Payment under compulsory motor liability insurance does not cover damage

What to do if the amount of the insurance payment under compulsory motor liability insurance does not cover the costs of repairs?

Insurance compensation under compulsory motor liability insurance in terms of compensation for damage caused to the property of each victim is, as a general rule, limited to a maximum of 400,000 rubles. (Clause “b” of Article 7 of the Law of April 25, 2002 N 40-FZ).

The amount of insurance compensation (payment) may not cover the cost of repairs if the insurer underestimated the amount of compensation or paid the maximum possible amount, but the cost of repairs turned out to be higher.

If it is impossible to establish the fault of a particular driver from the documents about the accident (for example, both drivers violated traffic rules), then the insurer will compensate for the damage in equal shares. That is, for example, when there are two participants in an accident, compensation for each victim will be half of the amount of damage or in other proportions depending on the degree of guilt of the participants in the accident, established by the court (clause 22 of Article 12 of Law No. 40-FZ).

1. The insurance company underestimated the amount of compensation

If the amount of insurance compensation does not cover your repair costs as a result of the insurance company underestimating the amount of compensation, we recommend that you adhere to the following algorithm.

Step 1. Obtain from the insurer a copy of the insured event report

When considering the victim's application for insurance compensation, the insurer is obliged to draw up a report on the insured event. It describes the insured event (road accident), indicates its consequences, the amount of damage and insurance compensation, and also provides the calculation of insurance compensation (clause 4.22 of the OSAGO Rules, approved by the Bank of Russia on September 19, 2014 N 431-P).

The insurer is obliged to issue a report upon your written request within three calendar days, excluding non-working holidays, from the date of receipt of this request - upon receipt of the claim after drawing up the report on the insured event or from the date of drawing up the report on the insured event - upon receipt of the claim before drawing up the report about an insured event (clause 4.23 of the OSAGO Rules).

Step 2. Check that the insurer's calculation is correct

The correctness of the calculation can be estimated approximately using reference books on the website of the Russian Union of Auto Insurers. If prices are understated, then the calculation of the amount of insurance compensation is incorrect (Article 12.1 of Law No. 40-FZ; Clause 32 of the Resolution of the Plenum of the Supreme Court of the Russian Federation dated January 29, 2015 No. 2).

Such verification is preliminary and does not replace expert research. But on its basis, you can form an initial idea of the prospect of a dispute with the insurer, without incurring additional costs.

If the accident was registered without the participation of police officers, the insurer will compensate for damage only up to 50,000 rubles. In the event of an accident in the territories of Moscow, St. Petersburg, the Moscow or Leningrad region, compensation is limited to 400,000 rubles, but the insurer must provide data on the circumstances of the accident, recorded by technical means that ensure uncorrected registration of information (clauses 4, 5, 8, Article 11.1 of Law No. 40-FZ).

If the insurer's calculations were incorrect or you do not want to check the accuracy of the insurer's calculations, proceed to the next step.

Step 3. Obtain documentary evidence of the amount of damage

In the event of a lawsuit with the insurer, evidence of the amount of damage and the cost of restoring the vehicle will only be the conclusion obtained based on the results of an independent technical examination. Such an examination is carried out by an expert technician entered by the Ministry of Justice of Russia into the state register of expert technicians, in accordance with the Unified Methodology and using electronic databases of cost information (directories) approved by RSA (Article 12.1 of Law No. 40-FZ; Clause 32 of Resolution No. 2; clause 7.4 of the Unified Methodology).

To obtain this document, you must contact an expert technician or an organization that has expert technicians on staff and enter into an agreement to conduct an independent technical examination.

The register of technical experts is posted on the official website of the Russian Ministry of Justice. The cost of the examination usually depends on its complexity and the value of the damaged property.

Step 4. Contact your insurer with a written claim.

In this situation, it is necessary to follow the pre-trial procedure for resolving the dispute and contact the insurer with a claim. If this is not done, the court will return the statement of claim (Article 16.1 of Law No. 40-FZ; Article 135 of the Code of Civil Procedure of the Russian Federation).

Based on the results of consideration of the claim, the insurer will pay you or refuse to satisfy your claim (clause 5.2 of the MTPL Rules).

In case of refusal or failure to receive a response from the insurer within ten calendar days, with the exception of non-working holidays, you can go to court (paragraph 2, paragraph 1, article 16.1 of Law No. 40-FZ).

