If you are stuck in such a situation, here is what to do.

Mr. Alok Verma was visiting the city of Shantipur for the first time. While navigating back to his accommodation one evening using a popular maps application, he encountered a perilous situation. The app directed him towards an underpass which, unbeknownst to him, was severely flooded. It had just gotten dark, and the area was unlit, with no warning signs or barricades to indicate the danger ahead. By the time he realised the depth of the water, it was too late. His new sedan, purchased only a few months prior, stalled and was submerged.

In a state of panic, he tried to restart the engine, but the car was completely unresponsive. With the help of some local residents, he managed to push the vehicle out of the water. The locals informed him that this was a frequent occurrence at this specific underpass, which was maintained by the Shantipur Municipal Corporation. They mentioned that numerous complaints had been filed, but no permanent solution was ever implemented.

To Mr. Verma’s dismay, his insurance provider, Suraksha Bima Ltd., rejected his claim for the total loss of his vehicle. The company’s justification was “gross negligence,” alleging that he should have been aware of the hazard and acted more cautiously. This was despite him having a comprehensive insurance policy with an engine protection add-on. The core of the issue now lies in challenging this allegation of gross negligence, which seems misplaced given the civic body’s failure to maintain a safe passage.

Advice in such cases

• Immediately document the scene. Take extensive photos and videos of the submerged vehicle, the water level, the lack of warning signs, and the poor lighting conditions. This visual evidence is invaluable.
• Gather contact information from any witnesses, especially the local residents who can testify that this is a recurring problem. Their statements can help establish a pattern of negligence by the civic authorities.
• File a report at the nearest police station. An FIR (First Information Report) or at least a Non-Cognizable Report (NCR) creates an official record of the incident, which is crucial for insurance claims and legal proceedings.
• Inform your insurance company about the incident without delay, but stick to the facts and do not admit any fault or negligence on your part.
• Consult with Lawyer: The very basic and important step to start is talk to Lawyer / advocate. You should not hesitate in paying his consultation fee i.e. might be in range of Rs. 10,000 to 50,000 depends case to case. He is helping you in this situation of come out. He is expert in the domain and can help you explain the procedure which you might have never explored. A good lawyer can get the issues resolved much faster than you think.

Applicable Sections of Law

This situation involves multiple areas of Indian law:

• Law of Torts: The primary issue here is negligence on the part of the Municipal Corporation. They have a duty of care to maintain public infrastructure like underpasses in a safe condition. Their failure to install proper drainage, lighting, or warning signs constitutes a breach of this duty, making them liable for the damages caused.
• Indian Contract Act, 1872: Your insurance policy is a contract. The insurer’s right to repudiate a claim is governed by the terms of this contract. The term “gross negligence” is a high threshold to prove and cannot be used arbitrarily. It implies a reckless disregard for a known danger, which is not applicable when a driver is new to an area and the hazard is not visible or signposted.
• Consumer Protection Act, 2019: As a policyholder, you are a “consumer” and the insurance service is a “service.” Unjustified rejection of a valid claim amounts to a “deficiency in service.” You have the right to approach the Consumer Disputes Redressal Commission to seek redressal against the insurance company.
• Bharatiya Nyaya Sanhita, 2023 (BNS): While this case is primarily civil in nature, if the negligence of the civic authorities leads to grievous hurt or death, provisions like Section 109 of the BNS (causing death by negligence) could be invoked against the responsible officials.

If you are the complainant

• Formally challenge the insurance company’s rejection. Send a detailed written rebuttal through your lawyer, outlining the facts, enclosing evidence, and arguing why the allegation of gross negligence is unfounded.
• If the insurer does not resolve the issue, file a complaint against them in the appropriate Consumer Commission (District, State, or National, depending on the value of the claim).
• Consider filing a separate civil suit for damages against the responsible Municipal Corporation for their negligence in maintaining the underpass.
• Consult with Lawyer: The very basic and important step to start is talk to Lawyer / advocate. You should not hesitate in paying his consultation fee i.e. might be in range of Rs. 10,000 to 50,000 depends case to case. He is helping you in this situation of come out. He is expert in the domain and can help you explain the procedure which you might have never explored. A good lawyer can get the issues resolved much faster than you think.

If you are the victim

• Preserve all forms of communication with the insurance company, roadside assistance, and the service center. This includes emails, letters, call recordings, and messages.
• Do not sign any settlement or discharge voucher offered by the insurance company without fully understanding its terms. Accepting a partial payment might prevent you from claiming the full amount later.
• Obtain an independent damage assessment report from the vehicle’s authorized service center to accurately quantify your loss.
• Consult with Lawyer: The very basic and important step to start is talk to Lawyer / advocate. You should not hesitate in paying his consultation fee i.e. might be in range of Rs. 10,000 to 50,000 depends case to case. He is helping you in this situation of come out. He is expert in the domain and can help you explain the procedure which you might have never explored. A good lawyer can get the issues resolved much faster than you think.

How the police behave in such cases

In incidents like this, the police’s primary role is to document the event. They will likely register an NCR or an FIR, which serves as an official record. They may not actively investigate the negligence of the civic body unless a specific complaint is filed alleging endangerment or if the incident resulted in serious injury or death. However, the police report is a critical document that substantiates your version of events for both the insurance claim and any potential court case.

FAQs people normally have

Q: Can an insurance company reject my claim even if I have an Engine Protection add-on?
A: Yes, they can, but only on valid grounds as per the policy terms. An Engine Protection cover is designed for damage due to water ingression, but they might still try to invoke clauses like “gross negligence” to avoid payment. The validity of this rejection can be challenged.

Q: What is the difference between simple negligence and “gross negligence”?
A: Simple negligence is a failure to exercise reasonable care. Gross negligence is a more severe failure, involving a conscious and voluntary disregard of the need to use reasonable care, which is likely to cause foreseeable grave injury or harm. Driving into an unlit, unmarked flooded road in an unfamiliar city is highly unlikely to be considered gross negligence.

What evidence is required?

• Photographic and video evidence of the car in the water and the general condition of the underpass (lack of lights, signs).
• A copy of the police report (FIR/NCR).
• The insurance policy document, clearly showing the comprehensive cover and add-ons like Engine Protection.
• Statements from witnesses or locals confirming the recurring nature of the flooding.
• Records of your communication with the insurance company.
• Repair estimates and the surveyor’s report from the service center.

How long will the investigation take?

The insurance company’s internal review and investigation might take a few weeks. If you challenge their decision, the process can extend. A case filed in a Consumer Commission can take anywhere from a few months to over a year to reach a resolution, depending on the complexity and the caseload of the commission. A civil suit against the civic authorities is typically a more prolonged process.

Advocate Sudhir Rao, Supreme Court of India