The insurance company does not pay for the claim. How to act when the insurance company does not pay for the CMTPL. We apply with a written claim

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What to do if the insurer does not respond to the application

If, after 20 days from the date of receipt by the insurer of the application for compensation for damage, the policyholder has not received a call to inspect the car or transfer funds, then it is necessary to act in accordance with the following algorithm.

Independent damage assessment

First of all, you should contact an independent specialist who will examine your damaged car and draw up a conclusion on the cost of its refurbishment.

You will have to pay for the services of an expert yourself.

The result of the examination will be a specific amount to be transferred to the victim from the insurance company.

If, in addition to damage to property, damage was caused to health, then it is also necessary to contact a medical organization to obtain an opinion on the state of health.

Refusal to pay

The law clearly specifies a list of cases in the presence of which the insurer has the right to refuse a person to compensate for material damage.

Among such regulatory legal acts, one can single out:

• Civil Code of the Russian Federation;
• Federal Law “On Compulsory Insurance of Civil Liability of Vehicle Owners”;
• the rules of compulsory insurance of civil liability of vehicle owners, approved by the regulation of the Bank of Russia dated September 19, 2014 No. 431-P (hereinafter referred to as the OSAGO Rules).

Based on the above acts, the insurer has the right to refuse compensation for damage in the following cases:

• the insurer doubts that the accident really took place, or it is impossible to determine the damage to be compensated. For example, this is possible when the victim repaired his damaged vehicle before the inspection of the IC;
• the perpetrator of the accident did not insure his civil liability in the prescribed manner;
• The accident occurred during the period when the existing CTP policy was invalid;
• the owner of the vehicle did not disclose all the information about the accident to the insurer;
• An accident occurred during training driving, auto racing, as well as in the case of testing new vehicle structures in the case when the competition or test took place in a place that is specially designated for this;
• the driver of the vehicle was found guilty of an accident;
• damage to the vehicle was caused at the time of loading the vehicle;
• as a result of an accident, harm was caused to the life or health of persons who are passengers, provided that such harm is compensated for on the basis of the rules in force in the case of compulsory life and health insurance when carrying out passenger transportation;
• as a result of an accident, damage was caused to cultural monuments and other items that are recognized by civil law as particularly valuable;
• the result of an accident is pollution of the environment.

The above list of cases is exhaustive. This means that refusal to pay in the presence of other circumstances is not allowed.

Violation of the term of payments

In addition to the unjustified refusal to pay material compensation, another violation of the law by insurance companies is a violation of the terms of payment of monetary compensation.

Important! According to the legislation on OSAGO, the following lists of terms are provided:

• 20 days from the date of receipt of the application for inspection of the vehicle and transfer of funds;
• 30 days, when the victim, as agreed, began the repair work, which is being carried out at the service station.

This period includes calendar days excluding holidays, which are officially established by labor legislation.

During this period, the insurance company transfers funds to the victim or sends a written reasoned refusal about the reasons for non-payment of funds. The refusal can be appealed against in court.

Watch the video. What to do if the insurance company does not pay for OSAGO:

Not paid enough

In addition to a complete refusal to pay material compensation, which is necessary for a damaged car, insurance companies underestimate the amount paid to the victim.

Attention! Therefore, the victim should be aware of the maximum amounts to be paid. So, in accordance with Art. 7 of the Federal Law "On OSAGO", the insurance company is obliged to pay cash in the following amounts:

• 400,000 rubles in the event that property damage is caused;
• 500,000 rubles in the event that damage was caused to the health or life of a person.

When the damage exceeds the indicated amounts, the victim has the right to apply directly to the culprit with a demand to recover the funds not received.

Compensation funds that are subject to compensation to the victim are determined by the insurer in the following ways:

• in accordance with the standards established by law. For example, when a person died as a result of an accident, the insurance company will reimburse his relatives for 475,000 rubles and expenses related to the funeral - 25,000 rubles;
• based on the results of the examination carried out by the insurance company.

As a rule, it is in the latter case that problems most often arise: the insurance company, realizing that damage is a rather subjective category, tries in every possible way to reduce the amount of funds that are paid to the victims.