Note. The specified ten-day period for consideration by the insurer of the victim’s claim is subject to application to the relationship between the insurer and the victim that arose in connection with an accident that occurred after 07/04/2016 (clause 4 of article 3 of the Law of June 23, 2016 N 214-FZ).

Step 5. Prepare a statement of claim and present it to court

In the statement of claim, you can make demands for recovery (clause 21, article 12, clause 6, article 16.1 of Law No. 40-FZ):

1) the difference between the amount of damage (according to the conclusion of an independent examination) and the amount of insurance compensation received;

2) penalties for violating the deadline for payment of the specified difference - 1% of the difference in payment for each day of delay, but not more than the maximum limit of the insured amount, and/or financial sanction for violating the deadline for sending a reasoned refusal of insurance compensation - 0.05% of the maximum the limit of insurance compensation for each day of delay if the insurer violated the deadline for sending you a written refusal.

As a rule, the minimum set of documents attached to the statement of claim are:

1) copies of documents confirming the submission of a claim to the insurer;

2) copies of documents confirming ownership of the vehicle;

3) copies of documents about road accidents issued by the traffic police;

4) a copy of the insured event report;

5) a copy of the conclusion of an independent technical examination;

6) a copy of the statement of claim and the documents attached to it for the insurer.

You can submit a statement of claim and the documents attached to it at the location of the insurer (its branch or representative office), or at the place of your residence or stay, or at the place of conclusion or execution of the insurance contract (clause 2 of Article 16.1 of Law No. 40-FZ; Clause 2 of Article 17 of the Law of 02/07/1992 N 2300-1).

If the cost of the claim is no more than 1 million rubles, you are exempt from paying the state duty (clause 4, clause 2, article 333.36 of the Tax Code of the Russian Federation; clause 2, article 16.1 of Law No. 40-FZ).

If claims of a property nature are made and the price of the claim does not exceed 50,000 rubles, then the claim is submitted to a magistrate (Article 23 of the Code of Civil Procedure of the Russian Federation).

If the cost of the claim exceeds RUB 50,000. or if you also make demands of a non-property nature (for example, to establish the degree of fault in an accident), then the claim should be filed in the district court (Article 24 of the Code of Civil Procedure of the Russian Federation).

If the court satisfies the claims of the plaintiff, which were not satisfied by the defendant voluntarily, the court collects from the defendant in favor of the plaintiff a fine in the amount of 50% of the difference between the amount of insurance compensation to be paid and the amount of insurance payment made by the insurer voluntarily (clause 3 of Art. 16.1 of Law No. 40-FZ).

2. The cost of repairs turned out to be more than the amount of insurance compensation

In this case, the remaining amount should be recovered from the culprit of the accident (clause 1 of Article 1064 of the Civil Code of the Russian Federation).

Before going to court, we recommend that you send a written demand to the culprit of the accident for compensation for the damage caused to you. This pre-trial procedure for resolving a dispute is not mandatory, but sometimes it allows you to receive the compensation you are entitled to without going to court.

If the person at fault for the accident left your claim unanswered or refused to compensate for the damage, you have the right to go to court. To do this, we recommend following the following algorithm.

Step 1. Receive documentary evidence of the amount being collected

Evidence of the amount of the amount recovered will be the conclusion obtained as a result of an independent technical examination.

To obtain this document, you must contact an expert technician or an organization that has expert technicians on staff and enter into an agreement to conduct an independent technical examination. The register of technical experts is posted on the official website of the Russian Ministry of Justice. The cost of the examination usually depends on its complexity and the value of the damaged property.

In a dispute with the culprit of an accident, the wear of replaced spare parts may not be taken into account (clause 13 of the Resolution of the Plenum of the Supreme Court of the Russian Federation dated June 23, 2015 N 25). Evidence of the amount of damage can be provided by documents on repairs performed and paid for (payment orders, checks, certificates of work performed, etc.). It should be taken into account that in court the question may arise about the existence of a connection between the repaired damage and the accident, which will require a forensic examination.

You have the right to demand compensation not only for damage caused to the car, but also for the costs of conducting an examination, storing the car in the parking lot, and legal expenses (clauses 2, 4 of the Resolution of the Plenum of the Supreme Court of the Russian Federation dated January 21, 2016 No. 1).

