Motor fraud prevention steps

MOTOR FRUDULENT CLAIMS
& STEPS TO PREVENT THEM

What is FRAUD
What are the types of FRAUDSTERS
How to probe into a FRAUD
Case Studies
TECHNO-INVESTIGATION
Presented at
SEMINAR ON MOTOR INSURANCE
Organized By
Aurangabad Unit of Maharashtra Chapter – IIISLA
On
23 – 24 January 2016
at
A.S. Club, Aurangabad
Compiled and presented by

Gautam Panchal
B.E. (Mech.) FIIISLA
SURVEYOR & LOSS ASSESSOR
7/1, Devbhoomi Apartments, Nr. Vijay Cross Roads, Navrangpura, Ahmedabad 380 009 – Mobile : +91 98240 37096 - Email : gpanchal13@gmail.com
Motor Fraudulent Claims and Steps to Prevent Them
Presentation at
Seminar on Motor Insurance organized by Aurangabad Unit of Maharashtra Chapter – IIISLA on 23-24 January 2016
P a g e |1
WHAT IS FRAUD?
Fraud can come in many shapes and sizes and whilst a fuller definition will be considered in
reviewing legal definitions it is fair to say that fraud is usefully described as:
“Theft by deception – the dishonest obtaining of property by deception.”
If we accept that fraud can appear in many different shapes and sizes - what might these be?
Examples of insurance fraud can include:
● The loss that did not happen – most common in the all business.
● The contrived loss – particularly injury claims.
● The deliberate loss – commonly seen as arson but other methods exist.
● Genuine loss but overstated – probably the most common across all claims
books.
● Genuine loss excluded but made to fit the policy – often seen in personal lines
where security requirements exist.
● A loss where the goods claimed for were not owned by the insured.
It can be said that -

Incidence of fraud = the inclination + the opportunity
the resistance
“It is effective resistance which successfully manages fraud, whilst maintaining

high levels of customer service.”
This is attributable to various factors, including mounting fraud losses in some product areas,
greater competitive pressures to drive costs down, increased regulatory attention on fraud
issues and of course the recent global recession. Consequently, fraud is now being considered
at a strategic level.
Compiled and Presented by

Gautam Panchal
Presentation at
P a g e |2
TYPES OF FRAUDSTERS
1. Opportunistic fraudsters:
These are perhaps most commonly seen in insurance claims. They are fraudsters who,
as the name suggests, only perpetrate one fraud in one arena and that is in response to
a particular set of circumstances arising. Examples include:-
● The loss that did not happen – normally the most common
● Genuine loss but overstated
● Genuine loss excluded but adapted to fit the cover
● Loss where goods not owned by insured
2. Repeat fraudsters:
This might be someone who has had a particular claims experience in the past, for
example, an inflated estimate paid without enquiry who decides they will try for a little bit
more on a second occasion.
3. Organized fraudsters:
This would include the earlier example of valuation fraud and some of the accidental
damages, the members of which create and set up ‘accidents’ with a view to recovering
damages. Research around the world has tended to suggest that fraudsters are often
driven by ego, they plan to ‘beat the system’. An underlying reason for this is that
fraudsters are not untypically well-educated and have a perception of intellectual
superiority that allows them to believe they can ‘play the game and win’. Other key
drivers include:
● Need – lack of money, possibly the result of unemployment

● Greed – I would like more money or property to improve my lifestyle
● Desire to get value from insurance – recover money paid in premiums
● Peer pressure – the accepted norm – friends and colleagues are seen to have
made successful fraudulent claims

Gautam Panchal
Presentation at
P a g e |3
● Credit crunch/periods of inflation

● It is perceived to be easy money
In terms of gathering evidence and probing of fraud, it all starts with the event whether that be
fire, theft or other accident. The direct cause of the event and the consequent financial damage
need to be carefully considered. It is probably true to say that in establishing a case for fraud
three key factors should be demonstrated. These are:
● The method
● The means
● The motive
Use of broad language
Q: Did you secure your car by locking it before you leave it?
A: I always lock my car.
This suggests the individual is not entirely comfortable answering this question directly.
Use of negative language
“I have done nothing wrong”, “I am not a criminal”.