In this case, the technique of undetected damage that was identified on the vehicle is used, and the UK tries to challenge the results of an independent examination.

Claim to the insurer

After receiving the results of the examination in the form of an opinion, it is necessary to draw up a pre-trial claim to the insurance company. This claim must contain information about the participants in the accident, the place of the accident, the civil liability insurance of each of the participants, as well as the amount of damage that is established by the conclusion.

In accordance with the law, the claim after receiving it by the insurer is considered within 10 days.

A claim should be sent by mail with a valuable letter with an inventory. Keep the shipment receipt.

Handing in the claim in person is allowed. In this case, you should ask the authorized employee to sign and date the second copy of the claim.

ATTENTION! View the completed pre-trial claim form with the insurance company:

Attention! Our qualified lawyers will assist you free of charge and around the clock on any questions.

Complaint to the RSA or the Central Bank of the Russian Federation

Since going to court implies waiting for a long period of time, lawyers recommend trying to resolve a legal dispute out of court first.

The victim with a complaint can apply to the following authorities:

• RSA (Russian Union of Auto Insurers). This authority accepts complaints from policyholders, and also assists in resolving disputes with insurers;

To apply, you must fill out an application, the form of which is standard for each of the listed authorities.

A list of documentary information received from the insurer should be attached to the application.

ATTENTION! View the completed PCA application form:

Procedure through the court

One of the ways to protect your rights is to file a statement of claim with a judicial authority.

The limitation period, during which the victim has the right to exercise the right to judicial protection, is 3 years from the date of the accident.

To file a claim, you must prepare:

• documents confirming the fact of an accident (notification of an accident, decisions issued by the traffic police);
• information received from the insurance company (responses to an application or claim).

Please note that the state fee for this category of cases is not charged to the plaintiff. The magistrate's court should be applied in the event that the amount of the claim is less than 50,000 rubles. In other cases, the statement of claim is submitted either to the district or to the city court, depending on where the plaintiff lives.

Sample statement of claim

The statement of claim must be in writing. It can be sent by letter or submitted in person through the office of the judicial authority.

In the process of drawing up a claim, a person must indicate exactly information about an accident, about participants in a road accident, information about insurance companies, as well as the amount of damage and the claimant's claim.

In addition to the claims and facts about the accident, it is advisable for the plaintiff to refer to the regulatory framework that was violated by the insured.

Attention! The following list of documentation must be attached to the statement of claim:

• a copy of the statement of claim in accordance with the number of persons who are involved in the process;
• accident documents;
• application and claim to the insurance company;
• examination results.

ATTENTION! View the completed insurance claim claim form:

Unfortunately, in our time, situations of the following type are often encountered: a client pays for insurance with a maximum list of insured events, thereby hoping to completely protect himself. However, in reality it turns out completely differently: the client was injured or damaged property, turned to the insurance company with a request to pay for the damage caused by someone, but the insurance company refused to pay. How to proceed in this situation? Accept and no longer use the services of insurance companies or seek payment in court?

To begin with, it is worth understanding the reasons for the refusal (they are the ones that allow the insurer not to pay customers money). All grounds must be consistent with the Civil Code. It also contains "non-insurance" cases.

The following reasons are considered to be the main ones:

• the culprit does not have an insurance policy;
• the keys were forgotten in a stolen vehicle;
• the insurance company has not received the funds from the insurance agent;
• the maximum possible limitation period of the case has expired;
• documents submitted to the insurance company have errors in execution.

However, do not rejoice: you should always remember that insurance companies are very creative in choosing the reasons for refusal (which cannot be included in one list).

What to do if the insurance company refuses to pay for an insured event

When an insured event occurs, the owner of the vehicle goes to the insurer with a statement, which indicates a request for the return of funds as compensation for compulsory motor third party liability insurance for the damage caused. But the client does not always receive these funds: the insurance company does not pay for OSAGO quite often.

Important! The registration of the refusal also matters: it is drawn up in writing using the official bank of the company. In addition, the presence of arguments that influenced the adoption of this decision is mandatory.