Step 2. Prepare a statement of claim and present it to court

The claim must be sent to the court at the place of residence of the person responsible for the accident (Article 28 of the Code of Civil Procedure of the Russian Federation).

In the statement of claim, state the essence of the problem and state your demands for recovery of the difference between the amount of damage (according to the conclusion of an independent examination) and the insured amount paid by the insurer. Attach the following documents to the statement of claim (Article 132 of the Code of Civil Procedure of the Russian Federation; Article 333.19 of the Tax Code of the Russian Federation):

1) copies of documents confirming the filing of a claim with the person at fault for the accident;

2) copies of documents confirming ownership of the vehicle (PTS or registration certificate issued by the State Traffic Safety Inspectorate);

3) copies of documents about the accident (certificate of the accident, protocol, resolution, determination);

4) a copy of the insured event report;

5) a copy of the independent technical examination report;

6) a copy of the statement of claim and the documents attached to it for the person responsible for the accident;

7) a document confirming payment of the state duty.

If the cost of the claim exceeds RUB 50,000. or you also make demands of a non-property nature (for example, to establish the degree of fault in an accident), then the claim should be filed in the district court (Article 24 of the Code of Civil Procedure of the Russian Federation).

Collection of the amount awarded by the court in your favor is carried out on the basis of a writ of execution, which is issued after the court decision enters into force and, at your request, can be sent by the court for execution to the bailiff service (part 1 of article 428 of the Code of Civil Procedure of the Russian Federation; part 1 Article 5 of the Law of October 2, 2007 N 229-FZ).

When determining the tax base for personal income tax, income in the form of insurance payments in connection with the occurrence of insured events under compulsory insurance contracts, including under compulsory motor liability insurance contracts, is not taken into account. At the same time, amounts paid by the guilty party to an accident in an amount not exceeding the actual damage to the victim are not subject to personal income tax (Article 41, paragraph 1, paragraph 1, Article 213 of the Tax Code of the Russian Federation; Article 15, paragraph 1, Article 1064 of the Civil Code of the Russian Federation ; clause 1 of Letter of the Federal Tax Service of Russia dated November 23, 2005 N 04-1-02/888@; Letter of the Federal Tax Service of Russia dated August 27, 2013 N BS-4-11/15526).

How to draw up and submit a claim for compensation for damages from an accident? Find out →

What is the procedure for taxing personal income tax on insurance compensation amounts paid under a property insurance contract? Find out →

Website of the Russian Union of Auto Insurers - www.autoins.ru

Official website of the Ministry of Justice of the Russian Federation - www.minjust.ru

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What to do if MTPL does not cover repairs?

The maximum limit of insurance payment under compulsory motor liability insurance is 400 thousand rubles. This means that in the event of an accident, this amount may not be enough to cover all losses. So what then, should you pay extra yourself or contact the insurance company, collect a fee from the culprit, or be left without a car? There are a lot of questions. And below are detailed instructions on what to do in such situations.

Algorithm of actions: what and how to do if insurance does not cover damage

There are two reasons why the insurance payout is not enough to pay for the actual repairs to the car:

the insurance company purposefully reduces the final payment amount, understanding in fact the actual damage caused;
The vehicle's total repair costs exceed the permissible insurance limit. They are even limited by law - no more than 400,00 rubles.

And then in more detail about each situation. Read more about: “How much damage does the MTPL insurance policy cover in case of an accident.”

Who is obligated to pay extra for repairs?

A popular option: the car is brought to a service station, the amount of repairs exceeds the insurance payment, representatives of the workshop demand that the owner of the vehicle pay the difference. Of course, the subject can do this if he does not want to waste time. But such demands are absolutely illegal. If the subject, that is, the insured person, is not at fault for the accident, then he should not bear the costs of restoring the car.

If there are still not enough funds, then further actions depend on the situation: it is not enough due to an underestimation of the amount by the insurance company or due to exceeding the limit. If the actual amount of repair and restoration work is more than 400 thousand rubles, then you need to submit a claim for payment to the person at fault for the accident. How to do this will be discussed further. If, according to your calculations, the amount is deliberately underestimated by the insurer, then a claim is submitted to the company.

For example, the requirement for compensation for damage on the part of the culprit is also regulated by civil law. Therefore, if you refuse to pay, you can go to court.

