دور خبير التأمين فى أكتشاف الغش والتلاعب أثناء المعاينه

دور خبير التأمين فى أكتشاف الغش والتلاعب أثناء المعاينه

يوضح الخبير م / صلاح محمود عبد العظيم الخبير بالهيئة العامه للرقابة المالية ووزارة العدل على أهميه التامين على السيارات فى ظل ارتفاع اسعار الاصلاحات وقطع الغيار واصبح التامين ايضا شبه اجبارى بنسبه اكتر من ٨٠ ٪؜ لصالح البنوك لارتفاع اسعار السيارات واحتياج شرائها بقروض ومن هنا وحسب ثقافه العميل ووعيه التامينى وحسب التزامه بسداد القسط الشهرى للبنك وبناءا على ماذكر ومن تعرضى لبعض الحالات من الغش والتلاعب يوجد 3 حالات وهما :

الحاله الاولى :

حاله عند تعرض المؤمن له لحادث ويوجد اقساط متأخرة ومتراكمه عليه يسعى لتعويضها وسددها من خلال تعويض من شركة التامين بالتحايل وزياده التلفيات باجزاء من قطع غيار تالفه لا تخص السياره لزياده التعويض المستحق وهنا بظهر او تظهر الخبره الفنية والمهنية للقائم بالمعاينه ( خبير التأمين ) و امانته فى ان يقوم بنقل الحقيقه لشركه التامين من عدمه لابد ان يكون الخبير عنده من الخبره الفنية والمهنية والامانه لانه مؤتمن من خلال التكليف التى كلف بة بالمعاينه من الشركة ويعتبر حكماُ عادلاً بين العميل و شركات التامين بتقدير التلفيات الناتجه عن الحادث فقط دون ان يتربح المؤمن له من التعويض .

الحاله الثانية :

يوجد نوع اخر من الغش والتدليس عند تعرض السياره المؤمن عليها بوثيقه تأمين سيارات تكميلى لحادث جسيم نتيجه للسير عكس الاتجاه او السير بدون رخصه او السائق غير مؤهل للسواقه وفى هذه الحالات التعويض بيكون بمبالغ كبيرة يكاد يكون السياره فى حاله هلاك كلى وبمبلغ تامين يتعدى الملاين وهنا ايضا للخبير دور كبير جدا من الناحيه الفنيه والحنكه وهى ان يتخيل الحادث أثناء و قوعه وهل وصف الحادث الذى بالاخطار الوارد المقدم من المؤمن له ومحضر الشرطه مطابق للتلفيات الموجودة بالفعل فى الحادث أم لا و كلنا نعلم بان المتلاعب اخشى ان اقول الحرامى دايما ما ينسي شي ء هنا الدقه فى المعاينه وقراءة المحضر والاخطار والاطلاع على التلفيات تثبت كل الحقيقه ومن الامثله كثيرة منها على سبيل المثال لا الحصر ، ان يكون الحادث فى طريق الغردقه مثلاً و العميل يؤكد فى الاخطار والمحضر ان الحادث على الطريق الدائرى المعادى ويكتشف اثناء المعاينه والفحص والتحريات ومعاينه مكان الحادث أن المكان المدون بالأخطار من المستحيل حدوث حادث فى هذا المكان بالتلفيات الموجودة بالسيارة ووصف الحادث الذى ذكرة العميل ويكتشف وجود تذكرة كارته فى السيارة بطريق الغردقة بنفس التاريخ والوقت المدون بالاخطار للحادث مما يتنافى مع اقواله ويتسبب ذلك فى رفض التعويض بالكامل لأن ومن الامثلة حالات كثيرة تعرضت لها من خلال عملى فترة كبيرة كخبير تأمين فى مجال السيارات وبطرق كثيره تتعرض لها شركات التامين و الخبراء اصحاب الخبره والامانه دورهم أكتشاف الغش والتلاعب وتقديم الادلة القطعية لشركة التأمين فى التقرير المقدم منهم لشركة التأمين لايضاح الحقيقة كاملة أمام أدارة الشركة والقرار يرجع للشركة والحق فى قبول التعويض من رفضة لما يتناسب مع الصالح العام .

الحاله الثالثة :

وهى الغش الغير مقصود او الغش البرئ بمعنى بسبب عدم الوعى التامينئ وخوف المؤمن له من عدم صرف التعويض فى حاله انه المتسبب فى الحادث يخفى الحقيقه ويدلى برواية مفبركه ومكان حادث غير مطابق للتلفيات ويخفى هوية السيارة التى أصطدامت بة وأرقام لوحتها ويذكر أنها فرت هاربة وهنا بيخفى الحقيقه على شركة التأمين والخبير المكلف بالمعاينه مع مراعاه انه يحق له التعويض ومن هنا اناشد واوصى بالوعى التامينى على كل عميل يجب قراءة وثيقة التامين جيداً قبل التوقيع عليها ليعلم ما لة وما علية حتى لا يجعل نفسه فى مأزق عند تعرضه لحادث الصدق اقرب طريق للنجاه وحيث ان التامين اساسا مبنى على مبدا منتهى حسن النيه لابد عند تعرض المؤمن له لحادث ان يدلى بأقوالة الحقيقه فى الاخطار ومحضر الشرطة لأنه سيعوض ويصرف لة التعويض ما لم يخالف شروط الوثيقة وقانون المرور المصرى .

وفى النهاية سنستعرض فى المقال قادم أهم شروط الوثيقة وكيفية تقديم أخطار الحادث عند وقوع حادث وهل يجب عمل محضر شرطة فى نفس وقت وقوع الحادث أم لا .

شرطة السياحة بالواحات البحرية.. صمام أمان للمقاصد السياحية والصحراوية

شرطة السياحة بالواحات البحرية.. صمام أمان للمقاصد السياحية والصحراوية

سرّ الأرض – المهندس سمير كامل: شراكة تمتد من حفنة التراب إلى حصاد الوفرة

سرّ الأرض – المهندس سمير كامل: شراكة تمتد من حفنة التراب إلى حصاد الوفرة

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