Loss settlement is the activity of insurers in preparing an insurance act. Insurance payments are made on the basis of an application and an insurance act. Subject to all documentation requirements, as well as after an adequate assessment of the situation, a decision is made on the insurance payment, its amount or that such payment should be refused.
Insurance Event Notification
First of all, the insured receives a notice of the occurrence of the insured event, but in those cases when he has insured the interests of others, the insured person also. They both must notify the insurer of this, informing him of all the known circumstances of the situation. This happens by submitting a statement, sometimes called a claim to the insurer. If the policyholder fails to notify the insurer within the terms of the contract, he may be denied the payment of insurance funds and the settlement of losses. Such terms are usually specified in the contract and do not constitute too long periods of time. The most common example is car insurance, where the insurer's notice period is 1-2 days from the time of the accident. And if, for example, an accident occurred on a highway, the policyholder does not always succeed in meeting these deadlines and the settlement of insurance losses may not occur.
The earlier the better
The insurer should receive such notice as early as possible. This is done so that he has the opportunity to prepare for payment, and since his financial assets can be placed in the form of securities or foreign currency, he will need time to realize the payment to the insured. Another reason why you need to immediately inform the insurer about the insured event is that he could carry out a loss settlement by all possible means.
Reduction of losses from an insured event
The settlement of losses in the direction of reduction is the direct responsibility of the insured at the time of the insured event, and in order to fulfill this obligation he must take all possible measures. For example, if a fire occurs, he is obliged to immediately call the fire service and try to put it out on his own. If the theft has occurred, his task is to report it to the police. In an accident, if the car is badly damaged and transportation is not possible, provide security measures so that in its absence there are no additional negative incidents when, for example, third parties can remove expensive auto parts from it. The loss settlement center in St. Petersburg works very smoothly. It provides individuals and legal entities with legal fact-finding services, consumer protection, and debt and loss recovery. The center is located on Startovaya Street 8. The institution's working hours: Monday-Friday - 10.00-19.00, Saturday - 10.00-16.00.
From this we can conclude that the most important principle of insurance is the interaction of the insured with the insurers, when the actions of both should be carried out exclusively in the interests of each other. Here it is necessary to understand that well-coordinated work provides guarantees of a successful resolution of the situation for both parties. If an insured event occurs, the loss settlement office for each company engaged in such activities is different, and you need to contact it directly.
Reinsurance
Reinsurance is such a case when the insurer insures its own interests that are related to cash payments to policyholders, because the insured event involves damage to the property of the insurer. And such interests can be insured with a reinsurance contract. This is done taking into account the fact that in cases when the insurance payment is too high, it can be divided into several insurers. However, only one insurer who was originally involved in this insurance will still be liable for such a payment.
Insurance investigation
The insurance payment takes place only when the interests of the insured have been inflicted real harm. Therefore, it is necessary for both himself and the insurer to know for sure whether such a case is insurance and whether the insured interests actually suffered as a result of such an event. The interest of the insurer here is expressed in not paying extra funds if in reality the insured event did not occur or it occurred, but did not cause real harm to the interests of the insurer. This is important because in some cases he will have to assert his rights in court if he is denied the proper payment. By the way, the settlement of losses with VSK (the Military Insurance Company) seems to be a great way out, however, despite the fact that VSK is one of the largest companies in this field, problems arise, such as understating payments and refusing them or deliberate delay.
Subrogation Assurance
Subrogation is a kind of transition to the insurer from the insurer of the right to claim compensation for harm from the person due to which this harm occurred. In such cases, the requirement for the policyholder to take such actions as he would have taken if insurance coverage did not exist at all is obvious. In the event of an insured event, the policyholder is obliged to remember that by no means should he block the subrogation of the insurer with his actions.
There are so-called potentially dangerous actions during subrogation. These actions include:
- Any actions that may be assessed as the insurer's refusal of his own claims against the perpetrator of the damage
- Transfer of such claims to any other person, for example, as a concession to the claim.
- Actions that extend the process of settlement of losses, thereby affecting the insurance period. Despite the fact that the main statute of limitations is 3 years, there are cases when it is much lower - sometimes even only 3 months.
In a word, subrogation, which, as a rule, is only the problem of the insurer, actually becomes the problem of the insured.
How and when is the insurer obligated to pay?
Insurance compensation
In property insurance, payment usually occurs at a time, immediately after the insured event. It is called substitution, that is, a payment that compensates for the damage caused to the property. It often happens that the insurer does not have the necessary funds for such a payment, and begins to reinsure interest with other reinsurers. Sometimes it happens that he pays the entire amount on his own, and then receives the amount that he had previously reinsured. There are also cases when he, unable to make a payment at a time, pays money in installments. So often there is a settlement of losses in St. Petersburg.
Insurance coverage
In cases of personal insurance, all necessary payments are called collateral, which distinguishes this method from property, when they are called reimbursements. This difference in names is directly related to the difference in the nature and direction of payments. This is due to the fact that property damage is usually valued in money, and in personal insurance - not always.Here it is more about the insured person being able to receive funds in case certain events occur in his life.
With personal insurance, payments can be of two types. These are regular, which occur during a certain period, and one-time. Regular payments, as a rule, take place in health and life insurance, and they are usually called annuities. They are usually paid on a monthly or quarterly basis. They can also be urgent or lifelong, delayed or immediate, etc. What else involves the settlement of losses in St. Petersburg?
Payment term and liability of the insurer for delay
The insurance contract always indicates the period during which the insurer agrees to make payments to the insured person. But there are cases when the deadline for fulfillment of an obligation is not specified in the contract and is not described in any other normative act. In this case, such a period is determined in accordance with the provisions of the Civil Code. Most often, such a period does not exceed seven days from the moment the insured event occurs.
However, in a mass of situations, insurers believe that they are entitled to insurance payment from the moment of filing an application. According to the law, if the terms are not agreed in advance and within seven days the insurer has not fulfilled the obligation to pay the funds, the policyholder has the full right to apply to the court with a requirement to immediately make such payments. But if certain dates are specified in the contract, you must first wait for their expiration.
Write letters
In order to correctly meet the deadlines, the policyholder must send the insurer all the necessary written requests. This is done by mail, by sending a registered letter of receipt of delivery. Such notification arrives to the policyholder at the time of receipt of the registered letter by the insurer. He may also apply to the office of the insurance organization. Only here it will be necessary to strictly control the date of writing such a statement. Naturally, this is done only when the exact terms of the insurance payment are not specified in the contract. And the insurer, which did not make such payment on time, will be punished with a fine.
Who is adjuster?
The insurer may engage an independent intermediary, that is, an adjuster, who will represent the insured party in relations with the company. Settlement of losses requires control. In this case, violation of the rights of the insured is not allowed. Therefore, in some cases, this subject is necessary.