Option 1: the insurance payment is actually underestimated by the insurer

The examination was carried out correctly. The injured person has no comments and the insurance company agrees to pay the insurance benefit. When the subject receives the money, it actually becomes insufficient to cover the entire repair of the car. A frequent situation is when repair work exceeds the compensation by 10 times.

The task of the insured person is to find “mistakes” and understand who made the mistake. This can be done either by the company itself or by the appraiser. The second option is relevant when the insurer and the expert are interested parties.

The solution to the problem is to simply contact the insurer: you must request a report on the assessment. The representative of the Investigative Committee is obliged to provide it. If the insurance company grants a refusal, then you need to warn it about the responsibility and go to court. As a rule, such arguments work.

When the document is received, it is worth understanding: what part of the work is underestimated or some is not taken into account at all. Practice shows that they often forget to include some small damage, scratches, etc. in the compensation. Although all these little things are subject to repayment.

If desired, the car owner can independently conduct an examination. And it will show the real situation.

But the downside of this whole situation is that the prices for repairs in real service stations in individual regions differ significantly from those indicated in the RSA fact sheets. That's why such a difference can arise.

Option 2: The cost of the work is more than the maximum allowable payment

If the repair is more than the established 400,000 rubles, then the person responsible for the accident must pay the difference. This is his duty, not his right. For example, if the repair of the injured person’s car costs 550,000 rubles, an independent examination costs 10,000 rubles, then the culprit is obliged to compensate the subject at least (550+10) - 400 = 160,000 rubles. You can find out more about the limits here - “Amounts and maximum amounts of insurance payment under compulsory motor liability insurance.”

Procedure if payment under compulsory motor liability insurance does not cover repairs

The obligation to compensate for the difference between the maximum payment under compulsory motor insurance and the damage caused rests with the person at fault for the accident. In this case, the victim has the right to recover the amount of damage both immediately after the accident and for another three years after the actual accident. There are several options for the development of events: the culprit can independently offer to reimburse the costs, you can come to an agreement with him, or you will have to go to court. The most popular option is to draw up a pre-trial claim, which can resolve the controversial situation. And providing it to the culprit is a mandatory step towards resolving the conflict.

Package of papers required to substantiate the claim

Any claim must be documented. If there are no documents, then there is no reason.

To file a claim against the perpetrator you must:

papers confirming expenses incurred. This could be a check, receipt, conclusion, etc.;
documents confirming the costs of the examination;
documents confirming the payment received from the insurance company.

Regarding the examination, this is a mandatory stage for the injured person. The expert will assess the actual damage and issue an opinion. It is better to conduct examinations in companies that do not have any relationship with the insurer. You should not go to the organization that is imposed by the UK. A complete list of appraisal organizations can be found on the RSA website. The cost of services of such a company varies from 4 to 10 thousand rubles. But in megacities the price may be higher.

In addition to documents confirming the entity’s expenses, standard papers are also required:

ownership of the car. This may be a technical passport or registration certificate;
an act confirming the completion of repair work;
traffic accident report;
notice to the insurer.

The culprit of the accident may, if desired, require additional documents confirming the expenses of the victim. A pre-trial claim allows you to reach an agreement on mutual ambushes. Full information about: "What documents are needed for insurance payment."

How to recover the difference from the culprit of an accident

Theoretically, the injured person can demand from the culprit both the missing amount of damage and compensation for damage to health and moral damage. Additionally, the subject may request reimbursement for legal costs, storage of the vehicle in the parking lot, services of a tow truck, expert, etc.

An interesting point: the law provides for the possibility of the victim recovering the full amount of repairs from the culprit, without taking into account the depreciation of the vehicle’s spare parts.

Pre-trial procedure

The victim must first try to resolve the conflict peacefully. This is why a pre-trial claim is needed. It cannot be put forward orally. Only written appeal in compliance with the regulations.

The document must contain:

the amount that was actually spent on repairs;
the amount allocated by the insurance company within the framework of compulsory motor liability insurance;
the amount of the missing payment;
a reasoned request to compensate for the damage caused as part of the missing payment or as part of compensation for additional expenses.

The claim along with all documents is sent by mail. This must be done to obtain proof of posting.