This tells us something and it is probably an answer to a question yet to be posed.
However, the individual is not saying they are honest. We can look for the use of
generalization statements “as a general rule …”, “in most cases …”, “I usually …”
These phrases allow the fraudster to distance themselves from whatever it is that they
are saying and they are not showing 100% commitment to what is about to be said.
Use of qualifying language
This works in a similar way by blaming poor memory for not telling you the complete
truth. Examples of this can include “to the best of my knowledge …”, “at this point in time
…”, “as far as I can recall …”.

Gautam Panchal
Presentation at
P a g e |4
Omission
This can be offered using phrases such as “I think …”, or “I believe …”.
To hide other circumstances
The fraudster might wish to unnecessarily bolster his language/statement with phrases
such as “to be honest …”, “to tell you the truth …”, “I swear to God …”. In these cases
one shouldn’t necessarily believe what the fraudster is about to say.
Edit information in and out
Phrases such as “later on ...”, “before I knew it …”, “the next thing I remembered …” show that
something has been left out of the account or that this happened very quickly. Language may
be further extended by considering the use of associative language. Here somebody might
describe possession of their own in more generic terms. An example might be: “I left my Car by
the Shopping Mall but when I returned I found the car was gone.” In this case the interviewee
seeks to distance himself in emotional terms from the loss of the car.
Gathering the evidence

Probing into the Fraud
What? - The event (Fire, theft, accident) - How/Why?
What? - Direct cause (Act or condition) - How/Why?
What? - Method - How/Why?
What? - Means - How/Why?
What? - Motive - How/Why?

Gautam Panchal
Presentation at
P a g e |5
Fraud is proved when it is shown that a false representation has been made:
● knowingly, or
● without belief in its truth, or
● recklessly, without caring whether it be true or false.”
Case Studies
1. Precautions during Underwriting and aggravated loss amount

(Ref: 16337)
(i) The insured's vehicle was insured for the Total IDV (Insured's Declared Value)
as Rs.11,25,000/=.
(ii) The insured had purchased a 2006 model truck in the year 2009 as an open
box type truck. The insured had removed the goods body and had fitted a
secondhand cargo box and secondhand refrigeration plant and converted the
truck into a refrigerated van
(iii) The condition of the cargo box was so worn out that the steel structure used
was so badly rusted and corroded that it could be bent / broken with fingers.
Refrigeration plant was very old – may be more than 20 years old and there
was no identification plate / mark on it. The refrigeration plant was actually an
obsolete model.
(iv) Insured had submitted an estimated amounting to Rs. 13,16,950/= and his
demand was for the total loss of the vehicle for the full I.D.V. amount or Rs.
9,00,000/= towards Net of Salvage settlement.
(v) Finally the loss was settled for Rs. 2,96,498/= and the insured very willingly
accepted the amount.
(vi) Two comparative photographs are reproduced below – one of spot and one
during final inspection.

Gautam Panchal
Presentation at
P a g e |6
Photograph taken at the spot shows

that the front show is intact, LH side of
driver cabin is intact and the complete
load body is visible in the photo
Photograph after the vehicle reached

the workshop – badly damaged front
show, totally crushed driver cabin,
badly destructed load body and
refrigeration plant
2. Modifications
Precautions to be taken during underwriting
(Ref:16407-16434)
(i) The insured’s vehicle was registered and insured as tipper. As per the R.C.
Book, it was a 2515LPT truck chassis – Model 2004.
(ii) The vehicle was found broken into two pieces as both the chassis long
members were broken from the end points of the sub frame in between the
driver cabin and the tipper body.
(iii) It was stated in the claim form that after unloading some goods in Adani
Port, Mundra, when the insured’s said vehicle was going from one place to
another, suddenly due to breakage of steering line, the vehicle went out of
control, the driver jumped out of the vehicle, the vehicle fell into the sea and
broke into two pieces.
(iv) The accident had taken place on 13/03/2011 whereas the spot survey was
allotted on 18/03/2011 and conducted on 19/03/2011 at the garage.

