The insurance company does not pay, what should I do? Legal advice

The insurance market in Russia is still very wild. Companies unreasonably refuse to pay, go bankrupt or simply burst. When a client requests a refund, employees may not be as polite as when signing a contract. The reason is the low insurance culture on both sides of the transaction. The client who applied for payment is perceived as a swindler and a freeloader. Both sides of the transaction consider insurance to be a means of making money. The company believes that it is necessary to "fight back", and the client thinks that he will receive the money without any questions. It turns out a vicious circle. The insurance company does not pay, customers complain, the business is not developing.

Failure reasons

First you need to figure out why the insurance company (IC) does not pay compensation? Perhaps some clauses of the contract were violated. So, the most common causes of failure.

• Late or written notification of the occurrence of an insured event is a violation of the law. But the company can refuse on this basis only if it has not received the message at all or if the condition of the car has changed so much that it is not possible to determine the amount of damage. A phone call is easier to prove. It is enough to take a printout from the service provider. But this rule does not apply to cases where, after an accident, the client independently repaired the car.
• The damage mechanism does not comply with the conditions specified in the contract. This option is possible only for very busy people who do not have time for each scratch to contact the company. As a result, all minor damages are collected in a year and are given in one go. But in such cases, the insurance company does not pay, because they do not like this situation. To appeal the decision, it is enough to conduct an assessment of the damage by an independent expert. The court is most often interested in the fact of scratching itself, and not in the mechanism of their formation.
• The driver is not inscribed in CASCO. The price of car insurance is highly dependent on the number of drivers and their experience. And many customers are “crushed by a toad” to enter a second person into the policy. But the insurance company immediately has a reason to refuse to pay compensation, as there was an outsider driving. However, the Supreme Court of the Russian Federation does not accept such a refusal. Property is insured, not the people who manage it.
• The driver inscribed in the CASCO policy was drunk. This circumstance, from the perspective of the insurance company and the Supreme Court, is the basis for the refusal to pay compensation. Another thing is that in a country with such a level of corruption they can make anyone drunk. But you can still protect your rights. At the medical examination witnesses must be present. Everything that needs to be recorded on the camera. In the worst case, you should apply for a re-examination to another clinic.
• The car in which the keys and documents were located was stolen. In accordance with Art. 964 of the Civil Code of the Russian Federation, loss, theft of personal belongings and a registration card is not a reason for refusing to pay compensation.

These are the main reasons why the insurance company does not pay. But not all of them will be accepted by the court.

Option for Ukrainians

In this country, other legal provisions apply. There may be several reasons for the failure:

• The client is obliged to notify the occurrence of the insured event only in writing within three days. Calls with a corresponding message will not be accepted.
• Problems may arise if the client had an accident while riding a motorcycle, and the category “B” rights are prescribed in the policy.
• Drivers will have to indemnify themselves if it is proved that the cause of the accident was faulty headlights or lack of brake fluid.

This is just a small list of reasons why insurance does not pay for compulsory motor liability insurance.

Policy Nuances

Each owner of the vehicle must purchase a compulsory motor liability insurance policy. At the same time, many do not even think about choosing a company and buy it from agents on the street. But, as court practice has shown, the victim can receive compensation only in the insurance company. By acquiring a policy, a person does not insure his liability, but potential victims. But the entire amount paid by the UK may be requested from the culprit of the accident. But the CASCO policy insures damage to the vehicle.

Arbitrage practice

The number of claims that people file due to the fact that the insurance company does not pay does not decrease. But even more complaints about violation of the deadlines. Litigation begins after six months of waiting. The chance of winning the case is then 50:50. Such a situation is not clearly stated in the legislation.

The second most popular reason is expired policies. When an insured event occurs, the company declares that the specified form has long been written off as stolen. That is, payments will not be made on it. By the way, decent SKs post lists of such forms on the site. Another thing is that drivers rarely reconcile. According to the Motor Transport Bureau (MTIB), of the total number of policies in circulation, about 5% are overdue.

In Ukraine, the court often appeals to customers of bankrupt companies. But to no avail. Under the law, the Motor Transport Bureau (MTIBU) should deal with such cases. But the problem is that payments are made only after the liquidation of the UK. And this process can take several years.