If the client doubts the legality of the firm's decision, then he needs to carefully double-check the argumentation and conditions of the case (in practice, there are often cases of inconsistency between the company's internal rules and legal norms). If the conditions turn out to be unlawful, then the client will definitely win the case.

Often the company refuses payments due to errors in the documentation. This inaccuracy is easiest to correct: you just need to come to the insurer and correct every mistake in the documents, or bring the missing papers.

If the company recognizes the incident as a non-insured event, then the client has the right to resolve the case in court, or contact the RSA and the Central Bank of the Russian Federation.

If the insurer does not give an answer within 20 days (this period is necessarily prescribed in the contract), then the car owner must independently conduct an independent examination, indicating the presence of damage to the vehicle (the expense for the examination is also included in the documents when applying to the courts). If there is a need, then you need to contact a medical facility, where experts will assess the harm caused to life or health.

1. clearly stated facts about the incident;
2. the amount of damage caused;
3. instructions for contacting the RSA, the Central Bank of the Russian Federation and the courts in the absence of a response within 7-10 days.

Should I go to court? If you still have not received an acceptable response from the company, then feel free to resort to creating a lawsuit. In it, the client will be the plaintiff and the company will be the defendant.

The plaintiff is obliged to write a statement of claim to which I will be attached.

• Certified copy of each document provided to the company.
• The conclusion of independent experts, indicating the presence of moral and material damage.
• A copy of the claim filed with the insurance company and the company's response to it.

If the court decides that the plaintiff is right, the insurer will be obliged to pay him not only full compensation for OSAGO, but also a 50% fine, to which all the costs of the trial will be added.

How to avoid insurance company rejection

To reduce the likelihood of refusal to pay, you must follow the following list of actions.

1. The company should find out about the insured event. It is best to inform your insurer of all information immediately: this will not only help you to meet deadlines, but also help the company to independently understand the incident.

   Remember! All terms are spelled out in contracts (usually they range from 30 to 90 days). After this period, the insurance must send a written notice of its decision.

2. Collection of documentation. According to the legislation, it is necessary to prove all the circumstances of the case by submitting documentation. Always hand over the documents personally, making a stamp on the remaining copies confirming the acceptance of the documents - this will not allow insurers to “lose” your documents. If circumstances do not allow the transfer of papers from hand to hand, then send them using the mail or transport company (be sure to save the receipt and receipt of dispatch).
3. Call your insurers more often. If you are in doubt about the productivity of the insurers, be sure to call them, thereby monitoring the progress of the case. That being said, don't just ask general questions, but ask for detailed and clear explanations.
4. Don't be afraid to meet with the boss; it’s the boss that will force the negligent to get to work right away. This is directly related to the position of workplaces in the company: above each branch director, there are a number of high-ranking officials who will easily dismiss any of those lower in the career ladder due to reasons such as: the lost image of the company;
   failure to comply with the interests of the organization.
5. Submit complaints.If the slightest infringement of your rights, write complaints (filing a complaint must be documented in accordance with all the rules) so that the insurer responds to them in writing.
6. Write to other authorities. If you think that the insurance company does not fulfill its obligations well, then do not hesitate to submit written complaints to: the prosecutor's office;
   consumer protection service;
   Financial Services Market Regulatory Commission;
   interregional unions protecting the rights of the policyholder;
   If you are able to explain any of the above services to the current situation, they will come to the insurance company with inspections, thereby forcing insurers not only to fulfill their direct responsibilities, but also to present a huge number of documents.
7. Express your opinion. Do not hesitate and post in one of the blogs in your city a question from the series "the insurance company does not pay what to do." With due luck, you can find several people with similar problems and give a joint interview to one of the local TV channels or one of the most popular newspapers: usually insurers do not like the appearance of negative information about their own company, preferring to agree to virtually any client's terms.
8. Don't be afraid of lawsuits.

   Remember! For the most successful presentation in court, it is required to collect a large number of documents: certificates, papers, characteristics, letters, and so on. Every word in a lawsuit must be supported by evidence.

