Should the insurance company pay for an independent examination?

Will the insurance company pay for the costs of an independent examination?

Everyone is interested in whether the money you spend on organizing a truly independent examination will be reimbursed.

CONCLUSION: Yes, the costs of conducting an independent examination will be reimbursed if the difference between the calculation of the insurance company and independent experts is more than 10%.

Let's look at paying the costs incurred for an independent examination using an example. A standard situation: you received a payment under compulsory motor liability insurance, but it turned out to be very small. To exercise your right to fair insurance compensation, you turned to independent experts and received the coveted Expert Opinion, in which the result is several times greater than the payment made. After this, based on the expert opinion received, you filed a pre-trial claim with the insurance company.

1. If your claim was fully satisfied, then the insurance company made a payment based on the expert opinion you provided, and therefore, in accordance with Article 12, paragraph 14 of the Federal Law No. 40 on OSAGO, it is obliged to reimburse the costs of an independent examination.

ABOUT COMPULSORY CIVIL INSURANCE

RESPONSIBILITIES OF VEHICLE OWNERS

14. The cost of an independent technical examination, an independent examination (assessment), on the basis of which insurance payment is made, is included in the losses subject to compensation by the insurer under a compulsory insurance contract.

2. If the insurance company refused to pay additional insurance compensation or made an additional payment not in full. In this case, you will have to sue for underpaid insurance compensation. And the costs of the examination in accordance with Article 94 of the Civil Code are legal costs and are subject to compensation by the losing party.

CIVIL PROCEDURE CODE

Article 94. Costs associated with the consideration of the case

The costs associated with the consideration of the case include: amounts to be paid to witnesses, experts, specialists and interpreters; expenses for translation services incurred by foreign citizens and stateless persons, unless otherwise provided by an international treaty of the Russian Federation; travel and accommodation expenses of the parties and third parties incurred by them in connection with their appearance in court; expenses for the services of representatives; on-site inspection costs; compensation for actual loss of time in accordance with Article 99 of this Code; postal expenses incurred by the parties related to the consideration of the case; other expenses recognized by the court as necessary.

3. The most difficult situation is when the insurance company makes a partial additional payment of insurance compensation for your claim, but the difference after the additional payment between the calculation of the insurance company and independent experts is less than 10%.

The position of the Supreme Court is that if the difference in the estimate of the cost of restoration repairs between the payment made by the insurer and the plaintiff’s claim is less than 10 percent, this is a statistical error. Such claims will not be considered.

However, in this case, the cost of examination is a necessary measure to obtain full insurance compensation. And since the insurance company made an additional payment, it means that it admitted that the initial payment made was not true.

PLENATURE OF THE SUPREME COURT OF THE RUSSIAN FEDERATION

DECISION of January 29, 2015 N 2

ON THE APPLICATION OF LEGISLATION ON COMPULSORY INSURANCE BY COURTS

CIVIL LIABILITY OF VEHICLE OWNERS

28. If harm is caused to the victim, restoration and other expenses are subject to compensation, caused by the occurrence of an insured event and necessary for the victim to exercise the right to receive insurance compensation (for example, the cost of evacuating a vehicle from the scene of a traffic accident, storing a damaged vehicle, delivering the victim to medical institution, restoration of a road sign and/or fence, delivery of repair materials to the scene of a traffic accident, etc.).

Should the insurance company pay for an independent examination?

Who pays for an independent examination of compulsory motor liability insurance?

One way to correct this situation is to request an independent examination of the car. During such a study, the specialist determines the real cost of the damage caused to the vehicle. This allows the car owner to understand whether a similar examination from the insurance company was carried out correctly.

Independent examination after an accident

No insurance company pays this compensation voluntarily, but it is quite possible to obtain it in court. To do this, along with an independent examination, you also need to order a vehicle assessment (for cars no older than 5 years). In the event of a serious accident, its size can reach tens of thousands of rubles, but in total with damage it will not exceed the payment limit under compulsory motor liability insurance.

Will the insurance company pay for the costs of an independent examination?

Should the insurance company pay for an independent examination?

If the insurer has not inspected the damaged property and (or) has not organized its independent examination (assessment) within the time period established by paragraph 3 of this article, the victim has the right to apply independently for such an examination (assessment) without presenting the damaged property to the insurer for inspection.

Should the insurance company pay for an independent examination?