Gautam Panchal
Presentation at
P a g e |7
(v) Since the vehicle had remained under sea water for 6 days, all the parts
were badly damaged including the breakage of chassis frame in two parts
and was beyond repair mode settlement.
(vi) The driver was not made available to me for his statement / narration of the
accident.
(vii) I could not believe the statement of the agent of the insured that the vehicle
could not be traced out for 5 days. Now a days, the tracing agencies are so
well equipped that it could have been traced out on the same day or at the
most within 24 hours. The agent / consultant informed me that the power
steering line had broken and so the vehicle could not be controlled. My
opinion is that if the power steering line gets burst and even if the entire oil
gets drained out instantaneously, the vehicle will work as if there is no
power steering and the steering system will work as normal / mechanical
steering system.
(viii) The speed of vehicle cannot be very high on a jetty since the speed limit
specified in the jetty area is 20 kms per hour only. With such a low speed
motion, the driver could have easily stopped his vehicle by applying brakes
instead of jumping out of the vehicle.
(ix) The spot surveyor has mentioned that the insured’s said vehicle rolled over
the jetty wall. For a vehicle to roll over the jetty wall, it has to have a high
speed and enough momentum for it to roll over the wall.
(x) Normally, there are no walls on the sides of a jetty because the jetties are
made for loading and unloading of goods / containers from the ships and
usually it is a straight road. This is in contradiction to the statement of the
spot surveyor as mentioned in his report.
(xi) The LPT 2515 chassis are designed for construction of rigid trucks like
goods body, tankers, fly ash carriers, bulk cement carriers etc where the

Gautam Panchal
Presentation at
P a g e |8
chassis designed for tipper body are LPK series. This difference is
because of the extra strength required by the chassis frame of a tipper to
withstand the skew forces acting upon it during unloading i.e. lifting of the
tipper body with its full load
(xii) For conversion from rigid truck chassis to tipper chassis, extra steel straps
ware welded on the bottom side of chassis long members thereby affecting
the flexibility of the chassis frame during motion on uneven surfaces
(xiii) For fitting a tipper body, a sub frame is fitted on top of the main chassis
frame as well as to mount the hydraulic ram to lift the body, some extra
fitments are done by drilling holes in the main chassis frame thereby
affecting the originally designed and manufactured strength of the chassis
frame
(xiv) As per Section 52 of Motor Vehicle Act, no conversions are allowed in the
main chassis frame than those prescribed as per the manufacturers
standards and designs
(xv) Even Tata Motors does not recommend such conversions and their
warranty becomes null and void in such types of cases which is a well-
known fact since it is mentioned in their service book.
(xvi) In another case, an insured’s Swaraj Mazda truck was registered and
insured as Open Box Type whereas in fact, the vehicle was a closed body
refrigerated van. It was found that an open box truck was converted into
refrigerated cargo box. The I.D.V. (Insured’s Declared Value) was so less
that even after a major accident, the salvage value of the vehicle was as
good as the I.D.V. Since underinsurance is not applicable in Motor
Insurance, the insured was enjoying the benefit of all minor accidents even
though he was paying a very less premium amount.

Gautam Panchal
Presentation at
P a g e |9
3. Manufacturing defect
Trying to fit into cover and get compensation from insurance
(Ref:16361)
(i) The insured’s construction equipment was a Volvo Excavator. It was damaged
due to FIRE and the insured had submitted an estimate of the manufacturer for
Rs. 70,74,330/=
(ii) The operator was not holding any type of Motor Driving License nor was he
able to read or write.
(iii) Right from the time of commissioning the machine, it was attended to by the
manufacturer’s technicians for defects like noise, horn not working and
overheating etc.
(iv) The insured’s said excavator was commissioned on 13/10/2009 whereas the
insurance was taken from 25/01/2010 i.e. after malfunctioning of the electrical
system and other parts as mentioned above.
(v) On 12/05/2010, i.e. on the date of accident, leakage from engine and hydraulic
side were observed by the service engineer at 4:00 pm. On the same date i.e.
on 12/05/2010, at 4:30 pm, the insured’s said excavator caught fire which was
generated from the engine compartment.
(vi) Usually, fire takes place when any type of spark or heat comes in contact with
any type of combustible material. In this case, the electrical malfunction,
overheating of the engine and leakage of oil from engine side and the hydraulic
side were already observed by the service engineer of manufacturer.
(vii) It was established from the above facts and evidences that the insured’s said
excavator, which was covered under manufacturer’s warranty of one year from
the date of sale/commissioning, was already having malfunctions which could
lead to the generation of fire.

