Claim Procedure by IFFCO-Tokio General Insurance

All insurance contracts are based on the information provided by the insured in the proposal form. The proposal form forms the basis of insurance contracts.

Some important points, which would help you in the claims procedure.

• The loss or damage should be reported to the insurer immediately.
• On receipt of claim intimation, the insurer will forward a claim form.
• Submit the completed claim form along with an estimate of the loss to the insurer. It is preferable to submit an itemized estimate with separate values.
• The insurer will arrange for an inspection of the damaged items to assess the loss. In case of major losses, a specialist-licensed surveyor is deputed.
• The insured has to provide the required documents to substantiate the extent of loss.
• In case the cause of loss is not established, it is for the insured to prove that the loss or damage has occurred due to an insured peril.
• On agreement of claim amount between the insured and the insurer, the claim is settled.
• Excess as stated as per the Policy terms and condition will be deducted from the claim payable.

In view of varied nature of policies, certain points distinct to individual policies, in addition to the above, are listed below: (Please note that the documents mentioned are indicative and based on the circumstances of the claim, the insurer may request for additional documents)

Motor vehicle (Private & two-wheelers) claims

Claims under Motor policies.

• Notice of an accident (not necessarily a claim) involving third parties should be reported to the insurers.
• The insured may be interested to pay compensation without going into whether he is liable to pay or not. It is therefore an express condition of the policy that no claim should be admitted or a compromise arrived at, without the approval of the insurers.
• In case of major claims, the insurers may be willing to defend the criminal cases against the driver also on the basis of which compensation claims may be decided in the civil courts.
• Every accident involving third parties is required to be reported to the police. M.V.Act provides that a third party victim can proceed against the insurers directly. If the alleged accident is not reported to the insurers, the insurers can consider this as a violation of policy conditions. In such circumstances, even if insurers are required to pay compensation by a court of law, they have an option of recovering such claim amounts from the insured for violation of specific policy conditions.

Steps to be taken in case of an accident:

• Notice of accident should be filed with IFFCO-Tokio General Insurance’s toll-free number 1800 103 5499
• If damage is a major one, the accident may be reported before the vehicle is removed from the spot so that the insurers can arrange for spot inspection of damage.
• The vehicle may then be moved to a workshop, preferably to authorized workshop, for estimation of repair charges.
• On receipt of the completed claim form and estimate of repairs, the insurers will arrange a detailed inspection of damage and the cost of repairs will be ascertained.
• The insurers will ensure that a person duly licensed drove the vehicle at the time of the accident and that the vehicle is the one insured in their books. To that end, they will verify the Registration Certificate and the Driving license of the driver who drove at the time of the accident.
• Upon completion of the above procedure, the repairers will be authorized to carry out repairs. The insurer may undertake to settle the repair bills directly with the garage or reimburse the insured.

What to do in case of an Own Damage Claim?

• In the event of an accident-Please arrange for medical attention if anyone suffers injuries. Takedown particulars of other vehicles/people involved, if any. Please do not accept any negligence for the accident nor commit to anybody regarding compensation, if any.
• In the event of injury, death, third party property damage, burglary, theft, housebreaking and damage due to malicious act, riot, strike and terrorist activity, immediate information to the police station concerned is essential.
• If the accident is severe in nature, and the vehicle cannot be moved, ensure proper protection of the vehicle at the spot. Please do not attempt either to start the engine or drive the vehicle after the accident and before the required repairs.
• Arrange to shift the vehicle to the nearest garage of your choice and ask them to prepare a detailed estimate (labor charges with list of parts along with its prices)
• Please do not dismantle or alter the accident condition of the vehicle or repair until the vehicle is surveyed/assessed by a surveyor. Also to ensure that no parts or accessories are missing at any point of time.
• Inform us about any accident or loss immediately.
• Please submit the duly/completely filled-in claim form to us.
• Please contact us for guidance on the cashless facility to avail direct payment facility by us to such a repairer.
• Documentation to be submitted for verification & return (along with a set of photocopies)
• Original vehicle registration book (including the fitness certification, if it is a separate document)
• Original driving license.
• Documentation for submission
• Copy of the police complaint (FIR)
• Estimate of repairs.
• We may seek additional document(s) or ask for clarification(s) for processing your claim and that depends upon the claim. Please arrange to submit the same.
• All damages/losses will be surveyed and assessed by a surveyor/assessor and admissibility of the claim and mode of settlement is decided only after the process.

Please note: Ensure that you give us the correct & complete contact details (address /telephone no's / mail IDs in the claim form. If you receive any notice or summon with regard to the accident (other than criminal proceedings, if any), contact us with the petition copy. 

What to do in case of a theft claim?

• If your car has been stolen, the first thing to do will be to file a police report.
• Notify your insurance company as soon as you file the police report, this will help in case the thief has caused some damage to others with your car. Also please note, your insurance company will not process your claim if you have not filed a report with the police.
• When you notify your insurance company, provide them all the details of the loan/lease of your car along with the FIR.
• Provide them with a description of your car, mileage, service record if any. Also, submit the list of personal items stolen along with the car.
• It is also important to inform your RTO of the theft.
• Inform your financier immediately of the theft and ask them to discuss the case directly with your insurer this might expedite the claim process.
• In case the police recover the vehicle, inform your insurer about the same.
• If the vehicle is recovered, the Insurance company is liable to pay compensation on damages caused to the vehicle as per the terms and conditions of your policy and for stolen items if any, which are covered under your policy.
• If the vehicle is not recovered, the police have to provide a Non-Traceable Certificate (NTC) and the court will have to give a final report under sec 173 Crpc.
• If you have taken a car loan to purchase your car, the insurer will settle the amount directly to the financier. The settlement amount is on the Insured Declared Value (IDV). This might however differ based on usage and market value.

