What to do if the insurance company doesn't pay? The insurance company does not pay for compulsory motor insurance, the insurance company is delaying payments. The insurance company does not pay for compulsory motor insurance.

In many cases the insurance company doesn't pay or refuses in payment By OSAGO or CASCO for the damage caused.

If the period allotted by the insurance rules for payment has passed, and the insurance company does not pay or refuses to pay compensation without serious grounds, then it’s time to go to court.

The most ineffective way to force the insurer to pay is to write complaints to the RSA (Russian Union of Auto Insurers) and the FSSN (Federal Insurance Supervision Service). The answer that you will receive from these organizations will boil down to the following - “Thank you for your appeal, if you believe that your rights have been violated, go to court.”

A lawsuit with the insurance company is the most effective way to get all the money in case of underestimation, refusal or delay in payment. If you want quick money from your insurance without going to court, contact us - we will pay for your insurance.

Typically, the insurance company does not want to pay and takes a defensive position, which is expressed in the following:

1. Ignoring your statements and pre-trial claims
2. Failure of an insurance company representative to appear in court
3. Delaying the trial for various reasons
4. Failure to comply with a court decision that has entered into legal force
5. Appealing a court decision

Procedure if the insurance company refuses to pay:

Before going to court, you mustconduct an independent examination to assess the damage (if you haven't done it yet). If the case ends in your favor, the insurance company will be required to reimburse the cost of the examination.

The court must be filed at the place of registration of the insurance company or its branch (depending on where the contract was concluded). This location does not always coincide with what is specified in the policy. If the amount of the claim is less than 50,000 rubles, the case will be considered by a magistrate, if more than 50,000 rubles. - regional. To file a claim, you must pay a state fee, which depends on the amount of the claim.

The claim must (either independently orwith the help of a lawyer) state the circumstances of the case and indicate its essence - a list of rights that, in your opinion, were violated, as well as those grounds on which the court should make a decision in your favor, i.e. evidence of violation of rights.

The claim with attachments can be sent to the court by mail or brought to the judge yourself at the time appointed in court for working with visitors.

After filing a claim, wait about a month for the first preliminary hearing to be scheduled. After the preliminary hearing, the main hearing in the case is scheduled, at which you need to competently explain your reasons to the judge in order to quickly win the trial.

• Your costs for a lawyer, as well as payment for a power of attorney, examination, and state duty will be returned to you if you win.

• This is beneficial because your participation will be minimal; you will only need to transfer a power of attorney to represent your interests in court.

• In addition, we give a guarantee - we will win the case or return the money.

Problems with obtaining compensation under compulsory motor liability insurance can arise for various reasons. If the company does not pay due to non-recognition of the insured event, the issue is resolved through the court. When an insurance company forgets about clients due to license revocation or lack of finances, you need to write to the Union of Auto Insurers.

The reasons why an insurance company does not pay for compulsory motor liability insurance may be different. In some cases, applicants are refused payment, in others they complain about underpayment, in others they complain about the lack of any actions, answers, or explanations to requests. Let's look at three situations that are often encountered in practice:

1. compensation is not paid because the insured event is not recognized;
2. the insurance company's license has been revoked or it is in bankruptcy;
3. the company pays money, but the amount does not cover the actual damage.

Let us immediately note that the third reason is by far the leader among claims against insurance companies, and therefore we will consider in more detail how to effectively recover the underpaid amount of compensation.

What types of road accidents are not indemnified under compulsory motor liability insurance?

The insurance company has the right to refuse to pay for expenses after an accident if the case is not recognized as insured (Article 6, No. 40-FZ, 04/25/2002). The main condition for the occurrence of a risk under compulsory car insurance is damage caused by the driver. According to the law, the liability of a person, not a vehicle, is insured (for this purpose - CASCO). Therefore, if your car is scratched in a parking lot, or an advertising sign falls on it, they will refuse to compensate you for the damage. The same applies to the following incidents:

• the policy was issued for one car, and the person responsible for the accident was driving another;
• the damage was caused by the cargo and not the vehicle (carrier's responsibility);
• the damage was caused during competitions, training driving on the race track;
• damage occurred due to environmental pollution;
• the damage was sustained during loading or unloading at the impound lot.

