1. RAM AVADH SINGH
SURVEYOR AND LOSS ASSESSOR
BSc.(IS),DME,PDTQM&ISO 9000,AIII, MBA.FIIISLA
Motor Insurance peril
Accidental external means
Motor Insurance also known as vehicle or Auto insurance. Its primary
objective is , protection against physical damage resulting from traffic
collision and against liability that could also there from

2. What is not covered in the insurance policy
• 1 Normal wear and tear due to uses.
• 2 Loss or damage due to depreciation.
• 3 Damages caused due to speed testing.
• 4 Known or deliberate accidental damages.
What Motor insurance excludes
1. Not having valid license.
2. Under influence of intoxicating liquor/drugs.
3. Accident taking place beyond the geographical area.
4. While vehicle is used for unlawful purposes.
5. Electrical & mechanical breakdown

3. What is covered in the insurance policy
1. By fire explosion, self ignition or lightening.
2. By burglary , house breaking or theft.
3. By riot and strike.
4. By earth quake(Fire and shock damages).
5. By flood, Typhoon, hurricane , Storm, Tempest, Inundation, cyclone, hail
storm, frost.
6. By Accidental external means.
7. By Malicious Act.
8. By terrorist activity.
9. Whilst in transit by road, rail, water way, lift, elevator or air.
10. By land slide /rock slide.

4. Peril
Specific risk or cause of loss covered by an insurance policy, such as
fire, windstorm, flood or theft etc.
• ACCIDENTAL EXTERNAL MEANS:
Accident and accidental means: A sudden unforeseen and unexpected physical event
beyond your /our control caused by external visible and violent means direct result of
an accidental , external, violent and visible cause or similar word to the effect.
Accidental : An unforeseen, or unexpected and unfortunate occurrence.
It can either be the cause or the result that is unexpected but it must be at least one of
them.
Accident: Accident word is derived from Latin verb ‘:accidere” which signifies fall upon,
Befall happen , chance , in its most commonly accidently accepted meaning or its
ordinary or popular sense the word may be defined as meaning some sudden and
unexpected event taking place without expectation upon the instant rather than
something that continues , progress or develops, something happening by chance ,
some other unforeseen unexpected unusual, extraordinary phenomenal taking place
not according to usual cause of things or events out of range of ordinary calculations
that which exists or occurs abnormally or an uncommon occurrence .

5. • The word may be employed as denoting a calamity , casualty ,
catastrophe , or an undesirable or unfortunate happening any
unexpected personal injury resulting from any unlooked for mishap
or occurrence any unpleasant or unfortunate occurrence that
causes injury loss , suffering or death , some outward occurrence a
side from the unusual course of event that takes place without
one’s fore sight or expectation , an un designed sudden and
unexpected event .
• Accident is not always a precise in legal terms. It may be used
generally in reference to various types of mishaps, or it may be
given a technical meaning that applies when used in a certain
statute or kind of case where it is used. In its most limited sense
the word accident is used only for events that occur without the
intervention of human being.
• Not every unintended event is an accident for which insurance
benefit can be paid . All the circumstances in a particular case must
first be considered.
• Example – A policeman who wadded in to a surging crowd of forty
or fifty teenagers fighting then experienced a heart attack who was
found to have suffered from an accident.

6. • EXTERNAL :- Happening or arising or located outside or
beyond some limits or especially surface , coming from the
outside , purely outward or superficial, being on or toward
the outside of the body , originating or belonging from the
outside , relating to physical reality rather than with
thoughts or the mind. Here we can say different sores must
have different solves
• For example:-
A car accident may be external, violent and visible,
whereas a heart attack is violent but not external.
A Heart attack could lead to a car accident or a car accident
could lead to a heart attack or its could be that the two
events are completely unrelated.
It we decide likely that the consumer had a heart attack
before the accident, we need to consider weather they
were killed in the accident or whether they would have
dead anyway from the heart attack.

