What looked like a straightforward motor insurance claim soon turned into a complicated discussion about past repairs and fresh damages. This case study shows how a careful balance between facts, photos, and negotiation helped resolve a partial claim and how CoverYou ensured the insured’s satisfaction despite insurer pushback.
Case Background
In April 2025, a doctor from Jaipur reached out to CoverYou regarding her Maruti Baleno that had been in an accident. The car had already been taken to the workshop, and a claim had been initiated. The challenge arose when the insurer flagged the front bumper as pre-existing damage, refusing to approve its repair. Upon further investigation, it became clear that while the bumper had indeed been previously worked on, there was also new damage from the current incident. The case called for careful intervention and multiple rounds of negotiation.
Claim Timeline
- 11 April 2025: The Case was received via WhatsApp, and the insured was contacted immediately
- 16 April 2025: Further work approval received from insurer
- 19 April 2025: Final tax invoice prepared
- 24 April 2025: Vehicle delivered, insured confirmed satisfaction, and case closed
Challenge
The front bumper was denied approval due to signs of old and poorly repaired damage, including local paintwork and low-quality materials. Upon reviewing vehicle images and discussing with both the insured and surveyor, it was confirmed that the part had been damaged previously. However, the insured believed the current accident had added to the damage and expected full approval. We faced resistance from the surveyor, who was reluctant to approve the bumper without solid proof of fresh impact.
Support from CoverYou
1: Coordinated with the workshop and surveyed the actual condition of the bumper
2: Spoke with the surveyor multiple times, pushing for reconsideration
3: Highlighted that other parts (like bonnet and headlight) were approved despite limited evidence
4: Negotiated a partial approval, the insurance would cover the part cost for the bumper, while the paint cost would be borne by the insured
5: Clearly explained the outcome to the insured, showing photos from previous claims and aligning expectations
6: Maintained transparent communication and ensured the insured was comfortable with the decision
Final Outcome
The claim was successfully settled under the cashless facility with a total approved amount of ₹71,112 against the requested ₹77,062. The insured agreed to bear the paint cost for the front bumper, as part of it was old damage. The claim was officially resolved on 24 April 2025, and the insured confirmed satisfaction with the service, even leaving a positive review online.
Disclaimer
To protect client confidentiality, all identities and sensitive details in this case study have been anonymized. This real case is shared by CoverYou to demonstrate our commitment to fair resolution, constant support, and honest handling of claims even when situations are complex.