If you do not agree with the decision of the Investigative Committee, you can challenge it only through the court.

How to get a refund if the insurance company is liquidated

If you contact the insurance company using the details specified in the policy, and do not find it on site, no one answers your calls - you need to look for information about it in open sources. It is possible that the company is undergoing bankruptcy proceedings or its license has been revoked.

In such cases, you must apply for compensation under compulsory motor liability insurance to RSA - Russian Union of Auto Insurers (http://www.autoins.ru/). It is a registered professional association that maintains a reserve fund and makes compensation payments when its members are unable to fulfill their obligations.

Compensation is paid in the following cases (Article 18, Law No. 40-FZ, 04/25/2002):

1. if the damage was caused only to property (car), then compensation is due upon revocation of the license and bankruptcy of the insurer;
2. when people have suffered (their health or life) - the first two grounds are added to: the guilty driver does not have a compulsory motor liability insurance policy and damage was caused by an unidentified car owner.

The circulation period is limited to 3 years. If the decision is positive, compensation is paid within the legal limit: 500 thousand rubles.

How to recover an underpaid amount for car repairs

In most cases, car owners are faced with the fact that the amount credited to their account is half that which an independent appraiser or service station estimated the repair at. Since 2012, all disputes with insurance companies are considered by the courts according to the consumer rights law. Money not paid on time is considered a violation of the contract, and for each day of delay there is a penalty, a fine of 50% of the amount of underpayment and a penalty. In addition, the plaintiff does not pay the state fee, and the insurance company pays all legal costs.

You can do everything yourself: from writing a claim to submitting a writ of execution to the bailiff. But it is much easier and more profitable to use the services of professionals. The scheme is simple and proven. Let's explain it with an example.

09/11/2015 - an accident occurred;

09/15/2015 - the victim submitted an application, determination and certificate from the traffic police to Rosgosstrakh;

09/21/205 - 40,400 rubles were credited to the applicant’s account;

09/22/2016 - the victim entered into an agreement on behalf with a law firm.

According to the agreement, the lawyers agreed to:

1. write a claim - 3,000 rubles;
2. provide consultation - 1,000 rubles;
3. write a statement of claim to the court - 3,000 rubles;
4. participate in a court hearing - 3,000 rubles;
5. conduct an independent assessment - 7,000 rubles:
6. conduct an examination of the technical property value (loss of marketable value) - 4,000 rubles.

The client must pay from funds transferred by the insurance company. As a result:

11/02/2015 - 30,000 rubles were credited to the account, of which 11,000 were transferred by the car owner for examination services, 19,000 rubles. - made an additional payment for repairs. Thus, the amount of the independent assessment was 32% more. Then the lawyers already worked for themselves. The legal costs (10,000 rubles) were received by the client only on March 16, 2015, and he gave his honestly earned money to the lawyers.

All technical specialists are required to work according to the same rules approved by the Central Bank (Regulations of the Bank of Russia dated September 19, 2014 N 431-P “On the rules of compulsory insurance of civil liability of vehicle owners” (with amendments and additions). However, an interested independent mechanic finds weak points insurers.

It happens that the insurer refuses to compensate the victim of an accident for the harm caused, and sometimes a negative response to the application is justified. In other cases, losses are not compensated under false pretexts. Injustice must be fought, but not all motorists know how to do this. Read the article about what to do when the insurance company does not pay for compulsory motor liability insurance and what the procedure is.

