Claim Pitfalls, Complaints and Official Sources
Cashless vs reimbursement car insurance claims: step-by-step process and documents
How an own-damage motor claim works in India: intimation, FIR, survey, cashless repair at a network garage or reimbursement, theft and total-loss claims, documents and timelines.
In a cashless claim, your car is repaired at one of the insurer's network garages and the insurer pays the garage directly; you pay only your share (deductibles, depreciation if you have no zero dep, consumables and anything not covered). In a reimbursement claim, you repair the car at a garage of your choice, pay the full bill and the insurer refunds the admissible amount. In both cases the sequence is the same: intimate the insurer immediately, file a police report where needed, let the surveyor inspect before repairs start, get approval, then repair and settle. The most common way to lose a claim is to start repairs before the insurer has seen the damage.
This guide is part of claim rejection reasons.
Cashless vs reimbursement at a glance
| Cashless | Reimbursement | |
|---|---|---|
| Where | Insurer's network garage | Any garage you choose |
| Who pays the garage | Insurer pays its share directly; you pay your share | You pay the whole bill first |
| Paperwork | Garage handles much of it | You submit original bills and payment proof |
| Speed | Usually quicker for you | Refund after documents are verified |
| Rates | Garage works on agreed rates | Insurer may cut labour rates it considers excessive |
| Good for | Most accident repairs | Cars serviced at a non-network authorised dealer, or remote areas |
Check the network list for your city before you buy or renew; see the renewal checklist.
Step-by-step: an accident damage claim
- Make the scene safe. If anyone is injured, call 112 and get medical help; the cashless treatment scheme for road accident victims covers treatment at designated hospitals (see third-party claims).
- Photograph the vehicles, number plates, road, and damage before anything is moved, if safe.
- Intimate the insurer through its helpline or app as soon as possible. Note the claim number.
- Police report. Required for theft, third-party injury or death, and serious accidents. For minor single-vehicle damage, many insurers do not require an FIR; ask.
- Tow the car to the garage, using roadside assistance if you have it. Do not drive a car with fluid leaks or a flooded engine.
- Survey. The insurer appoints a surveyor, or for smaller losses its own assessor. Under the Insurance Act, losses above a threshold (₹50,000 for motor, per reports of the 2024 master circular) must be assessed by an IRDAI-licensed surveyor. Do not allow dismantling beyond what the surveyor approves.
- Estimate and approval. The garage prepares an estimate; the surveyor approves parts and labour.
- Repair. The garage repairs the car. Some surveyors re-inspect before delivery.
- Settlement. For cashless, sign the satisfaction note, pay your share and take delivery. For reimbursement, pay the garage and submit the original invoice and receipt.
Documents usually needed
- Claim form, signed
- Policy copy
- RC copy
- Driving licence of the person driving at the time
- FIR or police report where required
- Repair estimate and final invoice
- Payment receipt (reimbursement)
- KYC and bank details (cancelled cheque) for payment
- For theft: all original keys, FIR, police final report that the vehicle is untraced, RC, signed transfer forms (Forms 28, 29, 30 as the insurer requires), letter of subrogation
IRDAI's policyholder protection rules require insurers to ask only for documents relevant to the claim. Keep copies of everything you submit and note the date.
Worked example: what you pay at a cashless garage
Illustrative. A car 4 years 3 months old, no zero dep, compulsory deductible ₹1,000. Approved repair: plastic parts ₹14,000, metal parts ₹20,000, paint material ₹5,000, labour ₹11,000, consumables ₹1,500. Total ₹51,500 (GST included in each line for simplicity).
| Item | Depreciation | Your share |
|---|---|---|
| Plastic parts ₹14,000 | 50% | ₹7,000 |
| Metal parts ₹20,000 | 35% (4–5 years) | ₹7,000 |
| Paint material ₹5,000 | 50% | ₹2,500 |
| Labour ₹11,000 | 0% | ₹0 |
| Consumables ₹1,500 | Not covered | ₹1,500 |
| Compulsory deductible | ₹1,000 | |
| Total you pay | ₹19,000 |
The insurer pays the garage ₹51,500 − ₹19,000 = ₹32,500. With zero dep and consumables cover, your share would have been just the ₹1,000 deductible. The claim payout estimator runs this for parts.
Theft claims
- File an FIR immediately and inform the insurer the same day if possible.
- Inform the RTO of the theft.
- The insurer waits for the police untraced report (final report) before settling. This can take weeks or months.
- Settlement is the IDV less the deductible. Return to invoice cover, if held, adds the gap to invoice value.
- You hand over all keys and sign documents transferring the vehicle to the insurer, so that if it is recovered later it belongs to the insurer.
Total loss (constructive total loss)
Where the repair cost exceeds about 75% of IDV under standard wordings, the insurer can settle as a total loss: IDV minus the deductible, with the insurer taking the salvage, or IDV minus deductible minus salvage value if you keep the wreck. Ask for the salvage valuation in writing.
Timelines
The 2024 master circular sets time limits for appointing surveyors, submitting reports and deciding claims; news reports describe a 15-day limit for the survey report and a short limit for settlement after that. If your claim is delayed, write to the insurer quoting the claim number and the date of the survey report, then escalate through the complaints process.
Frequently asked questions
Can I choose a non-network garage and still get cashless?
Usually not. Cashless works only at network garages. You can still claim reimbursement.
Does the surveyor decide the claim?
The surveyor assesses the loss; the insurer decides admissibility and pays. You can ask for the survey report.
My garage has replaced a part the surveyor did not approve. Will I be paid?
Probably not for that part. Get the surveyor's approval for any additional part, in writing.
Is GST on repairs paid by the insurer?
GST on admissible parts and labour is part of the claim, subject to the same depreciation on parts.
Sources
- IRDAI — claims handling rules and licensed surveyor information
- Bima Bharosa — complaints about delayed claims
- Parivahan Sewa — RTO intimation and vehicle records