When the culprit of the accident receives documents, he can:

fully satisfy the claims of the injured person;
partially satisfy the injured person;
agree with the victim on a different procedure for compensation;
completely refuse compensation.

In the latter option, in case of refusal, the victim is forced to act in a single direction - go to court.

Consideration of the case in court

Where to file a claim depends on the value of the claim. If it is more than 50,000 rubles, then the claim is filed in the district court. If the amount is less than the specified amount, then to the magistrate's court. In any case, the document is submitted at the place of residence of the culprit, that is, the defendant.

A claim to recover compensation from the culprit is filed according to generally accepted standards. There are no specific features in this. You can cope with the task yourself, without involving a lawyer. Moreover, the truth is on the plaintiff’s side. The main thing is to document all expenses incurred. The list of papers is similar to those that the victim submitted along with the pre-trial claim (see above).

Judicial proceedings must end with a decision on collection. The victim’s task is to receive a writ of execution, which will indicate the amount of recovery. It is necessary to contact the FSSP – the bailiffs – with this sheet. Their task is to use the writ of execution to find the culprit and collect the due amount from him. How this will happen is not so important. They may even confiscate property by selling it at auction. Therefore, it is in the interests of the perpetrator to reach an agreement with the victim before the court decision.

Let's sum it up

Thus, if the insurance payment is not enough to pay for the repairs, you do not need to pay the difference yourself. The law provides for the possibility of recovering the amount from the guilty person. However, the situation does not have to be resolved in court. If there is a possibility and there are no contradictions, then the same pre-trial claim easily resolves the issue. If the insurance payment is underestimated by the insurance company itself, then you need to deal with the insurance company. They may well “forget” some repair service in the general price list.

Repairs and payments under compulsory motor liability insurance are not required to fully cover the damage, the court decided

The norms of the document, which is used to calculate the cost of restoration repairs, were challenged by the car owner. But the Supreme Court did not side with him.

According to today's standards, insurers are obliged to send cars of the injured party damaged in an accident for restoration repairs (the priority for in-kind compensation for damage was established in the spring of 2017). If it is not possible to repair the car (for example, the owner lives too far from the service station with which the insurance company has a contract), then the company must provide him with a cash payment that will cover the cost of restoration.

To calculate the amount of payment, the Unified Methodology for determining the amount of costs for restoration repairs within the framework of compulsory motor liability insurance is used. This document is approved by the regulations of the Central Bank. It indicates the price of parts taking into account wear and tear, as well as the cost of work, for each region of the Russian Federation. The unified methodology is periodically updated, bringing it into line with current price tags. By the way, earlier complaints were made against this directory, since prices for a number of items were seriously underestimated. This did not allow car owners to carry out full repairs within the limits of the amounts received from insurers.

Another issue related to compensation for damage by insurers was considered by the Supreme Court. Thus, the car owner was dissatisfied that after the accident he was not reimbursed for the cost of the airbrush design (according to asn-news, airbrushing on one part costs about 15 thousand rubles, the entire car costs 200 thousand rubles). The plaintiff argued that this violates his right to full compensation for damages under the civil law contract. After all, the law “on compulsory motor liability insurance” states that the payment must cover the costs required to bring the car to its pre-accident condition.

This time the Supreme Court did not side with the car owner. The judge explained that according to the Unified Methodology, as part of restoration repairs under compulsory motor liability insurance, painting work is “assigned to the minimum volume permitted by the manufacturer’s technology,” that is, only the “pre-accident properties” of the car are restored. And not “pre-accident condition”.

At the same time, as the Supreme Court noted, paragraph 3.4 of the Unified Methodology separately stipulates that the amount of monetary payment from the insurer for the restoration of the car does not apply to the additional expenses of the car owner, which went towards improving and modernizing the vehicle.

Earlier, back in 2017, the Constitutional Court ruled that the amount of damages involves covering the costs that the owner will incur to restore the car, taking into account the need to ensure road safety. At the same time, the Unified Methodology, according to the Constitutional Court, is based on the most “massive, standard conditions for using vehicles,” that is, it cannot take into account the characteristics of each individual vehicle.

As explained in the Supreme Court, despite the fact that under compulsory motor liability insurance it is impossible to reimburse the cost of airbrushing, the victim has the right to demand the required amount directly from the culprit of the accident (according to Article 1072 of the Civil Code of the Russian Federation).