There are several legal reasons not to compensate for damages from an accident. All of them are listed in the Civil Code of the Russian Federation, the Law on Compulsory Motor Liability Insurance, and the rules for compulsory motor vehicle insurance from the Bank of the Russian Federation:

• the vehicle was not damaged as a result of an accident, that is, no insured event was recorded;
• it is impossible to determine the damage caused, since the owner repaired the car before inspection or examination;
• the driver's civil liability was not insured;
• the accident occurred when the policy was not in force;
• the owner did not report her to the company;
• he is trying to obtain compensation from the insurer for benefits lost due to the accident or moral damage;
• the car owner did not provide the car for inspection or organized by the insurer;
• the accident occurred during training driving, auto racing that did not take place on public roads;
• the damage consists of a negative impact on nature;

• the damage to the car was caused due to the characteristics of the cargo, insured under other rules, during its transportation or loading;
• the driver of the wrecked car was found guilty of the accident;
• the damage was caused under circumstances covered by another type of insurance;
• during an accident, cultural monuments, antiques, and church valuables that are not covered by compulsory motor liability insurance were damaged;
• the documents provided to the insurer turned out to be false, incorrectly executed, or the driver refuses to present any of them.

The situation looks very uncertain when the blame for an accident is placed equally on all participants. Insurers do not miss the opportunity to refuse to pay for damage in this case either. But here you can fight, because the Law on Compulsory Motor Liability Insurance says:

If all participants in a traffic accident are found responsible for the damage caused, insurers provide insurance compensation for damage caused as a result of such a traffic accident, taking into account the degree of guilt established by the court of the persons whose civil liability they insured.

Procedure for the policy owner

If there are no legitimate reasons for the lack of compensation for damage from an accident, it is necessary to seek to obtain it. The insurer can submit a formal denial in writing, and this is the best option for the victim. But sometimes the company simply does not respond to the application within 30 days, which are allotted for sending the vehicle for repair, or 20 days, allotted for reflection on monetary compensation.

This should also be regarded as a refusal. If the insurance company does not pay under compulsory motor liability insurance, the procedure is to first remind the company again of its obligation, and then go to court.

Pre-trial work

The first thing a motorist should do is to have his damaged car examined. To do this, turn to independent specialists working in an institution that has a license for this type of work. Once the place and time of the examination have been determined, the insurance company must be notified about it by sending a notification letter.

A representative of the company can participate in it. But if he doesn’t show up, the procedure is carried out without him. Based on the results, the expert draws up a conclusion, which contains information about the nature and methods of vehicle damage, calculations of the cost of repairs, photographs and other necessary information. But the document will not be accepted as confirming the need for payments in the following case:

The results of an independent technical examination, independent examination (assessment) of damaged property or its remains independently organized by the victim are not accepted to determine the amount of insurance compensation if the victim did not present the damaged property or its remains for inspection and (or) an independent technical examination, independent examination ( assessments) on the dates agreed with the insurer...

When a motorist has an independent expert report, he must:

• Draw up and send a claim to the insurance company (in person or by letter with notification). In addition to the motorist’s data, it must contain the claim for compensation and its justification. The claim is also accompanied by copies of the victim’s documents, including those for the car, and one copy of the independent expert’s report. The insurer must respond to it 10 days after registration.
• File a complaint with the RSA. These are not the bosses of the insurance company, but colleagues. But they monitor the compliance of Union members with laws, and if a company violates them, they can help. The complaint must also be accompanied by evidence that the insurer refused compensation without reason.
• Contact the Bank of Russia. He controls the work of insurance companies, and those who violate the law can lose their license. There you should send a complaint, copies of all documents related to the dispute, including the expert opinion.

Expert opinion

Nadezhda Smirnova

Automotive Law Expert

And the Central Bank will help obtain compensation if the insurer clearly violates the law. But in a dispute with a victim of an accident, when it is difficult to immediately determine who is right, they often take the side of the company.

