accidental damage to the computer insured under the policy and which is covered by the policy. How to claim In case of any such incident which falls under the scope of the policy, the following steps should be followed: 1. Please inform the insuring office by phone, letter or fax. 2. Take all necessary steps to minimise the loss. 3. Obtain estimate of repair from repairer of your choice. 4. Submit this repair estimate and claim form to the surveyor deputed by the insurance

8 company. 5. After getting clearance from the surveyor, proceed for repairing machine or ordering for replacement as the case may be. 6. Submit actual bills of repair/replacement with proof of payment to the surveyor. Key Documents required for settlement of claim for Electronics Equipment A. Claim form containing the following information. a. Date, time, cause of loss. b. Details of damaged property. c. Amount of loss claimed. d. Sound value of the property at the time of loss. e. Other insurance, if any. B. Certified True copy of the policy along with schedule and Endorsements/clauses. C. Payment details of premium amount. D. Newspaper reports on the incident, if any. E. Photographs. F. Estimate of repair from repairer. G. Bills of repair/replacement with proof of payment. H. Survey Report is very important where claim amount is over Rs.20,000/- as per provisions of the Insurance Act I. Discharge voucher. J. Letter of Undertaking where applicable. N.B. Waiver of requirement of any claim documents can be made on the merit of each claim case by the claim sanctioning authority with the approval of the Head of the Department. Contractors All Risk Policy: This policy is specially designed to give financial protection to the Civil Engineering Contractors in the event of an accident to the civil engineering works under construction. Highlights This policy is specially designed to give financial protection to the Civil Engineering Contractors in the event of an accident to the civil engineering works under construction. In case the policy period exceeds 12 months, the premium can be paid in quarterly installments with the first installment being more by 5% and the last installment being paid 6 months before expiry of the policy. Scope

9 The policy comprises of 2 Sections : Section I-Material Damage-covering physical loss, damage or destruction of the property insured by any cause, other than those specifically excluded in the policy. Section II-Third Party Liability-covering the legal liability falling on the insured contractor as a result of bodily injury or property damage belonging to a third party. The main exclusions under Section I for which no claim is payable, are loss or damage due to: i. faulty design ii. rectification of aesthetic defects of structure not relating to any physical loss or damage to the structure due to any accident, or of material defect or of workmanship defect. The exclusion of defective material / workmanship is limited to the parts of the structure immediately affected and does not apply to any consequential loss to correctly executed items, arising out of the accident due to defective material or workmanship. iii. Loss or damage due to gradual deterioration, atmospheric condition, rusting etc. iv. Loss discovered only at the time of taking inventory. v. Loss arising out of penalty for delay, non-fulfilment of terms of contract. Add on covers The policy can be extended to cover the following items :- a. construction equipment like scaffolding, shuttering materials b. construction equipment like scaffolding, shuttering materials c. Damage to surrounding property not forming part of the contract work. d. maintenance visit / extended maintenance cover to cover accidental loss or damage whilst carrying out any rectification during maintenance period and / or any amount incurred for rectification of such original defects or faults during construction. Who can take the policy The policy can be taken by the principal, contractor or sub contractor, jointly or separately. How to select the sum insured The sum insured selected under section I should represent total contract value including the estimated cost of labour charges and cost of materials but excluding profit. The cost of materials supplied by the principal is to be declared separately. In case of long term contracts, there is bound to be escalation in prices. The basic policy will pay only as per the original cost and prices. However escalation clause can be opted for, under which escalation upto 50%, can be selected to take care of such increase in