Gautam Panchal
Presentation at
P a g e | 10
(viii) The above also indicates that the insured’s said excavator was not in perfect
working condition at the time of incidence of Fire. In other words, it can be said
that the malfunctions of the electrical system, overheating of the engine,
leakage of oil and the generation of fire due to electrical short circuit was a built
in inherent defect of the insured’s said excavator and was a liability of the
manufacturer as per their terms and conditions of the warranty.
4. Insurable interest
(Ref:16454)
(i) A very high end luxury car was registered in the name of an individual.
(ii) The insurance for the same car was taken in the name of a Public Limited
company headed by the same individual.
(iii) The motive behind this was to save the vehicle tax by 50% as it was
registered in an individual’s name and the expenses of the insurance could be
claimed by paying the premium from the company account.
(iv) Technically analyzing the situation, the insured does not have any insurable
interest in the property owned by an individual.
5. Unawareness / Ignorance / Carelessness

(Ref:16412)
(i) Many well established businessmen who are doing their business for decades
usually come out with two types of excuses in order to fit into the policy
conditions to get the benefit out of the insurance.
(ii) For an example, the class of vehicle of the driver at the time of accident
should be the same as the classification of the vehicle driven. Many a times,
due to shortage of available operators/drivers, they employ any driver holding
a license to drive a Heavy Motor Vehicle.

Gautam Panchal
Presentation at
P a g e | 11
(iii) In such cases, they do not even bother to get the driver trained by the
manufacturer for that particular machine due to very fast changeover of the
drivers from one employer to another and also due to corporate politics.
(iv) Again for an example, any person holding a license and authorized to drive a
Heavy Goods Vehicle (H.G.V.) can definitely drive a Goods Truck of that class
but is not authorized to drive a Heavy Goods Tanker carrying hazardous
chemicals without a proper endorsement in the license and without
undergoing the required training.
(v) Firstly the insured will give a reason that this license is valid only and if the
surveyor is not convinced then they will say that they were not aware of this
type of endorsement or Training.
__________________________________
Techno-Investigation – Steps to prevent Fraud

(An Example to understand and analyze a malicious intention for fraud)
i. Incorrect declaration (Non-disclosure of material facts) of the property at

the time of underwriting the policy.
The Machinery i.e. the drilling rig was declared as an Offshore Drilling Ring
under a Comprehensive Package Policy (Offshore) for Oil and Gas Well Drilling
Tools Floater Form (All Risk)
First of all, I would like to inform you that the insured property was not at
all an Offshore Drilling Rig nor it was an Onshore Drilling Rig. For your
reference, I am giving below a photographs of Offshore and Onshore
Drilling Rigs :-

Gautam Panchal
Presentation at
P a g e | 12
Offshore Drilling Rig
Onshore Drilling Rig

Gautam Panchal
Presentation at
P a g e | 13
The insured’s Rig is an Ingersoll Rand Drilling Rig and looks like –
The insured’s said Drilling Rig is neither an Offshore Drilling nor an Onshore
Drilling Rig but it is a Truck Mounted Mobile Drilling Rig. It is registered as a
Motor Vehicle by the Durgapur (West Bengal) R.T.O.
In Insurance contracts Utmost Good Faith means that “each party to the
proposed contract is legally obliged to disclose to the other all information which
can influence the others decision to enter the contract. Failure to reveal
information even if not asked for, gives the aggrieved party the right to regard
the contract as void. Non-Disclosure, which may be innocent or fraudulent. If
fraudulent then it is called concealment.
Therefore, assuming that it does not require a proof or a strict proof of fraud, but
mere concealment of relevant and material facts is attracting provisions of sec.
17 of the Indian Contract Act. Any policy of Insurance is a Contract between the
insurer and the insured. The Insurance Contract is guided by the principles as
laid down in the Indian Contract Act.