Going to court

Often the insurance company refuses to pay compulsory motor liability insurance even after considering the claim. Then the conflict can only be resolved by the court. You should contact them after receiving a response or ignoring the complaint within 10 days. The victim must:

If the deadline for sending a reasoned refusal of insurance compensation to the victim is not met, the insurer, for each day of delay, pays the victim money in the form of a financial sanction in the amount of 0.05 percent of the insurance amount established by this Federal Law for the type of harm caused to each victim.

If the decision is negative, you can file an application with a higher court.

If the insurance company does not pay for compulsory motor liability insurance, this does not mean that the company is right. Sometimes the company is simply trying to deceive the motorist, hoping that he will be satisfied with the refusal. In fact, it is possible to receive compensation from the insurer not only for car repairs and restoration of health. The court may demand payment from him for moral damage caused to the motorist by a negative response from the company and by going through the authorities.

Useful video

Watch this video about what to do if the insurance company refuses insurance payment:

Insurance companies want to make money. Therefore, they take every opportunity not to pay insurance compensation for damage after an accident under OSAGO or CASCO. It is also known that insurance companies do not pay as much as required for compulsory motor liability insurance and comprehensive insurance - this is confirmed by statistics collected by the Supreme Court of the Russian Federation.

This is interesting: in 2007, insurance companies voluntarily paid 41,100,000,000 rubles, in 2013 - 77,374,829,000 rubles. In 2007, claims courts recovered 1,397,151,258 rubles from insurance companies, and in 2013 - already 25,333,531,031 rubles, which is 19 times more. This is the money that insurance companies had to pay to car owners, but they didn’t want to do this themselves, and people went to the courts, and did the right thing, as it becomes clear. In 2007, Russian courts filed 27,393 claims against insurance companies, and in 2013 - already 328,000. An increase of 11 times.

Let's look at the main reasons why insurance companies refuse to pay. These reasons can be real or far-fetched.

Not all documents have been submitted

If the insurance company does not pay for MTPL or CASCO insurance, citing this reason, then this may be both true and a trick of the insurance company not to pay.

What to do? Read the Regulation of the Central Bank of the Russian Federation “On the rules of compulsory insurance of civil liability of vehicle owners” No. 431-P. There, paragraph 3.10 lists all the documents that the insurance company may require. Remember - the insurance company does not have the right to demand any other documents. This is established by the same paragraph of the Regulations of the Central Bank of the Russian Federation.

Important addition: The OSAGO Law establishes that if the documents are not submitted in full, the required composition, then the insurance company is obliged to notify the driver about this within three days from the date of submission of the documents.

If she did not do this, and now refuses to pay, citing the fact that there are not enough documents, then she should write a claim and prepare for court.

By the way, if there are any blots, typos, etc. in the submitted documents, the insurance company is also obliged to notify the applicant about this, again within three days.

Your case is uninsured

At the same time, there are situations when the case is actually uninsured. For example, if one car hits another in a parking lot, then the insurance company’s refusal to pay will be legal.

However, in the MTPL Law the concept of an insured event is not clearly defined. Insurance companies, of course, take advantage of this by declaring many “borderline situations” uninsurable events. In such cases, it can be extremely difficult to achieve payment without a professional lawyer.

The driver did not provide the car for inspection

There is no reason for a conscientious driver to hide a damaged vehicle from the insurance company. Moreover, the driver has the obligation to provide the car for inspection or examination - the insurance company will not pay for compulsory motor liability insurance or CASCO insurance until the examination is carried out.

Clause 3.11. The regulations of the Central Bank of the Russian Federation establish that within 5 days from the date of submitting documents to receive insurance payment, the driver is obliged to provide the car itself for inspection or examination. The driver and the insurance company representative are required to agree on the time and place of the inspection or examination.

If for some reason it is impossible to provide the car for inspection (for example, it is so damaged that it cannot be moved on the road), then the insurance company must be notified.

The driver did not submit an insurance claim at the right time

At the same time, neither the Law on Compulsory Motor Liability Insurance nor the Regulations of the Central Bank of the Russian Federation stipulate within what time the driver is obliged to contact the insurance company to report an accident. Both documents state that he must do so “at the earliest opportunity.”