10 prices. The sum insured under section II should represent the per accident limit (the maximum legal liability that may fall on the insured as a result of an accident in the insured's site). The limit per policy period should be fixed taking into account the maximum number of such accidents which can reasonably be expected to occur. How to claim In the event of any loss or damage giving rise to a claim under the policy, the following steps should be taken :- Take necessary steps to minimise the loss. Inform insurance company immediately. Extend full cooperation to the surveyor deputed by the company. Submit duly filled in claim form along with necessary documents to substantiate the financial loss suffered as a result of the accident. Key Documents required for settlement of claim for Contractors All Risk Insurance A. Claim form containing the following information. a. Date, time, cause of loss b. Details of damaged property. c. Amount of loss claimed. d. Sound value of the property at the time of loss e. Other insurance, if any. B. Certified True copy of the policy along with schedule and Endorsements/clauses. C. Payment details of premium amount. D. Newspaper reports on the incident, if any. E. Photographs. F. Estimate of repair from repairer. G. Bills of repair/replacement with proof of payment. H. Survey Report is very important where claim amount is over Rs.20,000/- as per provisions of the Insurance Act I. Discharge voucher. J. Letter of Undertaking where applicable. N.B. Waiver of requirement of any claim documents can be made on the merit of each claim case by the claim sanctioning authority with the approval of the Head of the Department. Period of Insurance

11 Unlike other policies where the period of insurance is one year, in this policy the period of insurance should be equivalent to the period of contract, commencing from the date of unloading of the first batch of material at the site of construction and expiring on the date of handing over of the contract work to the principal. Although it is possible to extend the policy period in case of delay in completion of contract, it is always advisable to choose a slightly longer period of insurance initially, to avoid paying the higher extension premium. As a matter of financial discipline, the Government has directed on 19 th August, 1998 to all corporation, Boards, Z.P., Nagarparishad wherein the state Government direct control, should place their Contractor All Risk insurance with the Government Insurance Fund only. As a result huge numbers of proposal are being received by the Government Insurance fund and therefore large amount of insurance premia is being earned by the Government Insurance Fund as non-tax revenue. While scrutinizing the proposal, if some technical difficulties arise, then the pre-insurance survey are be conducted by the insurance surveyors approved by IRDA. 1. The Government of Maharashtra has issued Resolution for taking insurance of contract works and that of the workers deployed for execution of the same from the G.I.F. However, having no agency for procurement of insurance business and inadequate staff, the following procedure is being adopted for providing insurance protection to the contract works awarded by various establishments under the direct / indirect control of the State Government. The G.I.F. has a single office located at Mumbai in Maharashtra state and no Divisional / Regional Offices have been set up. Being Self Insurance Scheme of the State Government, services of Brokers / Agents have not been availed of, which is the general practice in public / Private Sector Insurance Companies. The Government Resolution makes it compulsory to effect insurance of contract works, awarded by various establishments under the direct / indirect control of the State Government, with the G.I.F. For effective implementation of insurance scheme, all Government Departments, Semi-Government Department, Corporations, Boards, Public undertakings, Universities, Authorities, Municipal Corporations, Municipal Councils, Zilla Parishads or any other institutes under the direct / indirect control of the State Government, being Principal to the Contract, are required to adopt the following procedure to ensure that the contract works awarded by them to various contractors are insured with the G.I.F. only. (A) For the contract works having value upto Rs.25 Lakhs, the principal to the Contract is required to deduct an 0.50% of the Contract Cost from the 1 st Running Bills submitted by the Contractors towards the premium for insurance of the Contract Works and that of the workers deployed at the works sites and send it to the G.I.F. by Demand Draft / Cheque drawn in favour of Directorate of Insurance, Maharashtra State, Mumbai along with a detailed statement, as per specimen given below, within 30 days from the date of deduction of premium amount. Sr. No. Name of the Contractor Descriptions of the Contract works Works order No. Period of Contract / Insurance Contract Cost Premium 0.50% As the premium amounts are being deducted from the R.A. Bills of the Contractors, the Director of Insurance reserves his right to condone the time limit of 30 days for payment