Legal advice

The insurance company has 5 days after receiving a notice from the client in order to inspect the car and assess the amount of damage. Based on this analysis, an act is issued with the amount of compensation payable. Very rarely, this figure suits customers. Most often it is understated. What to do in this case?

Lawyers recommend that you turn to independent experts - they have permission to conduct an assessment of cars damaged in road accidents. The expert opinion has great legal force. It can be used in court.

But there are more severe cases. For example, if a company was taken away a license or it went bankrupt. In this case, the decision should be made by the Russian Union of Auto Insurers (RSA).

If the culprit of the accident does not have an insurance policy, then a claim can only be brought to him in court. This option is also allowed if the amount of damage exceeds the liability limit of the UK. For OSAGO policies concluded from 10/01/2014, the following restrictions apply: 400 thousand rubles. for damage to property, 160 thousand rubles for causing harm to health.

Other options

Under the new legislative norms, SK debt can be redeemed. A cession agreement is concluded between the victim and a third party. The client receives a certain amount immediately. But a certain percentage of the damage is transferred to a third party. This party will be engaged in litigation with the UK.

You can say as much as you like that the insurance indemnity does not want to pay the full amount of compensation, but in fact only 3 out of 10 clients go to court. A good way to save money on financially unprepared customers. If the insurance company has not paid the compensation, you need to get an independent examination, file a written claim with the bank account details and write a statement of claim 7 days later. In any case, you can’t do without consulting a specialized lawyer.

5 ways to take money

1. Write a claim in writing, indicating the essence of the problem.The company has 30 days to take action.
2. Complain to the Consumer Rights Protection Society. This organization must respond to the letter and visit the company with a check, the result of which is to inform the client. If the UK at least a little value their reputation, then such a measure should stir them up. Option did not work. Insurance does not pay. What to do in this case? Turn to higher structures.
3. Complain to the Financial Services Commission. This body issues an activity license to the UK. All applications are reviewed 15 days. But in order to complain to the Financial Services Commission, the client must have very good arguments.
4. If the insurance does not pay under CASCO, you can complain about it to the Motor Transport Bureau. The organization also accepts claims if the culprit is exempted from acquiring a policy (for example, a disabled person) or did not buy it at all.
5. Collapse in court is after exhausting all the previous options. But this is a complex process that requires money and patience.

Driver Algorithm

An insured event has occurred. Call the emergency service and wait for the police. In no case should you move the car from the scene of the accident. While waiting, fill out a notice in the free form for the UK.

Upon arrival of the police, you can start shooting on a mobile phone camera. The scene should show the place of an accident, the location of cars with state registration numbers, road markings, traffic lights, etc. Thus, you can protect yourself from the "chemistry" with references. If you can find two witnesses to the accident, get their contact details. Carefully read the documents in which you sign.

After registration, the victim should have a certificate of accident, a protocol and a decision indicating the guilty person.

Package of documents in the UK

• Passport.
• Power of attorney.
• Certificate of car registration.
• Driver's rights.
• Notification from the scene of an accident.
• Bank details of the victim.
• Invoices for expenses.
• Printed photos from the scene of the accident (if any).

Prepare copies of all submitted documents in advance. Write a statement and ask the SK employee to put a stamp on the application form. This must be done, otherwise it will be difficult to prove that you submitted the documents.

We rent the car for inspection in the UK. According to the results of the inspection, the act should indicate whether the details are subject to replacement or repair. If this mark is not, it is better not to sign the document and independently conduct an examination with an independent appraiser. It is advisable not to repair the car until the UK transfers the money.

According to the legislation, applications are considered 30 days. After this period, you can write a complaint to the Government with a message stating, for example, that the insurance “Consent” does not pay money.

Conclusion

Vehicle owners can have two types of policies: compulsory motor third-party liability insurance, CASCO - at will. In the first case, compensation should be paid to the victim, and in the second - to the person who signed the contract. How not to pay insurance premiums and not violate the law? It is enough to issue an insurance policy by paying a fixed rate once. But problems with the payment of benefits may arise for clients even with such policies. SK refuses to pay, citing various reasons, and sends the car for an expensive examination. What to do in this case? Get the opinion of an independent expert and complain to all authorities with this paper.