71. In the insured event report, based on the available documents, the insurance payment is calculated and its amount is indicated. A copy of the insured event report is transferred by the insurer to the victim upon his written request no later than 3 days from the date the insurer receives such a requirement (if the claim is received after the insured event report is drawn up) or no later than 3 days from the date of the insured event report is drawn up (if the claim is received before drawing up an insured event report).

Independent examination of compulsory motor liability insurance - who pays?

When calculating the cost of research, specialists from expert companies always take into account the make and class of the car, the year of its manufacture and, of course, the cost. Agree that a new expensive car from a well-known manufacturer is crammed with electronics. To carry out an examination of such a car, you will need not only modern equipment, but also a highly qualified specialist.

Will the insurance company pay for an independent examination?

For example, an accident occurred far from the place where the insurance company was contacted. You are repairing your car in the area where the damage occurred. How to drive a broken car? Having arrived home, you go to the MTPL insurer, and he refuses to pay on the grounds that the repair of the damaged property does not allow one to reliably establish the existence of an insured event and the amount of losses.

The insurance company does not pay money for an independent examination

The sooner you seek the help of independent specialists, the higher the chances of a positive solution to your problem. The ideal option is to invite independent experts directly to the accident site. This allows the specialists of the expert company to take into account all the circumstances of the accident, as well as all the factors that could have provoked it.

How to conduct an independent examination of a car after an accident

vehicle registration documentation;
documentation about the accident that the victim handed over to the insurer (or copies thereof);
certificates of road accidents, if any;
referrals for examination, if there is an agreement for expert services that was concluded between the expert organization and the insurer;
other documents drawn up in connection with the accident.

Independent examination for compulsory motor liability insurance

In the market for legal and other services for motorists, there are many independent firms where accident commissioners, insurance or auto lawyers, expert appraisers, lawyers and other specialists are ready to provide their services at a reasonable price and without involvement in the interests of insurance services.

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1) if the cost of your appraiser’s services turns out to be higher than the cost of the insurer’s appraiser’s services, you will not be paid the cost of such an appraisal with reference to Art. 15 of the Civil Code and other general norms of the Civil Code in support of the fact that these expenses are not reasonable and necessary.

Conducting an independent examination of compulsory motor liability insurance

First of all, you should know that before an independent examination of compulsory motor liability insurance is carried out, replacement or repair of damaged parts or the car as a whole is strictly prohibited. Otherwise, the participant in the accident simply will not receive payments from the insurance company legally.

How to conduct an independent examination of OSAGO

Before concluding an agreement on appraisal work, make sure that independent experts (legal firm or individual) are members of a self-regulatory organization of appraisers and have a compulsory appraiser liability insurance policy (in accordance with Article 15.1 of Federal Law No. 135 “On Appraisal Activities in the Russian Federation”) . Otherwise, the result of the examination will be considered invalid. Compare prices for services and terms of completion of work in different appraisal organizations.
After concluding the contract, it is necessary to invite representatives of the insurance company for examination. Why send a registered letter to the Investigative Committee at least 3 days in advance with a notification that must indicate: the place and time of the inspection, the make/model of the vehicle, the full name of the culprit and the victim.
If the damage is expected to exceed RUB 120,000. (limit of liability of the insurer), it is advisable to call the culprit of the accident by registered mail. If the culprit and the Investigative Committee are not notified of the examination, this may entail not only a refusal to pay, but also a refusal by the auto expert to inspect the vehicle.
Do not be upset if the insurer's representatives ignore the invitation to attend the examination. Most often this is what happens. If the case goes to court, it will be enough to prove that everything was done according to the law, i.e. present copies of the telegram letter, the notification itself and a receipt for payment of postal services.
After this, you can receive a report on the cost of restoration repairs (damage assessment), which must be bound, numbered, signed by the appraiser and sealed. Be sure to keep a copy of the report in case the Investigative Committee refuses to pay, does not return the result of the examination, and the case goes to court.
We fill out an application (in two copies) with the insurance company with a request to review the amount of damage based on a new examination. The report of independent experts is attached. Be sure (!) to take confirmation of the fact of transfer of documents and put the incoming number on the 2nd copy of the application.
It would be even better to draw up a pre-trial claim, which is sent along with the report to the insurance company. The pre-trial claim is also drawn up in two copies so that the second copy can be marked as having been received by the insurance company.
Within 30 days, expect a response from the insurance company: payment or refusal of compensation (most likely).
If a refusal is received or there is no reaction from the insurance company, prepare a statement of claim to the court.