   In addition, the best solution is to use the help of a professional lawyer specializing in such cases (do not forget to attach invoices for legal services to the application).

The insurance company does not pay for CASCO: assistance of an auto lawyer without prepayment

As you know, each problem requires an individual approach. There is no exception, and the problem called "the insurance company does not pay for CASCO." What to do? Use the services of a lawyer.

An experienced specialist will offer a comprehensive solution to the problem, using several types of documents for this:

• claim against the insurer;
• statement of claim to the court;
• a complaint to the FSF;
• a complaint to the RCC;
• other documents.

In addition, an experienced specialist will help you build the most correct line of accusation and behavior during the entire trial.

Does the insurance company not pay for OSAGO? This situation is not uncommon in our country. According to statistics, almost every second victim is not paid insurance compensation, or the amount of payment is underestimated, and the fact that insurers do not meet the statutory deadline is not even worth mentioning, this is almost a rule. If the insurance company has not paid for OSAGO, do not be discouraged, but start acting immediately and decisively. It is much more profitable to receive insurance compensation through the court. In addition to insurance, you will receive a fine of up to 50% of the amounts recovered, a forfeit, moral damage, and the payment for the services of a lawyer and an expert will be reimbursed.

So, we start to act. First, it needs to be independently evaluated by an expert technician. In about a week, send a telegram to the insurer notifying the date, place and time of the independent examination. Ask the experts questions: "What damage were received as a result of this accident?" Ask the expert to prepare an opinion in duplicate.

After the examination is ready, you should write a pre-trial claim. Submission of a pre-trial claim is a mandatory procedure provided for by the legislation of the Russian Federation. Without this procedure, the court will not accept your statement of claim for proceedings. The claim is written in free form, the only requirement is to indicate your bank details. Attach your expertise to it, you can just submit a copy of the expertise, submit in duplicate, put a mark on one of the claims received by the insurer and wait for payment within 7 days.

Insurers usually do not respond to this document. While you wait, you can already start preparing a statement of claim to the court. Now the Internet is simply littered with samples of claims for the recovery of insurance compensation, and you can independently defend your interests in court. But it takes a lot of time to independently represent interests in court and, moreover, you will certainly come across "pitfalls" that are not so easy for an ordinary person to bypass. The first thing that will surprise you is the huge queue at the court, hearings never start on time, and sitting outside a judge's door for three hours is a common thing for lawyers. Also, insurers in various ways are trying to delay the case and set various "traps". Therefore, in order to save your nerves and time, it is better to turn to professional lawyers.

Features of the procedure for filing a claim with the court

In fact, the process from filing a claim to receiving funds takes two to four months. If the defendant applies for the appointment of a forensic examination, then this is another plus month. Within 30 days, a court decision comes into force, then, on average, a writ of execution is made within two weeks.

After you receive the writ of execution, you can transfer it to the bailiffs, or to the bank where the insurer's bank account is opened. The application for the recovery of the awarded amounts is written in strict accordance with the Federal Law “On Enforcement Proceedings”. The application must be prepared in two copies, one is submitted to the bank, and the second is marked with a receipt. Within three working days, you will receive funds to the specified account.

What if the insurance company did not pay on time for OSAGO?

The Law on MTPL of 01.10.2015 provides for a penalty for failure to comply with the deadline for the insurance payment, which is determined at the rate of 1 percent for each day of delay from the amount of insurance compensation payable to the victim for a specific insured event, minus the amounts paid by the insurance company voluntarily in the manner established by Article 12 of the Law on MTPL.

The penalty is calculated from the day following the day established for making a decision on the payment of insurance compensation, and until the day the insurer actually fulfills the obligation under the contract.

For example, the amount of damage including depreciation is 100,000 rubles. The delay is 45 days. 1% of 100,000 rubles is 1,000 rubles. Calculation: 45 days * 1,000 rubles = 45,000 rubles forfeit.