12 of premium amount within 30 days from the date of its recovery. As and when the detailed statement as per enclosed specimen statement and Demand Draft / Cheque is received from the Principal, the G.I.F. shall issue a Single Insurance Policy (Schedule Policy) covering all the contract works mentioned in the statement sent along with the Demand Draft / cheque. This Insurance Policy shall provide a cover to the Principal as well as to the Contractors under Contractor s All Risk Insurance / Transit Cum Erection Insurance, as the case may be, and the Workmen s Compensation Insurance. (B) If the Value of contract exceeds Rs.25 Lakhs, the Contractor is required to approach the office of the G.I.F. at Mumbai and submit the proposal of insurance in the prescribed form and pay the premium amount, in cash or by Demand Draft. The Insurance Cover Note / Policy shall be issued only on receipt of duly filled in proposal form and the premium amount. (C) In case of Contract Works having contracted sum more than Rs.25 Lakhs, the Principal must exercise effective vigilance of ensure that the Contractors submit proper insurance cover note / policy for the contract work awarded to them in time. If they do not submit the proper proof of insurance in time, the principal shall recover the 1% of the Contract Cost from the Running Bill of the Contractors and send the same by Demand Draft / Cheque along with statements, as given above, within 30 days from the date of recovery of the amount. (D) For information it is stated that whenever the Contract Cost is more than Rs.50 Crores, the concerned Contractors have to obtain Pre-insurance Survey Report from the Empanelled Surveyor of the G.I.F. On receipt of such Pre-insurance Survey Report, duly filled in proposal forms and the premium amount, further action to effect insurance under direct servicing method or co-insurance cum servicing method shall be initiated by the G.I.F. If the Contractors have not effected insurance directly with the G.I.F. or under coinsurance cum servicing arrangement with the consent of the G.I.F., the Principal to the contract shall ensure that an 1% is being deducted from the Running Bill of the Contract and paid it to the G.I.F. by Demand Draft / Cheque along with detailed statement of such recoveries. Workmen's Compensation Insurance Salient Feature The employers legal liability under the W.C.Act to pay compensation to employees not covered under E.S.I.Act for bodily injury or disease sustained / contracted out of and in the course of employment is covered by this policy. Liability to employees under Indian Fatal Accident Act 1855 and at Common Law are also covered under the policy. Scope of Cover a) The Workmen s Compensation Insurance Business in India is controlled by the Workmen s Compensation Insurance Tariff (W.C.Tariff). The Tariff provides for two types of Insurance as follows: Table A: This policy provides indemnity to the Insured if any employee in the Insured s immediate service shall sustain bodily injury by accident or contracts disease arising out of and in the course of his employment by the Insured in the Business and if the Insured

13 shall be liable to pay compensation for such injury either under. i) Workmen s Compensation Act, 1923 and subsequent amendments of the said Act prior to the date of issue of the Policy provided that the insurance granted is not extended to include any interest and/or penalty imposed on the insured on account of his / their failure to comply with the requirements laid down under the W.C. Act, 1923, and ii) the Fatal Accident Act, 1855 of at Common Law And in addition all costs and expenses incurred with the company s consent in defending any claim for such compensation. Table B: This Policy provides indemnity to the Insured against their legal liability under the Fatal Accidents Act, 1855, and at Common Law. (This Policy is not issued to cover employees who fall within the definition of workmen under the Workmen s Compensation Act, 1923, as amended). b) The Policy excludes i) Any injury by accident or disease directly attributable to war, invasion, act of foreign enemy, hostilities (whether war be declared or not), civil war, Mutiny, insurrection, rebellion, revolution or military or usurped power. ii) iii) iv) the Insured s liability to employees of contractors to the Insured. Any employee who is not a workman within the meaning of the Laws. Any liability of the Insured which attaches by virtue of an agreement but which would not have attached in the absence of such agreement. v) Any sum which the Insured would have been entitled to recover from any party but for an agreement between the Insured and such party. Key Documents required for settlement of claim for Workmen Compensation Insurance A. Claim form containing the following information. a. Date, time, cause of Accident b. Details of loss. c. Amount of loss claimed. d. Other insurance, if any. B. Certified True copy of the policy along with schedule and Endorsements/clauses. C. Payment details of premium amount. D. Photographs. E. First Information Report / Letter of intimation to the Police Station duly endorsed /Police Panchnama. F. Final Investigation Report. G. Doctors Prescription H. Medical bills if cover as extension is granted. I. Discharge Card

