0% found this document useful (0 votes)
17 views1 page

Affidavit for Vehicle Insurance Claim Settlement

Mr. Ashwin Sekhar, the registered owner of a Tata Nexon vehicle, states that the vehicle was involved in an accident on August 14, 2025, and a claim has been lodged with the insurance company. He agrees to accept a settlement of Rs 235,200 as full and final settlement of the claim and acknowledges that the insurance policy will be canceled without a refund. He also affirms that he will not pursue further disputes regarding this matter and understands the legal implications of making a false affidavit.
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
0% found this document useful (0 votes)
17 views1 page

Affidavit for Vehicle Insurance Claim Settlement

Mr. Ashwin Sekhar, the registered owner of a Tata Nexon vehicle, states that the vehicle was involved in an accident on August 14, 2025, and a claim has been lodged with the insurance company. He agrees to accept a settlement of Rs 235,200 as full and final settlement of the claim and acknowledges that the insurance policy will be canceled without a refund. He also affirms that he will not pursue further disputes regarding this matter and understands the legal implications of making a false affidavit.
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

AFFIDAVIT

I Mr Ashwin Sekhar residing at F6 -43, E1 Sector Vasant Kunj, New Delhi- 110070
hereby solemnly state that I am the registered owner of Tata Nexon vehicle bearing
Regn. No. MH01 DP 3013 Engine no. REVTRN11JZXK58860 and Chassis no.
MAT627129LLJ24505 having address as 11D Vatsala NOFRA, Near Rc Church,
Colaba Mumbai 400005 The said vehicle is insured with M/s Generali Central India
Insurance Company Limited vide policy no. 132/02/01/0925/MTP/3210034730 for the
period 28 Sep 24 to 27 Sep 25. The said vehicle met with an accident on 14 Aug 25 near
Basement of F6 building, E1 sector Vasant Kunj, New Delhi. A claim in respect of the
above accident has been lodged with the insurers of the vehicle, claim number being
FGC1811250000250223. I hereby grant full and final consent to accept Rs 235200/-
(Rupees Two Lakhs Thirty Five Thousand and Two Hundred only) as full and final
settlement of the said claim on Nett of Salvage basis. Based upon our representation, the
insurance company has agreed to settle the claim on Nett of Salvage basis. I shall retain
the salvage and sell the same along with R.C. Book and all vehicular documents
pertaining to the said vehicle. I understand that the policy shall be cancelled with effect
from the date of accident without any refund of premium. I shall surrender the original
policy document and the covernote to the company. The estimation and parking charges
of the repairers shall be borne by me. I solemnly state that I shall not raise any further
dispute regarding the matter before any court, consumer forum, insurance ombudsman,
Deptt. of Public Grievances or any other such authority or institution. I grant the
insurance company full and final discharge from its liability under the above-mentioned
policy. In case of any dispute, I undertake to refund the full claim amount to the
company. I hereby declare that I am submitting this affidavit on our own, of our own free
will and not under any duress or pressure. I am aware that making a false affidavit is an
offence punishable under law.

Common questions

Powered by AI

Obtaining full and final consent, as seen in Ashwin's affidavit, is crucial for both the insurer and insured as it terminates any pending liabilities under the policy and legally closes the claim. This ensures the settlement is binding, minimizing the risk of future disputes or claims related to that incident, thereby protecting the insurer from additional financial obligations .

By agreeing to the cancellation of the policy post-accident, Ashwin forfeits the ability to make any future claims on the vehicle under that policy, reducing his coverage for any subsequent damages. This decision primarily affects his financial risk, as he would have to seek new insurance for continued coverage, potentially at higher premiums or with limited choices due to the history of claims .

The stipulation for policy surrender without premium refund requires Ashwin to adjust his financial plans by accounting for new insurance costs immediately after the accident. He loses the value of remaining coverage for which he initially paid, likely increasing his cash outflows as he must procure and potentially pay more for equivalent future insurance during the same period .

By agreeing to refund the full claim in the event of a dispute, Ashwin opens himself to significant financial risk if any discrepancies arise post-settlement. This obligation could become burdensome if future litigation or disagreements prompt the insurer to demand repayment, which might strain his finances or involve legal costs irrespective of subsequent issues related to the claim .

According to the affidavit, Ashwin Sekhar assumes responsibility for the estimation and parking charges for repairs. Additionally, he agrees to bear the costs without expectation of a refund of insurance premium and undertake any actions necessary to sell the salvage .

Ashwin Sekhar agrees to limit his legal actions by stating he will not raise any further disputes regarding the matter before any court, consumer forum, insurance ombudsman, or any other authority. He agrees to provide the insurance company a full and final discharge from liability, indicating his acceptance of the settlement terms and closure of the issue .

Ashwin's declaration emphasizes the voluntary nature of the affidavit submission, which legally strengthens its validity by affirming that his statements and consent are genuine and not coerced. This assures parties involved that the documentation accurately reflects his intentions and understanding of the settlement without external influence .

Submitting a false affidavit can lead to legal consequences, including criminal charges for perjury, since affidavits are sworn statements made under oath. In India, falsifying an affidavit document is considered an offence under the Indian Penal Code. If found guilty, Ashwin Sekhar might face penalties such as fines or imprisonment depending on the severity of the deceit .

Retaining the vehicle salvage puts the onus on Ashwin to manage and potentially sell the vehicle parts or scrap. While this could offer financial gain if the salvage is sold lucratively, it involves effort and risk. The nett settlement reflects this initial financial burden, as the insurance payout is reduced by the anticipated salvage value .

The 'Nett of Salvage' concept is relevant in Ashwin Sekhar’s case as the insurance company agrees to pay the claim amount minus the salvage value. This means Ashwin retains ownership of the damaged vehicle (salvage) and can sell it separately. This arrangement impacts the settlement because it allows the insured to potentially recover more than the insurance payout if they manage to sell the vehicle or its parts for a good price .

You might also like