Sequence of actions to receive insurance payment under compulsory motor liability insurance after an accident

Some insurance companies act even more cunningly and pay out just enough for a claim so that the difference between the calculation of an independent expert report after an accident and the payment to the insurance company is 9-9.5%; in this case, you formally cannot go to court, since, according to the Plenum’s explanation Supreme Court, this difference is within the average statistical error.

Will the insurance company pay for the costs of an independent examination?

But do not forget that another development of the situation is possible, when insurers do not agree with the conclusions of experts and place more trust in the conclusions made earlier. In this case, you receive a reasoned refusal to your claim, and the only way to prove your right is to file a lawsuit in court. Moreover, just the fact that your claim has been accepted by the court for consideration does not mean that the final decision on it will be positive.

Should the insurance company pay for an independent examination?

Will the insurance company pay for the costs of an independent examination?

Independent examination after an accident

Once again, we draw your attention to the fact that if the examination/assessment was scheduled within the prescribed period (5 days), then you cannot refuse to undergo it. Do not listen to the advice of would-be experts who say the opposite. This was allowed before, but on February 28, 2008, a new procedure was established. Giving up NE will bring nothing but problems.

Should the insurance company pay for an independent examination?

During the specified period, the insurer is obliged to draw up a report on the insured event, on the basis of it, make a decision on making an insurance payment to the victim, make an insurance payment, or send a written notice of a complete or partial refusal of an insurance payment, indicating the reasons for the refusal. Integral parts of the insured event report are the conclusion of an independent examination (assessment), if one was carried out, and (or) an inspection report of the damaged property.

Should the insurance company pay for an independent examination?

Who pays for an independent examination of compulsory motor liability insurance?

This position is explained quite simply. If, after receiving insurance compensation, the car owner does not agree with the amount paid, he must justify his doubts. You cannot demand a larger amount from the insurer based only on your assumptions.

Independent examination of compulsory motor liability insurance - who pays?

An independent examination is understood as a comprehensive examination of the damage to a vehicle that has been involved in a traffic accident by disinterested experts, as well as an assessment of the amount of material damage caused during a collision.

Will the insurance company pay for an independent examination?

With the increase in the number of cars on our roads, the number of road traffic accidents in which the technical equipment involved is damaged in some way is also growing. (We do not consider issues related to tragic cases when road accidents lead to harm to health or death of people in this section).

How to conduct an independent examination of a car after an accident

Determine who is at fault for the accident. The insurer of the culprit must compensate for the damage.
The insurance agent will assess the extent of damage, their quantity, and nature.
If an accident is registered according to the European Protocol, drivers fill out an Accident Notice, draw a diagram of the accident, and indicate all the details of what happened.
Collect information from witnesses of the accident, if there were any, and enter information about them into the Notification.

Will the insurance company pay for the costs of an independent examination?

Insurance companies pay the costs of the victim in an accident, and this is directly provided for in paragraph 14 of Art. 12 of the Federal Law on Compulsory Motor Liability Insurance. Conducting an independent examination is often the only way to ensure for yourself that you will be compensated for the fullest possible amount of losses. As analytics data from cases in which such an examination was carried out show, if the difference between the assessment results of insurers and independent experts is more than 10%, you save quite significant amounts, and the examination is obviously beneficial for the victim.

Conducting an independent examination of compulsory motor liability insurance

However, it is beneficial for the insurer to pay less compensation, so most often insurance organizations cooperate with companies that provide these services. “Their” experts most often underestimate the amount of damage, and accordingly the insurance company pays less compensation than necessary.

Independent examination for compulsory motor liability insurance

In addition, if disputes arise with an insurance company that refuses to pay at all, then in a pre-trial settlement, the results of an independent examination can be attached to the claim, and then to the lawsuit if the insurer continues to refuse to charge the insurance premium.

The insurance company does not pay money for an independent examination

How to conduct an independent examination of OSAGO

If the victim does not agree with the assessment of damage and is sure that the expected payment under compulsory motor liability insurance will not cover the costs of restoring the car, he has the right to organize his own independent examination (in accordance with the Federal Law “On Compulsory Motor Liability Insurance” and Article 21 of the “Rules for the Organization and Conduct of an Independent Examination”) ", approved by Decree of the Government of the Russian Federation No. 238).