14 J. Leave Orders K. Pay/wages roll L. Fitness Certificate M. Discharge voucher N. Death certificate for fatal Injury O. Post Mortem Report for fatal Injury P. Legal Heir Certificate Q. W. C. Commissioner award in case of fatal Injury. R. Letter of Undertaking where applicable. N.B. Waiver of requirement of any claim documents can be made on the merit of each claim case by the claim sanctioning authority with the approval of the Head of the Department. Contractor Plant and Machinery Policy: this policy covers all different types of machinery used for handing material or construction. Add on Covers The policy can be extended to cover a. Third party liability - personal injury and property damage. b. Damage to owner's surrounding property. Who can take the policy The policy can be taken by any one of the following parties, either individually or jointly :- The owner of the machine The contractor / user of the construction machinery The financial institutes who have an interest in the construction machinery. How to claim In the event of any loss or damage giving rise to a claim under the policy, the following steps should be taken:- Take necessary steps to minimise the loss. Inform insurance company immediately. Extend full cooperation to the surveyor deputed by the company. Submit duly filled in claim form along with necessary documents to substantiate the

15 financial loss suffered as a result of the accident. Key Documents required for settlement of claim for Contractor Plant and Machinery A Claim form containing the following information. a. Date, time, cause of loss b. Details of damaged property. c. Amount of loss claimed. d. Sound value of the property at the time of loss e. Other insurance, if any. B. Certified True copy of the policy along with schedule and Endorsements/clauses. C. Payment details of premium amount. D. Newspaper reports on the incident, if any. E. Photographs. F. Estimate of repair from repairer. G. Bills of repair/replacement with proof of payment. H. Survey Report is very important where claim amount is over Rs.20,000/- as per provisions of the Insurance Act I. Discharge voucher. J. Letter of Undertaking where applicable. N.B. Waiver of requirement of any claim documents can be made on the merit of each claim case by the claim sanctioning authority with the approval of the Head of the Department. Burglary: Policy is designed to cover business premises only like godown, factory, office etc. Highlights Policy is designed to cover business premises only like godown, factory, office etc. There are three types of policies available :- Full Value Insurance: The policy must be effected for the full value of the property to be insured. First Loss Insurance: In the event of improbability of total loss, proposer can opt for a percentage of total stocks to be insured Stock Declaration Policies: These policies are given where large stocks frequently fluctuate in quantity during the year. The sum insured is fixed at the maximum value of stocks which the insured anticipates he will hold at any one time. A deposit premium of 100% of the annual premium will be paid at the beginning of the insurance. Monthly declarations of value are to be sent to the company and the deposit premium will be

16 adjusted at the end of the policy period based upon the average of the monthly declarations Scope a. Loss or damage to the property insured by theft following upon actual, forcible and violent entry into the premises. b. Damage to the premises following upon entry as above or any attempt thereat The indemnity provided is to the extent of the intrinsic value of the property so lost or damaged, subject to the limit of the sum insured. Exclusions The company shall not be liable in respect of : i. Gold, watches, jewellery, precious stones, plans, designs, money, business books etc. unless specifically insured. ii. Loss or damage where any insured or member of the insured s household or of his business staff is concerned in the actual theft or damage. The policy shall cease to attach: a. If the premises are left uninhabited for 7 or more consecutive days and nights. b. In the event of material alterations to the premises whereby the risk is increased. c. If the insurable interests has passed from the insured otherwise by will or operation of law In event of claim a. The insured should give immediate notice to the police and also to the company and within 14 days submit to the company his claim in respect of loss or damage sustained. b. The insured should also tender to the company all reasonable information, assistance and proofs in connection with any claim here under. Key Documents required for settlement of claim for Burglary Insurance A. Claim form containing the following information. a. Date, time, cause of loss b. Details of loss. c. Amount of loss claimed. d. Other insurance, if any. B. Certified True copy of the policy along with schedule and Endorsements/clauses.

