Jaipur, March, 2025.

In the wake of rising fraudulent and bogus claims, Shriram General Insurance Company (SGI), one of the largest non-life insurance providers in India, has strengthened its claims investigation team for investigating motor third party claims.

A Motor Accidents Claims Tribunal (MACT) is a special court established under the Motor Vehicles Act to adjudicate compensation claims arising from motor vehicle accidents, providing a faster and less expensive alternative to civil courts for victims of  road accidents. Unfortunately, many claims that come up for settlement at the MACT are fraudulent or bogus claims.

The Claim Review team will thoroughly examine the claims to spot inconsistencies. While claims found to be bonafide will be forwarded for processing and settlement, claims that raise any suspicion will be handed over to the Investigation team for in-depth investigation into the submitted documents and evidence. Upon completion of the investigation, claims deemed fraudulent will be escalated to the Legal team for defence in the tribunal.  

The teams under the leadership of Mr. Ashwani Dhanawat, Executive Director, SGI to thoroughly examine claims that are filed and will be supported by latest AI Tools that will help them in fraud detection. The three teams, comprising of personnel with relevant experience are Claim Review, Claim Investigation and Legal to handle legal proceedings.

Mr. Ashwani Dhanawat, Executive Director, Shriram General Insurance said, “Shriram General Insurance remains steadfast in its mission to safeguard shareholder value and policyholder trust. By prosecuting those who seek to exploit the system, we are not only protecting our stakeholders but also ensuring that resources are preserved for genuine claimants who rely on us during their time of need.”

Bonafide claims will see faster settlement. Few days ago, SGI's took prompt action to ensure swift claim settlement for the family of Surat-based Dilipbhai Maganbhai Patel, who died in a road accident. SGI expedited settlement process of the third party claim worth Rs. 46 lakhs and ensured that the family received monetary compensation in 15 days flat.

“SGI set a benchmark by settling a motor TP claim in 15 days. The quick and efficient settlement by SGI provided much-needed relief to the grieving family. This underscores SGI’s commitment to protecting shareholder value and policyholder trust,” Dhanawat said.

The Investigation team has unearthed a slew of bogus claims and the Legal team successfully secured SGI's exoneration from liability by the Tribunal. 

• Smt. Preeti & Others vs. Shriram General Insurance Co. Ltd. & Others (MACT Lakhimpur Kheri): A ₹10 lakh compensation claim was withdrawn after cross-examination revealed a conspiracy involving the claimant, vehicle owner, and driver to falsely implicate an insured vehicle.
• Balu vs. Appasaheb & Others (MACT Osmanabad): A ₹1 lakh claim was rejected when the tribunal determined the alleged accident was staged, with no involvement of the insured vehicle, and implicated the vehicle owner and police authorities.
• Smt. Surti Bai vs. Pankaj & Others (MACT Jabalpur): A ₹10 lakh claim was dismissed due to insufficient evidence linking the insured vehicle to the accident and inconsistencies in the reported date.
• Raj Kumar vs. Sitaram & Others (MACT Chitrakoot) & Horilal vs. Sitaram & Others (MACT Chitrakoot): Claims of ₹20 lakh and ₹21 lakh were struck down after police investigations confirmed the accident allegations were baseless, with claimants failing to substantiate their assertions.

Escalating the Battle with Criminal Action

Building on these tribunal successes, SGI is now pursuing criminal proceedings against the perpetrators of these fraudulent claims. The company has filed criminal complaints before Judicial Magistrates in the respective jurisdictions, with two courts already issuing notices to the accused. These fraudsters face prosecution under key provisions of the Bharatiya Nyaya Sanhita (BNS), including Section 246, which addresses the dishonest presentation of false claims in court.

This strategic escalation underscores SGI’s zero-tolerance policy toward insurance fraud, sending a clear message that such actions are criminal offenses with serious legal repercussions.