When buying a car and for its further use, we are definitely advised to insure it in order to receive some compensation in case of an accident. As soon as an insured event arises, the insurance company does not always "happily" try to pay the injured party the required compensation. Why does the insurance company not pay for the CMTPL? How to get insurance companies to fulfill their immediate obligations? You can find answers to this and other questions in this article.

If you find yourself in a situation related to the reluctance of the insurance organization to fulfill its immediate obligations to pay the due compensations, both CASCO and OSAGO, then you should take special measures to help protect your interests and the family budget. Most often, in such situations, insurance agents try to minimize the payments due to the client, or not issue them at all. This is a familiar story for most insurance providers and their clients.

Council number 1! If you find yourself in a similar situation, you should not pointlessly demand the due payments from insurance agents, but seek help from a legal office.

The help of a competent lawyer is most often able to force a negligent company to fulfill its immediate obligations. In our country, many law offices have been opened, which provide legal advice services on a free basis, which is quite popular among the population today. Especially if the client has applied to this office for the first time. Based on this, we can conclude that only an experienced professional in the legal field is able to force a company to provide the required compensation to its citizens.

Contacting a legal organization will help you determine the legality of the actions of the insurance company and find the very grounds on which you can "push it against the wall."

After the lawyer points out to the client some "levers" by acting on which it is possible to force the insurance company to fulfill its debt, the injured party itself determines the strategy of its next actions. In many cases, clients completely transfer the entire case to the specialists of the legal office to resolve the conflict that has arisen. This behavior of the client is noticed if the insurance company does not pay for the insurance company either.

How to behave in case of non-payment of insurance CASCO?

When employees of the insurance company refuse to pay compensation to their client, according to the CASCO policy, it is necessary to require a reasoned refusal in writing on paper. Such a paper will be a strong argument for the trial. The reasons for the refusal of the insurance company to pay the due funds may be:

• unreasonable examination;
• lack of important securities;
• doubts of insurance agents about the details of the insurance accident;
• refusal without explanation.

Such situations are the initiators of the necessary legal proceedings. When insurance agents require additional certificates or other papers from the client, there is some delay in the client's appeal to the court.

But it is worth taking into account the fact that there is a certain period of limitation of actions. According to this period, all claims and cases of violation of CASCO payments should be considered within the first two years, as soon as an insured event occurs. Based on this, it can be concluded that if after six months from the date of the insured event, no payments have been received from the insurance company, then most likely it is not worth waiting for them, but you should go to this organization yourself. It will be possible to force negligent employees to provide the due payments only through legal proceedings.

And if the insurance company does not pay for the CTP, what to do? In the event that the insurer refuses to make the required compensation to the client under OSAGO, it is also necessary to take from him a written refusal on paper with an explanation of the reasons.

When the insurance company does not pay for the CTP, the procedure should be as follows: a written refusal is taken and, on the basis of it, a statement of claim is written to the court. In this case, you can go to court if the due payments have not been received within the first month from the date the client receives the necessary papers.

Even when the insurance company refuses to pay for the CMTPL, citing minor inaccuracies in paperwork, experienced lawyers will be able to force it to fulfill its obligations to citizens. Sometimes employees of insurance companies can provide standard unsubscriptions in cases of unjustified non-payment of the due compensation. In this situation, experienced lawyers immediately refer the case for further proceedings to the judicial authorities, thereby bringing the insurer to the due responsibility.

There are frequent cases associated with non-payment of the required compensation to the client for an insured event due to the existing legal basis. Such a case is the moment associated with not establishing the true culprit of the accident. For example, administrative proceedings may be closed due to sharp differences in eyewitness testimony with drivers. Such cases require immediate appeal to the courts for further investigation.

Council number 2! When insuring a car, it is advisable to give it to employees of the insurance company for additional inspection. Such actions will save you from the appearance of unnecessary doubts on the part of the insurer when it is necessary to pay compensation or in court proceedings.

To find out the truth of your position if you have not received compensation from the insurer, you can use a free legal consultation in any relevant organization. Doing this will save you time, health, and money.

The insurance company underestimates the amount of payments. What actions to take?