17 C. Payment details of premium amount. D. Newspaper reports on the incident, if any. E. Photographs. F. Departmental Enquiry Report in the event of claim under Fidelity Guarantee, Cash in Transit, Cash in Safe Bankers Indemnity. G. First Information Report / Letter of intimation to the Police Station duly endorsed /Police Panchnama if available. H. Final Investigation Report if available I. Survey Report is very important where claim amount is over Rs.20,000/- as per provisions of the Insurance Act J. Discharge voucher. K. Letter of Undertaking where applicable. N.B. Waiver of requirement of any claim documents can be made on the merit of each claim case by the claim sanctioning authority with the approval of the Head of the Department. Personal Accident Policy: The insurance provides compensation in the event of death or disability directly due to accident. Highlights This policy offers compensation in case of death or bodily injury to the insured person, directly and solely as a result of an accident, by external, visible and violent means. The policy operates worldwide and is a 24 hours cover. Different coverages are available ranging from a restricted cover of Death only, to a comprehensive cover covering death, permanent disablements and temporary total disablements. Family Package cover is available to Individuals under Personal Accident Policy whereby the proposer, spouse and dependent children can be covered under a single policy with a 10% discount in premium. Group personal accident policies are also available for specified groups with a discount in premium depending upon the size of the group.

18 Scope This policy is basically designed to offer some sort of compensation to the insured person who suffers bodily injury solely as a result of an accident which is external, violent and visible. Hence death or injury due to any illness or disease is not covered by the policy. The following types of coverages are offered under a Personal Accident policy:- Table D 1. Death cover wherein 100% of the capital sum insured is payable. Table C 1. Coverage under Table D 2. Loss of two limbs / both eyes / one limb and one eye wherein 100% of the capital sum insured is payable. 3. Loss of one limb or one eye wherein 50% of the capital sum insured is payable. 4. Permanent Total Disablement other than above e.g. paralysis due to an accident, wherein 100% of the capital sum insured is payable. Table B 1. Coverage under Table C 2. Permanent Partial Disablement i.e. where a part of the body becomes permanently disabled due to an accident, e.g. total and irrevocable loss of use of a finger due to an accident. In such cases, a percentage of the capital sum insured as specified in the policy is paid. Table A 1. Coverage under Table B 2. Temporary Total Disablement i.e. where the insured person becomes temporarily disabled from undertaking any work as a result of an accident for e.g. fracture of legs. In such cases, a weekly payment of 1% of the capital sum insured subject to a maximum limit, is paid for the number of weeks or part thereof (maximum 100 weeks), during which the insured person is totally disabled. The insured can claim only under any one of these sections as a result of any one accident. The policy also covers expenses incurred for carriage of dead body from place of accident to the residence subject to a limit of 2% of the capital sum insured or Rs.2,500 whichever is less. Under an Individual Personal Accident policy or Family Package Policy, an education fund is payable for a maximum of 2 dependent school going children, in case of death or permanent total disablement of the insured person.

