H) MOTOR THIRD PARTY (MACT)/LEGAL

We have handling Motor Third Party (MACT) Cases, Consumer Litigation, other legal matter and providing claims investigation services on all areas of General Insurance.

We are dealing in MACT, Motor, Property [fire/Marine], Workman Compensation, Medical, Personal Accident, Live Stock, Liability Insurance etc.

Some investigation being carried out specifically insurance companies require

  1. MACT Investigation (Detecting frauds in Motor Third Party Claims)
  2. Comprehensive Investigation of MACT claims
  3. Age / Income proof of Deceased / Claimant
  4. Police report verification
  5. Document verification
  6. Criminal record from court
  7. Claimant, Insured and Driver statement and verification
  8. Motor theft Investigation
  9. W.C., P.A., Cattle death/injury investigation
  10. RTO Papers verification from RTO like D.L., R.C. Book, Fitness, Permit etc.
  11. Handling High value cases with expertise remarks to reduce liability.
  12. Sting operation for capturing and exposing fraudulent cases.
  13. Liaising with Regional Transport Authorities for verification of RTO records.
  14. Liaising with district court officers and collection of criminal documents.
  15. Liaising with Income Tax officers for verification of ITR's.
  16. Liaising with Police Authorities for filing police complaints against culprits & internal fraud.
  17. Any other relevant verification or investigation required by court of law or insurance company
  18. Investigations for Cases in the states of Bihar, Jharkhand and Chhattisgarh engaged in fraud control & loss management Identification, Analyzing & Eradication of external Fraud Cases, Setting targets & driving the Team for the achievement of the same by monitoring incidence ratio & related parameters.

TP Claims-Legal

  1. Reporting to Manager Legal and Handling Audit and closed File Review and compliances of PAN India:
    Responsible for Initiation and development of the Audit process of Close files and formulation of checklist as per ISO Norms and IRDA Guidelines.
  2. Responsible for Development of software module Audit of Closed files both Settled and Court awards to ensure compliances as per ISO norms and IRDA Guidelines.
  3. Analysis of both system and process lapses
  4. Preventive and corrective measures of both system and process lapses for continual improvement as per ISO Norms.
  5. Training - Developing Agencies with requisite downloads and over all case specific strategies to minimize Institution’s losses mainly involving Out of Court Third Party Claims Settlements, fake witness tracing & fraud detection, Exonerations in fake Claims through Courts of Law.
  6. Initiated Cost analysis of individual investigation agencies towards achievement of better quality investigation reports through devising ways & means for varied fraud detection processes with superior quality feedbacks thereby creating detective mind & skill sets with legal perspective also negotiations by amicable solution and best alternate dispute resolution.
  7. Monitoring & devising new processes to improve the Investigation Quality & Efficiency towards reduction in Claim Settlement Amounts and Fraud Claim Identification for finally getting the Company exonerated from the liability while maintaining the Cost of Investigation.
  8. Legal – Co-coordinating with panel lawyers on cases follow-up upon the MACT Claims under Fraud Scanner & further exoneration from the courts.
    Understanding systems and processes applicable in the company and also Industry practices.
  9. Escalated inflow of fraud Third Party cases via running special projects and filing FIR on the fraudsters Escalation of Fraud identification ratio
  10. Advocating and Collateral checks to identify early frauds and mitigate fraud risk by taking appropriate actionable. Conducting sting operations & Mystery Shopping towards fraud busting

    11. Got exposure and dealt in various areas viz., Accident Claims (MACT), Consumer Complaint, Money recovery suits, DRT Cases, Partition suits, Suits for Specific Performance, Workmen's Compensation matters, Legal opinions in respect of Properties.

    Workers compensation claim

    Conducting enquiries and investigations in to the Group personal accident ‘Workman compensation claims, as lodged by the various corporate houses etc. as to the Genuinity & admissibility of the concerned claims.