In many cases, negligent insurers try in every possible way to cut the payments to customers due to an insured event. If the insurance company does not pay for the CMTPL comprehensively, the procedure should be as follows: first, you need to deal with the existing situation. The situation when the insurer cuts the due payments occurs when questions arise about the results of technical expertise. The insurer has the right to determine the place where the vehicle undergoes technical expertise. This means that when the required compensation is reduced, one can refer to the resulting calculation of the experts of the insurance company, which consists of:

• the cost of spare parts;
• evaluation of the work performed;
• percentage of wear of replaced auto parts;
• the general condition of the car and other things.

Of course, the employees of the insurance company carry out such calculations with their due benefit.
Many lawyers recommend carrying out repair work on your car after an accident only when the insurer pays the required compensation. If you receive a much smaller amount of the expected compensation, it is worth involving a team of independent experts in the assessment of the work. To carry out such an examination, the initiator of the accident on the road with his insurer should be invited.

It is in your rights to submit a pre-trial written claim, which concerns the underestimation of the due compensation from the insurer. Such a statement will be a plus for you at the trial, since you can rely on it as an excuse to submit documents for further proceedings.

Submitting an application to the court gives the victim the right to receive, in addition to the payments due for the insured event, compensation for material damage in the form of an additional amount. If you succeed in winning this case, the insurer will have to carry out the compulsory MTPL payment due to you in an increased amount. A plus to this is the payment of all legal costs by him, as well as payment for the examination performed.

When you receive a small payment for OSAGO, you are given the full right to collect the due interest from the unscrupulous insurer. This provision is enshrined in paragraph 1 of Article 395 of the Civil Code of the Russian Federation.

The car owner should focus on the fact that such situations often end up with an independent appeal of the client to the court. A special representative is supposed to protect your interests at such a meeting. It is extremely difficult to "bring the insurer to clean water" independently without the help of an experienced lawyer. Therefore, in such situations, it is best to entrust your case to an experienced lawyer who knows all the legal intricacies and will easily sue you for the payments.

Documents required for filing a claim with the insurance company

To file a claim for non-payment of the due compensation from the insurance company to the court, you need to collect the following package of papers.

1. A copy of all papers that confirm the existence of an insured event. This includes the relevant regulations, protocols, certificates, papers from the traffic police, or a notice filled in by both parties to the accident.
2. A copy of the paper that confirms the submitted claim for damage to the insurer.
3. Reporting form confirming an independent examination of the determination of the cost of damage caused to the car due to the accident.
4. Statement of claim.
5. Copies with originals of receipts and receipts confirming the expense paid.

Of course, if the driver, after the accident, repaired his car himself for his own money during the first month, hoping to subsequently receive the due payments from the insurer, then it is highly likely that he will not receive them. Such an independent restoration of the vehicle deprives the car owner of the chance to conduct an independent expert assessment of the damage caused to the car in the event that the insurer does not pay the due amount to the client within the first month.

Payments may not be made by the insurance company if it is impossible to conduct an examination of the damaged machine by independent expert organizations due to the fact that it has already been repaired and brought to perfect condition. Therefore, it is practically impossible to calculate the damage received by the client in this case.

Such a case provides only for the provision of a work order from the service center, where the auto repair work was provided. One has only to take into account that not always provided documents from such organizations are taken into account by insurers for the implementation of OSAGO payments.

The reason for this rejection of securities by the insurance organization is the action of the methodological guide, which determines the true cost of standard hours for a motor vehicle. In this case, the normal wear and tear of the machine with its general technical condition at the time of its presentation for examination is taken into account. Experienced lawyers and lawyers recommend that if you get into an accident, do not take up auto repairs yourself, but wait for the due payments from the insurer.

When a car owner, valuing his own time, starts to repair a car without receiving payments from the insurer, before starting the restoration work, contact independent experts and conduct an examination with them at their own expense. After that, the car owner should wait for the results of the examination in the form of a report and only then send the vehicle for repair.

What to do if the insurance company refuses to pay for OSAGO?

To get acquainted with the procedure for the unwillingness of the insurance company in the event of an insured event to pay the required compensation, you should watch this video.