Gautam Panchal
Presentation at
P a g e | 14
Accordingly for any Contract to be valid, there are certain prerequisites, of which
Consensus Ad idem and Utmost Good faith are two important conditions. Any
contract entered into, between parties, without the compliance of the above two
prerequisites, are void ab initio. In the present case, the proposer had concealed
certain vital information with regard to the property to be insured, which had led
to the issuance of a wrong policy by the insurer.
This concealment and non-disclosure of material fact amounts

to absence of both Utmost Good faith as well Consensus
between the parties, and hence makes the Contract void from
the date of its inception.
ii. The Insured does not have any insurable interest in the said Drilling Rig
The registered owner of the insured’s said Drilling Rig is –

Oman Drilling and Soil Tech Co.
Whereas the insurance is in the name of –

M/s. Deep Industries Ltd.
This means that Insured does not have any insurable interest in the said Drilling
Rig
iii. Violation of Section 146 of the Motor Vehicle Act since there is no
Insurance against Third Party Risk while using the Motor Vehicle in Public
Place / road
Irrespective of the underwriting policy, the fact cannot be denied that the
insured’s said Drilling Rig is registered under Motor Vehicle Act and was being
driven on its own propulsion power on a public road. Hence as per law, the
vehicle will have to be used as mandated under the MV Act. Since it is proved
that the vehicle was used/driven on the roads, violating various rules under the

Gautam Panchal
Presentation at
P a g e | 15
MV Act , the claim do not merit for consideration, being used in violation of the
law of the land as explained hereunder :-
iv. Section 146 – Necessity of Insurance against Third Party Risk :
No person shall use, except as a passenger, or cause or allow any

other person to use, a motor vehicle in public place, unless there is
in force in relation to the use of the vehicle by that person or that
other person, as the case may be, a policy of insurance complying
with requirements of this chapter.
The insured’s said Drilling Rig is a Motor Vehicle and was being used on a Public
Road without any Third Party Insurance which is a violation of Section 146 of the
Motor Vehicle Act
v. Violation of the section 125 of the Motor Vehicle Act.
The insured’s drilling rig is mounted on a custom built carrier. This carrier does
not have a normal driver cabin like regular trucks but it is a steel cabin of 32
inches width and having 62 inches exterior height, one-man type offset to left
side of the engine. Therefore, accommodating 3 persons in a width of 32 inches
is like partly sitting on each other. Even as per the R.C. Book, the seating
capacity specified by the R.T.O. authorities is only one. It is evident from the
claim intimation given by the insured and the spot survey report that a total of
three persons were travelling by the said vehicle at the material time of accident.
Section 125 of the Motor Vehicle Act states that –
No person driving a motor vehicle shall allow any person to

stand or to sit or to place anything in such a manner or position
as to hamper the driver in his control of the vehicle.

Gautam Panchal
Presentation at
P a g e | 16
The insured, vide their claim intimation dated 07/03/2011, have stated that “the
vehicle met with an accident due to brake failure and the driver could not
control the vehicle.”
The above confirms that the driver was hampered in his control of the vehicle by
accommodating two more (total three) persons in his driving cabin though it has
been designed to accommodate only the driver (1 person only)
vi. Driving License of the driver driving the insured’s said vehicle at the time
of accident is not Valid and Effective
As per the R.T.O. authorities, the insured’s said vehicle is classified as OTH
(OTHERS) class of vehicle. Therefore, an endorsement of OTH or BRIGS
(Boring Rigs) is necessary to drive a Drilling Ring on public roads/places. Since
the driver of the insured’s said drilling rig is not having any such endorsement in
his driving license, it is obvious that the
Driving License of the driver driving the insured’s said vehicle at

the time of accident is not Valid and Effective.
vii. Violation of Section 125 of the Motor Vehicle Act (Obstruction of Driver)
The insured’s said drilling rig is mounted on a custom built carrier. This carrier
does not have a normal driver cabin like regular trucks but it is a steel cabin of
32 inches width and having 62 inches exterior height, one-man type offset to left
side of the engine. Therefore, accommodating 3 persons in a width of 32 inches
is like partly sitting on each other. Even as per the R.C. Book, the seating
capacity specified by the R.T.O. authorities is only 1. It is evident from the claim
intimation given by the insured and the spot survey report that a total of three
persons were travelling by the said vehicle at the material time of accident.
Section 125 of the Motor Vehicle Act states that –