But this does not mean at all that it is necessary to immediately start calling the insurance company, while still sitting behind the wheel of a damaged car. The fact is that, again, neither the Law on Compulsory Motor Liability Insurance nor the Regulations of the Central Bank of the Russian Federation indicate that if the driver violates the requirement “to make an application at the first opportunity,” then he will be deprived of the right to payment.

If the insurance company does not pay for MTPL or CASCO insurance, based on the fact that the driver allegedly filed a claim late, then it is necessary to write a pre-trial claim and understand that most likely you will have to go to court against the insurance company.

Insurance companies get very creative when it comes to avoiding paying claims. Therefore, in one article it will not be possible to predict all the reasons why an insurance company may refuse to pay.

It is more important to know that we are ready to provide you with free legal advice on how to claim insurance compensation from the insurance company. Please note that the consultation is free and does not obligate you to anything.

1. Remember that the fact of submitting documents to the insurance company has legal significance. Ask a company employee for a receipt for accepting these documents or some other paper that will list the documents that you submitted. There must be a date. In this case, the insurance company will not be able to later say “but they didn’t bring us any documents.”
2. Ask questions if something is not clear to you. Sometimes people are embarrassed to ask, they don’t want to appear stupid. Remember that it is okay not to know something. But being embarrassed to find out is not normal.
3. If the insurance company misses the deadline (for example, it did not pay the insurance within 20 calendar days and did not send a reasoned refusal, but simply “keeps silent”), then you do not need to reassure yourself “well, they have to”, “the law says”, “they obliged." Practice shows that if the insurance company begins to violate your driver’s rights, then it will only get worse. You need to write a claim and understand that you will have to go to court.
4. Don't take the position of a supplicant. You have entered into an agreement with the insurance company. Both you and the company have rights and obligations established by law and contract. By fulfilling its duties, the insurance company is not providing you with a service - it is simply fulfilling its duties.
5. Don't be afraid to seem like an inconvenient, grumpy, scandalous client. Of course, you shouldn’t start swearing at this either; There is no point in arguing with the insurance company at all. But at the same time, we must remember that a healthy and reasonable willingness to defend one’s rights increases the chances of a decent payment. And by the way, the absence of “softness” forces the company employee to respect the client as a person. Psychology-s.

Does it make sense to write a pre-trial claim?

If the insurance company does not pay for MTPL or CASCO insurance, then it makes sense to write a pre-trial claim, but only if it is written legally correctly. That is, legal language, with internal logic, with references to current laws, regulations and rules. Then the insurance company will see that a lawyer has become involved in the case, which means that the driver is serious - apparently, he is ready to go to court.

There is no point in an unprofessionally written complaint that boils down to the idea “you have to pay me, therefore you have to pay.”

Do I need to write to the prosecutor’s office or other regulatory authorities?

No. Most likely, an answer will come from there with advice to go to court. And time will be lost.

Why you need to contact a professional lawyer

• Because you most likely do not know all your rights under the MTPL Law. For example, that you can not take money from the insurance company, but agree to repairs that will be carried out at a service station in the direction of the insurance company. And the car owner can choose this service station.
• Because statistics say that if the insurance company decides not to pay for compulsory motor liability insurance or comprehensive insurance, then most likely the driver will have to go to court. In this case, the car owner is obliged to submit a pre-trial claim, and a correctly drafted one.
• Because a professionally written claim indicates that the car owner is serious. This fact can convince an insurance company that does not pay under compulsory motor liability insurance or comprehensive insurance that it is better to pay instead of being a defendant in court.

You are guaranteed anonymity. Everything you tell our lawyers will remain confidential, as required by law and professional ethics.

If the insurance company does not pay for compulsory motor liability insurance or comprehensive insurance, then you should hurry up. Time limits are a very important criterion in law. Therefore, the sooner a professional lawyer gets down to business, the greater the chances of winning in court.