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If the insurer has not inspected the damaged property and (or) has not organized its independent examination (assessment) within the time period established by paragraph 3 of this article, the victim has the right to apply independently for such an examination (assessment) without presenting the damaged property to the insurer for inspection.

Is the insurance company obligated to pay for an independent examination?

Answer: As a rule, a standard report consists of a vehicle inspection report, a photo table, costing and wear calculation. It all depends on the required set of services and the degree of damage to the car (minor repairs - up to 5 parts, medium - 5-15 parts and large - over 15). The cost of each operation separately can be viewed here.

Payment for independent examination

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Payment for independent examination

do you really think that everything is so simple? :)

re-read paragraph 2 of article 12 again. just CAREFULLY. and understand that providing the car for inspection is your RESPONSIBILITY.

first, communicate with experts (I myself know how “independent” they are) from the insurance company and only THEN - your expertise.

no need for amateur performances. the entire sequence is written in black and white.

do you really think that everything is so simple? :)

re-read paragraph 2 of article 12 again. just CAREFULLY. and understand that providing the car for inspection is your RESPONSIBILITY.

first, communicate with experts (I myself know how “independent” they are) from the insurance company and only THEN - your expertise.

no need for amateur performances. the entire sequence is written in black and white.

do you really think that everything is so simple? :)

re-read paragraph 2 of article 12 again. just CAREFULLY. and understand that providing the car for inspection is your RESPONSIBILITY.

first, communicate with experts (I myself know how “independent” they are) from the insurance company and only THEN - your expertise.

no need for amateur performances. the entire sequence is written in black and white.

again. The fact of the matter is that there is no need to confuse cause and effect. especially don't confuse the consequence :)

The essence is simple - FIRST provide the car for inspection and (or) organize an independent examination by the insurer. and only THEN – your possible actions.

Payment for an independent examination in case of an accident according to the law?

I was involved in a car accident and I was innocent. Insurance Rosgostrakh, I’ve heard a lot about reduced payments, tell me when it is necessary to do an independent examination so that it is included in the insurance costs? And there were cases of their refusal to pay for an independent examination. Which article of legislation provides for payment for an independent assessment of an accident?

In accordance with Article 12 of the Law “On compulsory insurance of civil liability of motor vehicle owners” (clause 3.), the insurer is obliged to inspect the damaged property and (or) organize its independent examination (assessment) within no more than five working days from the date of the corresponding appeal of the victim, unless a different period is agreed upon by the insurer with the victim.
If the nature of the damage or the characteristics of the damaged property exclude its presentation for inspection and organization of an independent examination (assessment) at the location of the insurer and (or) the expert (for example, damage to a vehicle that precludes its participation in road traffic), the specified inspection and independent the examination (assessment) is carried out at the location of the damaged property within the period established by this paragraph.
The compulsory insurance contract may provide for other periods during which the insurer is obliged to arrive to inspect and (or) organize an independent examination (assessment) of damaged property, taking into account the territorial features of their implementation in hard-to-reach, remote or sparsely populated areas.
If, based on the results of the inspection of the damaged property carried out by the insurer, the insurer and the victim reach an agreement on the amount of the insurance payment and do not insist on organizing an independent examination (assessment) of the damaged property, such an examination may not be carried out. In accordance with paragraph 4 of the above article, if after the inspection of the damaged property by the insurer, the insurer and the victim have not reached agreement on the amount of the insurance payment, the insurer is obliged to organize an independent examination (assessment), and the victim is obliged to provide the damaged property for an independent examination (assessment).
If the insurer has not inspected the damaged property and (or) has not organized its independent examination (assessment) within the time period established by paragraph 3 of this article, the victim has the right to apply independently for such an examination (assessment) without presenting the damaged property to the insurer for inspection.
Based on clause 5 of Article 12 of the Law on Compulsory Motor Liability Insurance, the cost of an independent examination (assessment), on the basis of which the insurance payment was made, is included in the losses to be compensated by the insurer under the compulsory insurance contract.
It must be borne in mind that, according to clause 6 of Article 12, the insurer has the right to refuse the insurance payment or part thereof to the victim if the repair of damaged property or disposal of its remains carried out before the inspection and (or) independent examination (assessment) of the damaged property in accordance with the requirements of this article do not allow us to reliably establish the existence of an insured event and the amount of losses subject to compensation under a compulsory insurance agreement.