Recently it became known that the Supreme Court forced the insurer to pay for the MTPL policy purchased after an accident. The accident occurred in 2017, before the amendments to the three-day deferment of the e-policy came into force. So the culprit took out insurance during the day, which began to be valid from 00:00. As a result, the company had to “fork out”, since the premium was paid in full by the “cunning” client.

Insurance does not cover damage from an accident

If the insurance paid does not cover damage from an accident, many drivers simply add money for repairs. They do not like such a loss, but they cannot find an alternative option. This is a serious mistake, because every car owner has the rights and the opportunity to resolve the issue to increase the payment amount.

Suing insurance companies is difficult, but necessary. An experienced lawyer, whose phone number is listed above, will tell you how to correctly draw up an application and collect a package of documents. It will also help you go all the way, providing the driver with sufficient funds to restore the car.

In what cases is damage not covered by insurance?

An accident is a real problem that drivers have to face. Previously, they agreed on the spot, but now insurers are involved in the matter, which entails unnecessary complications. Yes, car owners now have funds for repairs, but the amounts do not always coincide with the truth.

In what cases does insurance not cover damage from an accident?

The amount of damage is underestimated;
Payout limit exceeded.

In both cases, a person is faced with the problem that insurance did not cover damage from an accident. He has to look for a simple way out of the situation, since he doesn’t want to pay for the repairs himself. The issued policy should guarantee the necessary money, but the rules usually do not coincide with reality. This makes you think about how to resolve the situation in your favor.

Steps taken by the culprit when deliberately underestimating damage

If insurance does not cover damage from an accident, the culprit has the hardest time. A third-party company can file a claim in court if the participant in the incident had CASCO, and the victim, when the calculation of the payment under compulsory motor liability insurance turned out to be incorrect. The issue should be resolved in advance so as not to subsequently encounter an unexpected payment, because the maximum period for claiming funds is 3 years.

In such cases, it is worth using the services of a lawyer. If insurance does not cover damage from an accident, if you do not want to go to court for a long time, you can order an independent examination and go to the office with a package of documents. Often such cases are resolved amicably, since it is not profitable for companies to delay the hearings. It is more useful for them to quickly understand the situation and continue working.

It is possible to refute the underestimation of damage. If your insurance does not cover damage from an accident, you should not be upset and prepare the specified amount. It's time to prepare a complete package of documents, supplementing them with the results of independent examinations and a correct assessment of damage. After this, it will be possible to achieve justice by spending a minimum of time.

What to do when the payout limit is exceeded?

After an accident, insurance does not always work correctly. In accordance with the legislation of the Russian Federation, a certain limit on payments by companies is established. This threshold is an obligation for them, but they are not responsible for exceeding it.

What indicators should you know?

When paying 1 participant up to 120 thousand rubles;
When paying several participants, the total amount is up to 160 thousand rubles.

If the insurance company does not cover the damages of the accident, the maximum amount is often exceeded. When evaluating expensive foreign cars, you can be convinced of their insignificance, because even partial body repairs cannot always be done on them. When the damage becomes critical and urgent replacement of parts is required, experts come to the conclusion that the available funds are not enough. The company transfers the specified funds, and the driver has to find the rest of the money on his own.

Exceeding the payment limit should be discussed with a lawyer. Only his knowledge is enough to find a way to solve the problem. When insurance does not cover damage from an accident, he will tell you how to reduce your own costs. The difference in the amount may be significant, so it is not possible to pay it off. To do this, you will have to calculate the damage again, and then be sure to meet with the victim.

What to do when OSAGO does not cover damage?

If MTPL does not cover repair costs, you should not immediately think about personal investments. Even if you want to quickly restore your own vehicle, there are obligations that the other party must fulfill. Judicial practice shows that in recent years litigation has occurred frequently, and people have managed to get a positive decision.

What do I need to do?

Independent examination;
Drawing up a request for payment;
Filing a claim in case of refusal.

If your insurance does not cover the damage in an accident, you should not give up. There are proven methods that tell you what to do if there is no payment under compulsory motor liability insurance. In such cases, a number of actions will be required that should be considered in detail. After which you will be able to draw the necessary conclusions, saving yourself from trouble.