The problem when the insurance company does not pay for OSAGO is familiar to many car owners firsthand. That is why in such a case there is a certain order of recommended actions, following which, depending on the "obstinacy" of the insurer, you can get what you want with more or less time: compensation for damage after an accident.

The insurance company issued a refusal for OSAGO

When an accident has occurred, according to the Law "On MTPL", as well as following the letter of the insurance contract, the policyholder must submit an application to the insurer's office for material compensation for the damage received. And although under the insurance contract the answer must be payment, in practice, clients often receive a refusal in one form or another. For this document, the following rules are required:

• Refusal is issued only in writing on a letterhead;
• The insurer is obliged to list the reasons for the refusal.

If the actions of the insurer are in doubt, it is necessary to very carefully check the compliance of the reasons indicated in the refusal with the law. Contradictions are much more common than commonly believed. However, when the clauses of the contract are contrary to the law, the priority belongs to the law and not to the insurance company. The client can point to the contract as much as he wants, but any contradictions in it with the current legislation are automatically sent by the parties to the articles of the Law "On OSAGO" on all controversial issues. The law specifies a limited number of reasons why the insurer may nevertheless refuse to pay a client for compulsory motor third party liability insurance:

• The absence of any documents from among those that the insured must transfer to the insurer after the accident together with the application (the list includes about 15 documents);
• Errors in the provided data;
• Non-recognition of the accident as an insured event.

The first two reasons are fixable, the car owner can bring the missing papers and correct the identified errors. If the insurer points to a third reason, then the dispute can be resolved in court, in the PCA, as well as through the Central Bank of the Russian Federation.

Procedure

The insurer does not respond to the application

When, 20 days after the submission to the insurer of an application for the occurrence of an insured event, the client does not receive any response, the time comes for the following actions.

Independent damage assessment

You can get an expert's opinion by concluding an agreement for the provision of such a service in a specialized firm. You will have to pay for such an examination yourself. As a result, the conclusion will indicate: what damage was caused to the car. For any instance, including the court, the document will have the force of proof. If not only the car but also the passengers was injured as a result of an accident, then an additional assessment of the damage to the health of the victims will be required.

Claim to the insurer

In a written claim, the client of the insurance company sets out all the important facts about the accident that occurred, how the damage was calculated, and also indicates that if the insurer refuses to pay the due compensation, then an appeal will follow to the RSA, the Central Bank of the Russian Federation or to the court 10 days after the delivery of this claims. The claim should be handed over to an authorized person in person at the office against signature or sent by registered mail with a notification and an inventory to the insurer.

Complaint to the RSA or the Central Bank of the Russian Federation

Since any court takes a long time to obtain a decision, you should first try to resolve the dispute with the insurer out of court. The policyholder can be contacted at:

• Russian Union of Auto Insurers (PCA), which receives complaints from clients of insurance companies and helps them resolve the dispute that has arisen;
• The Insurance Market Department of the Central Bank of the Russian Federation performs the same function.

The application form submitted to both authorities is unified, while the policyholder provides his personal and contact information. To save time on correspondence, it is better to immediately attach to the application copies of documents related to the merits of the dispute in question with the insurer.

Going to court

In a situation where the insured is not satisfied with the results of appeals to the authorities, the last resort remains - to file a statement of claim in court. An experienced insurance lawyer will help to formulate the claim, correctly state the essence of the insurance dispute, and also support the document with all the necessary evidence. The standard list of applications for claims of this kind includes:

• Copies of all those documents that the plaintiff attached to the claim against the insurer;
• Expertise of damage to the car and / or health of the victims;
• The insurer's response to the claim.

A positive court decision will oblige the insurer to pay the plaintiff the full amount of compensation, as well as a fine of 50% of this amount and compensation for all legal costs. That is why it can be argued that it is possible to obtain the due payments from the insurer if there is complete confidence in the legality of the claim. The insured will have to prove his own innocence on his own, but there are specialized departments to help him and, in extreme cases, the court.

If you still have questions or need professional help, then our online lawyer on duty is ready to promptly help you understand your specific case.