7. Proximate cause
• Insurance policies only provide cover for loss or damage if its is a result of
one of the perils listed in the policy. Determining that actual cause of loss
or damage is therefore a fundamental step in the consideration of any
claim.
• Proximate cause is a key principle of insurance and is concerned with how
the loss or damage actually occurred and whether it is indeed as a result
of insured peril.
• DEFINATION OF PROXIMATE CAUSE :-
• Proximate cause was defined in the case of Pawsy v/s Scottish union and
M/S National Insurance company :
• “Proximate cause is active direct and efficient cause of loss in insurance
that sets in motion an unbroken chain of events which bring about
damage , destruction or injury without the intervention of a new and
independent force also called direct cause ‘’
•

8. Admissibility, extent of admissibility and inadmissibility of
insurance liability
• Discussion point 1(A)
• Panel Hood / bonnet in running car got blown open and hit the windshield to
break it . This led the damage to windshield glass and panel hood/bonnet .
• Panel Hood/bonnet of any car can be blown open in two conditions
• Negligence at the part of the user/ driver by not locking the bonnet /hood . In
such type of the cases bonnet/hood not properly pressed or locked gets blown
open due to air pressure of opposite direction including filled air (Air fills inside to
bonnet and engine gap portion due to gap at front and side by not locking the
bonnet).here in this case negligence or will fill act is not covered as per the policy
terms and condition.
• Some old vehicles or more used vehicle may have lever /latch related wear and
tear cases or else, unlocking problems. Their lever/ latch got easily unlocked
example – Say a Maruti car or any model car bonnet got blown open while vehicle
was in speed, on examination it was observed that its bonnet area /size where
filled air inside and opposite direction wind at front developed pressure to lift the
lever as a result bonnet got blown open and hit the windshield glass. In the case
wear and tear / design of the bonnet lock- is the reason or its oldness that
develops more play in the lever/latch.

9. Claim position
• We should refer to the peril – accident external means
the external air is the reason but proximate cause is
the design fault wear and tear. So no insurance liability
in the case, reason being the accidental external means
should be un designed un expectable.
• Design Presumption by the manufacturers of the cars
and insured’s due care as well should be taken to cope
up all the aspect of the vehicle going to play on the
road.
• Here onus of proof lies with the insurers , incase of no
proof benefit of doubt plays in favour of insured.

11. Point 1(B)
Upon application of brakes on a turn a container body hit the cabin of a
prime mover to damage it
We should refer to the design validation of commercial vehicle load body.
• Commercial load body is used for transport application of various types of goods.
• Objectives of validation of design of commercial vehicle load body for model
stiffness and strength point of view the preliminary design is carried out as per
relevant standards and modeling is done using CAD tools.
• Finite element modeling of load body and frame component is done in hyper
mesh using shells elements.
• Rivets and bolts are modeled using beam element of approved diameter. Model
analysis of the load body is done in free condition.
• Stiffness analysis is done to find out the torsion stiffness, vertical bending stiffness
and torsion bending stiffness of the load body.
• Further it has to be analyzed for the strength criteria for the critical load cases
such as hydrostatic load case (Bump, Braking , acceleration and cornering ) and
service load case (front single wheel pot hole breaking , front double wheel pot
whole breaking , rear single wheel pot hole braking , rear double wheel pot hole
breaking).

12. • 1. We as a surveyor and loss assessor should refer to the state of design and the free
condition of the load body whether loaded or unloaded condition braking on true
means cornering stage of cabin and load body normally can not touch the cabin as
designed .
• See the vehicle dynamics
The law of nature :
Like every thing around us we are all affected by the laws of nature these law ensure that
(a) We don’t fall of the planet
(b) If we throw some thing it will keep going straight line away from us .
(c) A person walking in to tree will probably injure himself but a person running in to a
tree will ensure himself a more out of proportion to his increase in speed.
(d) If you wonder on the ice you stand really a good chance of falling over. These same
principles work on our vehicles and they can not be totally eliminated but they can
be controlled or their effect can be minimized.
Upon Application of brakes on a turn cornering effects as designed proposes that load
body will not touch the cabin rear unless there is mechanical failure in load body or
rear external means or rear force pressure bounds the load body to go forward
beyond the designed gap . Here view is very clear that such cases are not admissible
. The peril accident external means---- Cornering and brake that is not possible
under standard factor of design.