Independent examination

An expert assessment of damage by the company is carried out in the same company. At this stage, there is deception and forgery of results, so the driver should contact a third-party agency. After all the necessary checks have been carried out, final conclusions will be made, which, in accordance with the legislation of the Russian Federation, have legal force. They will become evidence that plays a major role in court. So getting them is a top priority for the car owner. Moreover, it is necessary to notify the insurer about the implementation of these actions.

Making a request for payment

Next, the lawyer will help you draw up a demand for payment in full. It must be submitted to the nearest branch, as well as in writing to the company management. This will allow you to give official progress to your actions and give the other party the opportunity to sign a settlement agreement. Professionals correctly indicate the main nuances, so a trial after this stage is usually not required. No one wants to aggravate the situation by spoiling their reputation, although the solution does not always come so simply. Sogaz makes payments under compulsory motor liability insurance quickly, but it is almost impossible to refute them.

Filing a claim in case of refusal

In case of refusal, you should collect a package of documents and file a claim in court. The trial will begin as soon as possible, since the main data for its conduct is an independent assessment of damage in an accident. These conclusions should be based on in order to obtain a positive decision. It will oblige the insurance company to transfer the full amount of damage to the driver’s account so that he can restore his own vehicle.

What to do when CASCO does not cover damage?

If CASCO does not cover damage from an accident, the situation is easily resolved. With such insurance, the car owner practically does not worry about damage to the vehicle, so companies rarely underestimate the amounts paid. When there are not enough funds sent, you should boldly go to the nearest office and receive the difference.

What should the culprit of an accident do if insurance does not cover the damage? The maximum payments under CASCO reach 400 thousand rubles , so a lack of funds rarely appears. Moreover, representatives do not like to argue with demands, since, based on the legislation of the Russian Federation, a court decision in any case will have to transfer money to the car owner, as well as pay a fine in the amount of 50% of the payment.

What should the culprit of an accident do if compulsory motor insurance does not cover the damage? Use the services of a lawyer who can tell you how to draw up demands and file a claim. As a result, the person will definitely receive the necessary amount and repair the car.

Video: the amount of the insurance payment does not cover the costs of repairs

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How much does the MTPL policy cover damage after an accident and what to do if the insurance limit is exceeded?

The main regulatory act regulating compulsory civil liability insurance is Law No. 40-FZ dated April 25, 2002. According to the contract, upon the occurrence of an insured event, the insurance company that issued the policy to the person at fault for the accident undertakes to compensate the damage caused to the injured party depending on its type (damage to property and (or) harm to health).

Compensation for damage under the MTPL policy

If two vehicles (VVs) were involved in an accident, and the fault of one of the drivers is proven, then the insurance company of the culprit pays compensation. If there are three cars in an accident, two of which caused damage to the third, then the damage to the victim will be paid by two insurers. If several participants in an accident suffered damage due to the fault of one, then the insurance company of the culprit is obliged to compensate the damage to all victims.

When an insured event occurs, the insurance company, based on expert opinions, determines the amount of payments taking into account the requirements of the law and within the limits established by law (Article 7 No. 40-FZ).

What is the maximum payout amount

The insurer's obligation to compensate for losses caused by the insured person under the MTPL agreement is valid for the entire term of the agreement. It does not take into account how many times insured events occurred during this period. When each of them occurs, compensation is carried out within the maximum limit.

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In accordance with Art. 7 of Law No. 40-FZ establishes the following limits:

500 thousand rubles. — the maximum amount of payments in case of harm to the life or health of each victim;
400 thousand rubles. — the maximum limit on compensation for damage received by the property (car) of each victim.

The above amounts are the maximum, however, compensation does not always reach such amounts, since the calculation takes into account a number of factors: wear and tear of the car, its value at the time of the incident, the nature of the damage, etc.

Compensation for health damage under compulsory motor liability insurance

In accordance with paragraph 1 of Art. 12 of Law No. 40-FZ, the victim has the right to contact the insurance company with a demand to compensate for damage caused not only to property, but also to health. Payments are made upon presentation of documents about the incident from the traffic police, as well as certificates from medical institutions confirming the fact of providing medical assistance to the party injured in the accident.

The amount of payments depends on the severity of the injuries received by the victim and is calculated by the insurance company based on the rules specified in the Decree of the Government of the Russian Federation dated November 15, 2012 No. 1164. The rules contain a table in which, depending on the nature and extent of health damage, the amount of payment is established as a percentage.