19 How to select the sum insured It is very difficult to put a value to a human life. Hence the principle of indemnity cannot be applied in this policy. However it becomes necessary to apply some yardstick for fixing the sum insured so that human lives are not overvalued for ulterior motives. Hence the capital sum insured is restricted to 72months income from gainful employment. This means that income from property, shares etc. will not be taken into account. For non working spouse, the sum insured is restricted to 50% of the sum insured of earning spouse subject to a maximum of Rs.1,00,000/- and for dependent children to 25% of the sum insured of earning parents subject to a maximum of Rs.50,000/-. In case of Gramin Personal Accident, Student Safety, Raj Rajeshwari, Bhagyashree policies the sum insured is fixed. In Individual Personal Accident policy, facility of cumulative bonus is given whereby the capital sum insured is increased by 5% every year on claim free renewals subject to a maximum of 50%. This cumulative bonus is available only under tables A,B & C. How to claim In the event of an accident giving rise to a claim the following steps should be taken:- In case of death claim :- 1. Assignee under the policy should immediately notify the policy issuing office. 2. Submit the claim form along with death certificate, post mortem report, police report and original policy. In case of injury claim :- 1. Notify the policy issuing office immediately. 2. Submit Police report if any. 3. Submit claim form along with medical certificate certifying the disablement. 4. In case medical expenses extension has been taken, then the prescription along with bills are to be submitted. Key Documents required for settlement of claim for Non- Engineering (a) Personal Accident (b) Janata Personal Accident (c) Workmen Compensation Insurance A. Claim form containing the following information. a. Date, time, cause of Accident b. Details of loss. c. Amount of loss claimed. d. Other insurance, if any. B. Certified True copy of the policy along with schedule and Endorsements/clauses.

20 C. Payment details of premium amount. D. Photographs. E. First Information Report / Letter of intimation to the Police Station duly endorsed /Police Panchnama. F. Final Investigation Report. G. Doctors Prescription H. Medical bills if cover as extension is granted. I. Discharge Card J. Leave Orders K. Pay/wages roll L. Fitness Certificate M. Discharge voucher N. Death certificate for fatal Injury O. Post Mortem Report for fatal Injury P. Legal Heir Certificate Q. W. C. Commissioner award in case of fatal Injury. R. Letter of Undertaking where applicable. N.B. Waiver of requirement of any claim documents can be made on the merit of each claim case by the claim sanctioning authority with the approval of the Head of the Department. MONEY INSURANCE: (Cash in Transit/Cash in Safe) Highlights Money Insurance policy provides cover for loss of money in transit between the insured's premises and bank or post office,or other specified places occasioned by robbery, theft or any other fortuitous cause. The policy also cover loss by burglary or housebreaking whilst money is retained at Insured's premises in safe(s) or strong room. Scope of Cover Section I: Covers money in transit under the following heads: Cash, Bank Drafts, Currency Notes, Treasury Notes, Cheques, Postal Orders and current Postage Stamps. Section II: Covers money in safe / on premises Basis of Sum Insured

21 Two amounts are specified in the policy: Limits of liability for any one loss (i.e. maximum liability of the Company) Estimated amount in transit during the year for the purpose of premium computation. Extensions This policy can be extended to include the risk of infidelity of the employees, terrorism and disbursement risk. Exclusions 1. Shortage due to error or omission 2. Losses due to the fraud/dishonesty of the employee of the insured. 3. Losses which are covered by other policies Key Documents required for settlement of claim for Cash in Transit/Cash in Safe i. Claim form containing the following information. a. Date, time, cause of loss b. Details of loss. c. Amount of loss claimed. d. Other insurance, if any. ii. Certified True copy of the policy along with schedule and Endorsements/clauses. iii. Payment details of premium amount. iv. Newspaper reports on the incident, if any. v. Photographs. vi. Departmental Enquiry Report in the event of claim under Fidelity Guarantee, Cash in Transit, Cash in Safe Bankers Indemnity. vii. First Information Report / Letter of intimation to the Police Station duly endorsed /Police Panchnama if available. viii. Final Investigation Report if available ix. Survey Report is very important where claim amount is over Rs.20,000/- as per provisions of the Insurance Act x. Discharge voucher. xi. Letter of Undertaking where applicable. N.B. Waiver of requirement of any claim documents can be made on the merit of each claim case by the claim sanctioning authority with the approval of the Head of the Department. MOTOR INSURANCE:

22 This policy covers all types of vehicles plying on public roads. Highlights This policy covers all types of vehicles plying on public roads such as:- Scooters &Motorcycles Private cars All types of commercial vehicles Motor Trade (vehicles in show rooms and garages) As per the Motor Vehicles Act, 1988 it is mandatory for every owner of a vehicle plying on public roads, to take an insurance policy, to cover the amount, which the owner becomes legally liable to pay as damages to third parties as a result of accidental death, bodily injury or damage to property. A Certificate of Insurance must be carried in the vehicle as a proof of such insurance. Two types of covers are available: 1. Liability only policy. This covers third party liability for bodily injury liability and / or death and property damage. Personal Accident cover for Owner-driver is also included. 2. Package policy. This cover loss or damage to the vehicle insured in addition to (1) above. No- claim discounts are available on renewal of policy, ranging from 20% to 50%, depending upon the type of vehicle and the number of years for which no claim has been made. Scope Liability Only policies: The policy covers the vehicle owner's legal liability to pay compensation for: 1. Death or bodily injury to a third party person. 2. Damage to third party property. Liability is covered for an unlimited amount in respect of death or injury and damage to third party property for Rs.7.5 lacs under Commercial vehicle and private and Rs. 1 lakh for Scooters / Motor Cycles. Package Policy In addition to the coverage under liability only, this policy covers loss or damage to the insured vehicle and its accessories due to: 1. Fire, explosion, self-ignition or lightning. 2. Burglary, housebreaking or theft. 3. Riot and Strike. 4. Malicious Act.

23 5. Terrorist Act. 6. Earthquake (Fire and Shock) Damage. 7. Flood, Typhoon, Hurricane, Storm, Tempest, Inundation, Cyclone and Hailstorm. 8. Accidental external means. 9. Whilst in transit by road, inland waterway, lift, elevator or air. 10. By landslide/rockslide The policy also pays for towing charges from the place of accident to the workshop upto a maximum limit of Rs.300/- for Scooters/Motorcycles and Rs.1500/- for cars and commercial vehicles. It is also permissible to opt for higher towing charges subject to payment of extra premium. A restricted cover is also available covering the risk of Fire and/or Theft only, in addition to the compulsory cover granted under "Liability Only Policy". However the same is not available in case of vehicle ratable under Class D, Tariff for Miscellaneous and special types of vehicles. The important exclusions under the policies are: Wear and tear, breakdowns Consequential loss Loss when driving with invalid driving license or under the influence of alcohol. Loss due to war, civil war, etc. Claims arising out of contractual liability. Use of vehicle otherwise than in accordance with `limitations as to use ' (e.g. private car being used as a taxi) Rating factors Rating depends upon the following factors: 1. IDV. 2. Cubic capacity 3. Geographical zone 4. Age of the vehicle 5. GVW of in case of commercial vehicles 6. Add on Covers Add on covers The policy can be extended to cover the following risks on payment of additional premium: 1. Loss or damage to accessories fitted in the vehicle such as stereos, fans, airconditioners etc. 2. Personal accident cover under private car policies for: o passengers o paid driver 3. Legal liability to employees.