14. • 1. If Load body hits the cabin on turn there might be violation of standard gap
between cabin and load body.
• 2. The cause may be due to the mechanical failure or failure of design aspect which is
uninsured.
• 3. The load body can hit the cabin rear wall also by the rear push force that causes
mechanical failure or load body hit at rear upper portion so its cabin side portion
pressed forward from its original state but this is very clear accident external means.
• Standards are made or designed for control and to live near the standard if not
followed are the violations.
• 2- Upon application of sudden brakes.
• (a)The head of co driver/driver hit the wind shield glass from inside leading its
breakage . When brake is applied to a running vehicle – the vehicle stops in
proportion of brake here law of nature acts due to impact of brake vehicle stops but
the driver /co driver body or any un mounted or flexible accessory inside or outside of
the car , will keep moving ahead in the speed as it was, will impact the body to hit the
wind shield glass in front. here both static and dynamic force will act.
• In the subject case, claim is admissible upon the brake if applied to save the accident
/ collision with some another vehicle in front or any other living/un living ahead
where application of brake sought mandatory. The accident external means in this
case is traffic rule or the object/vehicle /living being suddenly come in front
proximately caused to apply the brake.

15. • 2(B). The girder loaded in a goods carrying vehicle
broke loose of the fasteners, shifted forward leading
to damage, Break the back wall of the cabin.
• The girder loaded on a good carrying vehicle broke
loose fasteners, shifted forward and damaged the cabin
back wall needs proper investigation of the fastening
ropes, chain. It is also understood that no one will do
negligence in fastening the girder for carrying it to a far
place, so in case girder -if damaged the cabin over
secured fastening after broke opening should be
considered as accident external means and no
negligence at the part of road safety. Load carrying
rules applicable.
• Any willful act if proved to replace the old rusted cabin
may be considered as uninsured.

16. • 3 (A). A loaded dumper with its hydraulic jack open, moved forward with the result
its body tilted, the jack got bent/broken and finally the body rested on ground and
damaging its sub frame and chassis.
in order to save unloading cost tripper trucks are very popular now a days. These
bodies are also known as dump body. These are useful in simple way to unload the
material. Every extra kg of vehicle weight increases manufacturing cost, lowers fuel
efficiency and reduces vehicle pay load capacity with modeled and analyzed. Three
models of tripper dump bodies are considered whose specification are taken from
local industry bases.
Say 14 meter cubic capacity- bearing cubic load 18 ton.
Factors in designing the load body
1. Type of body
2. Induced stress and material properties
3. Vehicle and related structures
(a) To reduce body weight
(b) Having highest stress.
(c) Optimize in terms of reducing weight and reducing stresses.
1. In the concerned case hydraulic jack does not open without switching on the button.
if unwillingly or due to wrong operation, the jack opens is negligence at the part of
driver/operator is uninsured not admissible in case of insurance claim as per policy
terms condition- the clause of willful act.
2. If the occurrence happens while unloading due to misbalanced load (material
displacement unequally in the load body)jack may be tilted and all losses as
explained in question are liable to be paid on the ground the happening of an event
occurrence without the will of the person, by person whose agency consequence
happen.

18. 3-B
The wooden body of an overloaded goods carrying vehicle with
sugarcane uprooted from its mounting and was thrown off on road.
Wooden body fixing on the frame /chassis with appropriately designed
rivets and bolts modeled using beam element of appropriate
diameter . The welding standards should also be analyzed wherever
necessary. Here free conditions, vertical bending stiffness and torsion
bending stiffness of the load body may be the analyzing points.
The wooden load body if properly designed for a load carrying capacity
limit: there are no chances of such happening unless there is extra
load or disproportionately distributed load on the body . In such cases
overloading rule should be followed and insurance companies are
indemnifying as a substandard cases considering the average load
conditions and overload rules in lack of proofs of overloading and
exact cause of the accident. Although such claims are not admissible
since there is mechanical failure due to disproportionate load sharing
on load body and imbalances on the load body.