Gautam Panchal
Presentation at
P a g e | 17
Section 125. Obstruction of Driver :

No person driving a motor vehicle shall allow any person to
stand or to sit or to place anything in such a manner or position
as to hamper the driver in his control of the vehicle.
The insured, vide their claim intimation dated 07/03/2011, have stated that “the
vehicle met with an accident due to brake failure and the driver could not
control the vehicle.”
The above confirms that the driver was hampered in his control of the vehicle by
accommodating two more (total three) persons in his driving cabin though it has
been designed to accommodate only the driver (1 person only)
This is a violation of the section 125 of the Motor Vehicle Act.
viii. The insured’s said Drilling Rig (Vehicle) was not in road worthy condition at
the time of accident as per Rule 94 of Section 4 of the Central Motor Vehicle
Rules.
As per the photographs submitted by the final surveyor on 21/03/2014, through

an email, it is observed that the tyres on the rear wheels are not in good and
sound condition since the fabric and its casing is exposed by wear and tear of the
tread and also have cuts and abrasions on its side walls.

Gautam Panchal
Presentation at
P a g e | 18
Under Rule No. 94, Section 4 of the Central Motor Vehicle Rules, 1989, under
the heading of Construction, Equipment and Maintenance of Motor Vehicles,
under the sub-heading, Condition of Tyres, is stated that –
For the purpose of sub-rule (2), a tyre shall not be deemed to be of good
and sound condition if -
(i) any of the fabric of its casing is exposed by wear of the

tread or by any unvulcanised cut or abrasion in any of its
parts; or
(ii) it shows signs of incipient failure by local deformation or

swelling; or
(iii) it has been patched or repaired by an outside gaiter or

patch other than a vulcanized repair
(iv) the Non-Skid Depth (NSD) shall not be less than 0.8 mm in
the case of two wheeler and three-wheeler and 1.6 mm in
the case of motor vehicles

Gautam Panchal
Presentation at
P a g e | 19
Therefore, from the photographs submitted by the Final attending surveyor and
reproduced below, it can be said the insured’s said vehicle was not in road
worthy condition as specified by the Central Motor Rules.
ix. The insured has produced non-genuine documents (Bills) in order to make
Profit Out of Insurance
The insured has submitted bills of M/s. Akash Enterprise towards repairing
radiator, exhaust, carrier engine, overhauling of Rig engine, Transmission, Turbo
charger, Ingersoll Rand compressor, booster brakes, drill drive, top drive,
repairing of hydraulic cylinder mast, overhauling of Detroit engine, etc. as follows
:-
(a) Bill No. R-ST-10 dt 11/05/2011 for - Rs. 36999/=

(b) Bill No. R-ST-12 dt 16/08/2011 for - Rs. 76107/=
(c) Bill No. R-ST-19 dt 01/12/2011 for - Rs. 1364963/=
(d) Bill No. R-ST-23 dt 01/12/2011 for - Rs. 1364963/=
(e) Bill No. R-ST-30 dt 01/12/2011 for - Rs. 606650/=
(f) Bill No. R-ST-1 dt 27/02/2012 for - Rs. 352590/=
(g) Bill No. R-ST-13 dt 08/10/2011 for - Rs. 1213300/=
---------------------
TOTAL - Rs. 5015572/=
(i) The bill No. R-ST-19 dated 01/12/2011 towards overhauling of Rig
Engine, Transmission and renewal of Turbo Charger
as well as
(ii) The bill No. R-ST-23 dated 01/12/2011 towards Repairs to

Ingersoll Rand Compressor – both the bill are raised for the same
amount as Rs. 1364963/=

Gautam Panchal
Presentation at
P a g e | 20
It is impossible that the bill amounting to the same odd figure can be
raised for two totally different types of jobs for different makes and
different equipments
The web site address printed on the bills of M/s. Aakash Enterprise are –
(i) http://www.jigarenterprise.com
(ii) http://www.bunkhouseindia.org
On browsing through the websites, I got the following information regarding the
company profile :-
• Portable Cabins / Bunkhouse