1. Intimate a Claim

   In case of an emergency or loss, please contact our Third-Party Administrator (TPA) immediately for 24/7 assistance. The contact details of the TPAs are provided below for your reference.

   Europ Assistance India Pvt. Ltd.

   • State Hub Building No. 2, 7th Floor, Near ITC Maratha Hotel, Sahar, Andheri (East), Mumbai – 400059
   • Phone: +91 22 67872021
   • US Toll Free: 833 428 8421
   • Email: iffcotokiotravel@europ-assistance.com
   • Website: www.europ-assistance.in

   Paramount Healthcare Management Pvt. Ltd.

   • Travel Health Dept., 401 – 402, Sumer Plaza, Marol Maroshi Road, Marol, Andheri (East), Mumbai – 400059
   • Phone: 022 40004219 / 40004207
   • Fax: 022 40004280
   • US Toll Free: +1 866 978 5205
   • Email: travelhealth@paramount.healthcare
   • Website: https://www.paramount.healthcare/ProviderNetwork.aspx

   Please refer to the policy copy attached with your insurance documents to confirm the name of the TPA assigned to your policy.

2. Documents Submission

   Complete the Claim form with accurate information and submit the signed copy along with all required documents within 30 days of treatment completion or returning home.

3. Claim Assessment

   Our claims team will review the submitted documents and finalize the assessment in accordance with the policy terms and conditions

4. Settlement

   The settlement process will vary depending on the type of claim:

   Cashless (Applicable only for medical cover):

   ✓ Our service provider will guide and assist you throughout the entire process.

   ✓ We will provide a guarantee of payment to the hospital.

   ✓ The hospital will receive payment directly from us.

   Reimbursement:

   ✓ The approved claim amount will be credited to your registered bank account.

   ✓ You will receive regular updates via email.

5. Documents Required

   An illustrative list of general documents required for processing claims are as under;

   • Completely filled and Signed Claim Form
   • Policy copy
   • Passport, visa, and travel tickets (Original for verification and return)
   • Original Receipts for all expenses incurred
   • Original Medical records, prescriptions, and hospital bills (for medical claims)
   • Original Airline report / Property Irregularity Report (for baggage loss or delay)
   • Original Police report (for theft or accident cases)
   • CKYC documents
   • Cancelled cheque / NEFT form / Bank passbook, in case of reimbursement claim

   Please Note:The list of required documents may vary depending on the nature of the claim.

Claim Process – Non-Motor Claims

We aim to make the claims process simple, transparent, and hassle-free. Here’s how it works:

1. Claim Intimation

   Notify us immediately after the incident through any of the following:

   • Website: www.iffcotokio.co.in
   • Toll-Free: 1800-103-5499
   • Email: support@iffcotokio.co.in
   • Through: Agent / Broker
   • Visit: Any IFFCO-TOKIO Office
2. Surveyor Appointment

   A surveyor will be appointed within 24 hours of intimation to inspect and assess the loss, based on the nature of the claim, if required.

3. Documents Submission

   Provide the completed Claim form along with relevant documents.

4. Survey & Loss Assessment

   The surveyor will visit the loss site and start the survey immediately, unless there is a contingency that delays immediate survey.

5. Investigator Appointment

   An Investigator may be appointed in some cases, if required.

6. Repairs / Reinstatement

   Complete the repairs or reinstatement of the damaged property and submit invoices/payment proofs to the surveyor.

7. Final Assessment & Approval

   The surveyor finalises the assessment & submits survey report, which is required for claim approval along with Investigator report (if deputed)

8. Claim Payment

   The approved claim amount will be disbursed to you / financier, as applicable.

Duties of the Insured

To ensure smooth claim processing, please:

• Immediately inform us about loss upon its occurrence.
• Report to the police and/or fire brigade (as applicable).
• Take all reasonable steps to minimise further loss.
• Cooperate with the surveyor and/or Investigator and provide all necessary documents/information.
• For policies on a “Reinstatement Basis”, settlement will be made only after completion of repairs / replacement and submission of bills.

Illustrative List of Documents

An illustrative list of general documents required for processing claims are as under.

• Duly filled completed Claim form
• FIR and/or Fire Brigade report (if applicable)
• Meteorological report / Newspaper clipping (for Act of God perils).
• Root Cause Analysis / Forensic Report (if applicable).
• Loss estimate.
• Repair/Replacement invoices or bills.
• Stock registers (in case of stock loss).
• Photographs of damaged property, wherever applicable.
• No Objection Certificate from financier (if applicable).
• CKYC documents.
• Cancelled cheque / NEFT form / Bank passbook.

Please note that this list is not exhaustive. Surveyor / IFFCO-TOKIO may call for additional document / information as and when required.