Thus, the maximum value of 75% of insurance coverage is accrued only for spinal cord rupture, and the minimum amount of 0.05% is calculated for soft tissue damage.

Conventionally, all damage can be divided into the following types:

serious harm to health - the amount of compensation depending on the damage is 20% of the limit or more;
minor injury to health - the maximum amount of compensation does not exceed 15% of the established limit.

Lost earnings

A victim of an accident has the right to claim compensation in the amount of earnings lost during the period of treatment. Such payments are made by the insurer within the limit under Art. 7 No. 40-FZ after the injured party provides confirmation of the treatment received and evidence of lost earnings.

Compensation for disability

The amount of payments will depend on the disability group assigned to the injured person as a result of the insured event. Thus, in accordance with paragraph 5 of Resolution No. 1164, the following amount of compensation is established:

1st disability group - 100% of the maximum limit on the sum insured (500 thousand rubles);
Disability group 2 - 70% of the insured amount (350 thousand rubles);
Disability group 3 - 50% of the maximum payment amount (250 thousand rubles).

If a child was injured in an accident and was later assigned the category of “disabled child,” then in this case compensation is paid in the amount of 2 million rubles.

Payments upon death of the victim

If the victim died as a result of the accident, then the right to receive monetary compensation passes to spouses, parents, children and persons who depended on the deceased (clause 7 of Article 12 No. 40-FZ). The amount of payments in this case is 475 thousand rubles. for compensation for damage and 25 thousand rubles. for funeral expenses.

Is an accident in a parking lot an insured event under MTPL?

In the traffic rules, a road traffic accident (RTA) is understood as an event that occurred as a result of the movement of a vehicle on the road and with its participation, in which people were injured, the vehicle was damaged, or other damage was caused.

Traffic regulations apply not only on roads, but also in adjacent areas where traffic occurs. So, courtyards, parking lots and parking lots fall under this description.

If, while driving, one car caused any damage to another vehicle, then such an event can be classified as an accident, since the car was moving at the time of the incident. If a car parked in a parking lot is hit by the door of another car when it opens, or an icicle falls on it, then such an event cannot be classified as an accident, and, accordingly, it will not be possible to receive a payment under the MTPL policy.

What to do if MTPL payments do not cover all the damage?

When a victim contacts an insurance company to receive compensation for damage, one of the following situations may occur:

the insurance company calculated the amount of compensation, which in fact is less than the damage received as a result of the accident;
the maximum payment under the MTPL agreement does not fully cover the damage received by the injured party.

In the first case, when the insurer unreasonably underestimated the amount of compensation, you must act as follows:

Contact an appraisal company to conduct an independent examination and determine the damage received by the car as a result of an accident . Upon completion of the assessment, the applicant is given a report describing the damage and the amount required for restoration.
Submit a claim to the insurance company for underestimated compensation for an insured event , supporting it with an independent expert report.
If the insurer has not responded to the claim and compensation for damage has not been made, then the victim has the right to file a claim in court.

If the insurer fully fulfilled its obligations within the limits established by law, but the damage was received in a larger amount, then the missing amount can be recovered from the culprit of the incident.

Initially, the victim should try to resolve the issue out of court. If the culprit does not agree to make contact, it is necessary to send him a pre-trial claim. The injured party may go to court if it was not possible to recover compensation for the damage received in pre-trial proceedings.

As a rule, the culprit of the accident rarely agrees to compensate for the damage on a voluntary basis, so the victim should carefully follow the procedure. He must have in his hands documents from the traffic police, the results of an independent examination and certificates from the insurer about the amount of compensation.

The victim has the right to recover from the culprit of the accident:

compensation for damage, taking into account wear and tear of vehicle parts and the cost of restoration repairs;
expenses associated with the evacuation of the car from the scene of the accident and its storage while resolving the issue of payments;
loss of marketable value of the car;
damages for harm caused to the health and life of the victim;
compensation for lost earnings and expenses for rehabilitation treatment;
expenses for an independent examination, legal services and other expenses associated with an accident.

In both cases, if the case goes to trial and the decision is made in favor of the victim, all expenses (state fees, examination) are reimbursed by the defendant. This procedure is followed both in case of damage to property and in case of harm to the health and life of the victim.

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