24 4. Legal liability to non-fare paying passengers in commercial vehicles. Who can take the policy Any vehicle owner whose vehicle is registered in his/her name with the Regional Transport Authority in India. How to select the sum insured The sum insured of a vehicle in a Motor Policy is referred to as the I.D.V., which stands for Insured's declared Value. In case of theft of vehicle or if the vehicle is totally damaged and beyond repairs in an accident, the claim amount payable will be determined on the basis of the IDV. The IDV of the vehicle is to be fixed on the basis of manufacturer's listed selling price of the brand and model of the vehicle proposed for insurance at the commencement of insurance / renewal and adjusted for depreciation as per schedule. IDV of vehicle which is beyond 5 years of age and of obsolete models of the vehicles (i.e. models which the manufacturers have discontinued to manufacture) is to be determined on the basis of an understanding between insurer and insured. How to claim In the event of an incident giving rise to a claim under the policy, the following steps should be taken: In case of accidental damage to the vehicle: 1. Immediate intimation to the nearest office, which will issue a Claim Form. 2. Claim Form duly filled in to be submitted along with copy of Registration Certificate and driving license of the driver of the vehicle at the time of accident as also estimate of repairs. 3. Vehicle will be surveyed by a Surveyor, appointed by the insurance company, who shall submit his report to the company. In case of a major damage to the vehicle, a spot survey, at the site of accident, would also be arranged by the company. 4. Final bills/cash memos are to be submitted duly signed by the insured. 5. Salvage of the damaged parts may be required to be deposited with the insurance company after approval of the claim. In case of theft of the vehicle: 1. Lodge an F.I.R. with the police immediately. 2. Inform the policy issuing office with a copy of FIR. 3. Submit the Final Police Report as soon as it is received. 4. Extend full cooperation to the surveyor and/or investigator appointed by the company. 5. After approval of the claim by the company, get the Registration Certificate transferred in the name of the company, hand over the keys of the vehicle, and

25 submit a letter of Subrogation and Indemnity on stamp paper duly notarized. In case of liability claim: 1. Inform insurance company immediately of any incident likely to give rise to liability claim. 2. On receipt of summons from Court, the same should be sent to the company immediately. 3. Claim Form duly filled in along-with copies of Registration Certificate, Diving License, FIR are to be submitted. Key Documents required for settlement of claim for Motor Insurance Policy (Own Damage) A. Claim form containing the following information. a. Date, time, cause of Accident b. Details of loss. c. Amount of loss claimed. d. Other insurance, if any. B. Certified True copy of the policy along with schedule and Endorsements/clauses. C. Payment details of premium amount paid. D. Newspaper reports on the incident, if any. E. Photographs. F. First Information Report / Letter of intimation to the Police Station duly endorsed /Police Panchnama. G. Final Investigation Report. H. Estimate of repair from repairer. I. Bills of repair/replacement with proof of payment. J. Final Survey Report, Bill Check Report, Re-inspection Report Survey Report is very important where claim amount is over Rs.20,000/- as per provisions of the Insurance Act K. Satisfaction Report stating that the vehicle is repaired satisfactorily and is in road worthy condition. L. Letter of Undertaking where applicable. N.B. Waiver of requirement of any claim documents can be made on the merit of each claim case by the claim sanctioning authority with the approval of the Head of the Department Key Documents required for settlement of claim for Motor Insurance Policy (Liability Only)

26 A. Claim form containing the following information. a. Date, time, cause of Accident b. Details of loss. c.amount of loss claimed. d.other insurance, if any. B. Certified True copy of the policy along with schedule and Endorsements/clauses. C. Payment details of premium amount paid D. Newspaper reports on the incident, if any. E. First Information Report / Letter of intimation to the Police Station duly endorsed /Police Panchnama. F. Death Certificate G. Post mortem Report. H. Doctors Prescription I. Medical bills J. Discharge Card K. Disability certificate from Doctor. L. Certified copy of Award of Motor Accident Claims Tribunal. M. Opinion of District Government Pleader N. Letter of Undertaking where applicable. N.B. Waiver of requirement of any claim documents can be made on the merit of each claim case by the claim sanctioning authority with the approval of the Head of the Department. The Government Insurance Fund is self insurance scheme and therefore there is no separate advocate panel to defend Motor accident claims filed by third parties in Motor Accident Claim Tribunals. In consultation with Law & Judiciary Department, the services of the Government District Pleaders are being utilized. In some complicated and urgent situations with the approval of the Director of Insurance as a the Head of the Department, we appoint special advocate in the concerned field and protects the Government interest.