• Prefabricated Structures
• Cubicle Toilets
• Panels
• Portable Cabins on Rent
x. Insured had tried to mislead the insurance company by showing different

parts (batteries) than those damaged in the accident and thereby
misleading the insurance company and trying to make Profit out of
Insurance.
As per the spot survey report, only one battery is damaged whereas a
total of 9 batteries are allowed by the final attending surveyor. Moreover,
it was also observed that –
• The spot surveyor has submitted photograph showing only one

damaged battery whereas the Final attending surveyor has
submitted a photograph showing two batteries and has allowed
nine batteries
• In the photograph submitted by the spot surveyor, the top cover of

the battery is red in colour whereas in the photographs submitted
by the Final attending surveyor, the battery covers are black

Gautam Panchal
Presentation at
P a g e | 21
• There are no handles on the battery cover for lifting the battery in
the photograph submitted by the spot surveyor whereas in the
photograph submitted by the Final attending surveyor, there are
handles on the edge of the longer side of the batteries for lifting
the battery
• There are 4 vent hole covers / refill caps on the battery as per the
photograph submitted by the spot surveyor whereas 6 vent hol
covers / refill caps on the photograph submitted by the final
surveyor.
• Invoice No. 5169 of Nutan Auto Sales is dated 15/04/2011

whereas the first visit of the final attending surveyor is 14/05/2011
– this means that the batteries were purchased before inspection
by the final surveyor and also much before starting repairs to the
rig.
• For comparison and reference, both the photographs are

produced below :-
Spot Survey Photo Final Survey Photo

Gautam Panchal
Presentation at
P a g e | 22
In the last, I am thankful to –
All committee members of the Aurangabad Unit for their whole-heartedly

invitation as faculty in this seminar and for their warm welcome to me.
I am also thankful to all participants of this seminar for their attentiveness,

careful listening and making this seminar a great success !
Gautam Panchal

Gautam Panchal

Motor fraud prevention steps

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Motor fraud prevention steps

Uploaded by

Copyright:

Available Formats

MOTOR FRUDULENT CLAIMS

& STEPS TO PREVENT THEM

SEMINAR ON MOTOR INSURANCE

Compiled and presented by

“Theft by deception – the dishonest obtaining of property by deception.”

● The contrived loss – particularly injury claims.

where security requirements exist.

It can be said that -

“It is effective resistance which successfully manages fraud, whilst maintaining

Compiled and Presented by

● Need – lack of money, possibly the result of unemployment

Compiled and Presented by

● Credit crunch/periods of inflation

Use of broad language

Use of negative language

“I have done nothing wrong”, “I am not a criminal”.

Use of qualifying language

Compiled and Presented by

To hide other circumstances

Edit information in and out

Gathering the evidence

What? - The event (Fire, theft, accident) - How/Why?

What? - Direct cause (Act or condition) - How/Why?

What? - Method - How/Why?

What? - Means - How/Why?

What? - Motive - How/Why?

Compiled and Presented by

● without belief in its truth, or

● recklessly, without caring whether it be true or false.”

1. Precautions during Underwriting and aggravated loss amount

Compiled and Presented by

Photograph taken at the spot shows

Photograph after the vehicle reached

Compiled and Presented by

Compiled and Presented by

Compiled and Presented by

Compiled and Presented by

5. Unawareness / Ignorance / Carelessness

Compiled and Presented by

Techno-Investigation – Steps to prevent Fraud

i. Incorrect declaration (Non-disclosure of material facts) of the property at

Compiled and Presented by

Offshore Drilling Rig

Onshore Drilling Rig

Compiled and Presented by

Compiled and Presented by

This concealment and non-disclosure of material fact amounts

The registered owner of the insured’s said Drilling Rig is –

Whereas the insurance is in the name of –

Compiled and Presented by

iv. Section 146 – Necessity of Insurance against Third Party Risk :

No person shall use, except as a passenger, or cause or allow any

v. Violation of the section 125 of the Motor Vehicle Act.

No person driving a motor vehicle shall allow any person to

Compiled and Presented by

Driving License of the driver driving the insured’s said vehicle at

Compiled and Presented by

Section 125. Obstruction of Driver :

This is a violation of the section 125 of the Motor Vehicle Act.

As per the photographs submitted by the final surveyor on 21/03/2014, through

Compiled and Presented by

(i) any of the fabric of its casing is exposed by wear of the