19. • The sugarcane belt area truck owners basically use old vehicles for
sugarcane transportation. The load averages bases are being taken in to
account for calculating overloading on the vehicle. Computer based
slips of load are being given from the sugarcane purchase or delivery
centers.
• So average load conditions on the vehicle are being calculated /
adapted in case of such an accidents although are out of scope of the
accident external means and principally not admissible as per terms and
conditions of the policy in case accident happen due to overloading
uprooting the load body from its mounting also as per peril of accident
external means that comes under exceeding designed load bearing
capacity that in turn the load body got uprooted from the frame
.chassis or bearing capacity of load body mounting rivet, bolt and
welding . These accidents may be treated in mechanical breakdown
peril that are uninsured in the policy.
• The onus of prove of overloading and disproportionate load
sharing/imbalances lies on the insurers and overload exemption %
calculation left the insurer to give the benefit of doubt to the insured’s
such losses.

21. • 4(A)
• An unknown person made scratches by some sharp object on all round the body of
a car
If any unknown person makes scratches on any car by some sharp object or any
object that scratches the car all round or some pieces/ parts of the car is malicious
act, which is insured peril, is covered on production of FIR as a proof of malicious act
being done by some unknown person or else.
Malicious acts:
An act done maliciously is one that is wrongful and performed willfully or
intentionally and without legal jurisdiction . Involving malice characterized by
wicked or mischievous motive or intention .
Police registers the case of malicious act against unknown either in GD or under
section 427. The subject case is admissible and insurers also indemnify such case in
practice since are covered as per policy terms and conditions.
4(B)
A car was parked near a kennel and pet dog by his teeth damaged its bumper.
The damages to the car are by external means and by ignorance of an animal a pet
dog in legal terms - It is known that dogs do not eat plastic or metal and usually do
not damage the bumper of the car by his teeth, also is external means so the claim is
covered under insurance policy. The claim is admissible under the circumstances and
coverage given in the policy.

22. 5 Fresh accidental damages occurred on a preexisting accidental damaged
vehicle
Preexisting damages on the vehicle are not insured in the policy so the
damages on the vehicle before the commencement of the insurance contact
can not indemnified as per policy wording.
If fresh accident by accident external means or under any covered peril
occurs to the vehicle insured may be indemnified up to the extent of
damages with reference to preexisting damages extent.
A car having preexisting damages and is insured with an insurance company
met with an accident of severe nature or other. Insurance company is liable
to indemnify those damages which are not preexisting in the pre insurance
inspection report and photographs taken before the commencement of
insurance contact.
The damages to the mechanical parts like suspension/operational
attachment ,wheel radiator, condenser, intercooler, compressor, ECM , or
other module, engine parts and a like other parts are related to operation of
the vehicle where it can not be established that these damages were
preexisting in the vehicle since vehicle was insured after complete inspection
and finding it in road worthy state or operational in all respect and
respectively insurance policy was issued or commencement of insurance
contract was done or agreed by both the insurer and insured. In an ambit of
accident some parts /portion or all the parts got damaged in question.

23. Insurance liability stand still and insurance company shall pay/indemnify to the insured
proportion after deducting depreciation/ deductibles as are applicable in the contract of
insurance.
The body parts –preexisting damages can be indemnified if these parts sustain damages
beyond the limit of repair (however that were due for repair before the insurance)
• The cost of body parts are liability of insurers since the parts got damaged beyond the limit of
repair (that were uninsured) but to bring the vehicle in its pre state, replacement are necessary in
such situation parts cost minus depreciation as laid in the policy should be indemnified by the
insurers.
• The new body parts need painting but the pre existing damaged parts were also due for painting
and insurance contract was agreed by both the parties so painting on such body parts should be
borne by the insured but in practice insurers are giving 50% painting charges on such pre existing
damaged parts that again got damaged severely in afresh accident after the commencement of
insurance contract. In order to avoid the dispute of percentage pre existing damages also to give
the benefit of doubt to the insured too.
• The parts made of plastic and having pre existing damages sustained further more damages beyond
the scope of repair need necessary replacement are being indemnified on the ground to bring the
vehicle in its pre accidental state. So insurance company can deny to indemnify such parts , that
plastic parts were already damaged beyond the repair limit that were due for replacement thus
prior replacement liability was of the insured. Here the benefit of doubt plays the role .
• In order to avoid the dispute of percentile damages on the pre existing plastic parts damages and
again fresh accidental damages under the policy are being indemnified by the insurers after
depreciation /deduction as are laid in the policy/ terms and conditions of the insurance contract.

24. THANKS
RAM AVADH SINGH
Research Scholar
SURVEYOR &LOSS ASSESSOR