The insurance company does not pay for compulsory motor liability insurance. Procedure

What to do if the insurance company does not pay for compulsory motor liability insurance?

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With the introduction of compulsory motor liability insurance, many difficulties associated with the problems of compensation for damage in road accidents began to be resolved automatically. But a much larger number of people want to receive money compared to those who want to give it away. Insurers are no exception in this case.

Often, the driver has to face a situation where the payment period is delayed, or an unreasonable refusal to compensate for damage follows, while the basis for it is clearly far-fetched. What should someone who finds themselves in a similar life situation do?

Pre-trial claim to the insurance company in case of non-payment under compulsory motor liability insurance

Insurance company claim

The legislator orders the victim who has a conflict with the insurer to send him a claim. The task when writing a complaint is to reflect in it what errors were made by the organization (unreasonable non-payment, reduced amount, late payment, etc.), and in addition, demand their correction.

Article 16.1 of the Federal Law on Compulsory Motor Liability Insurance provides the insurer with 10 days to write a response to the person filing the claim.

When this period expires, he is assigned the following responsibilities:

Correction of violations;
Sending a justified, reasoned refusal in writing. Having received such a refusal, it can be appealed to a judicial authority.

For a pre-trial claim, a free form is acceptable, but it must reflect information about:

the name of the insurance company to which it is sent;
the full name, address, surname, first name, patronymic, place of residence or postal address of the victim (or other beneficiary), to which the insurance company must send a response if the claims seem untenable;
requirements for the insurer, which describe the circumstances in connection with which the claim is being submitted, and also provide links to the provisions of regulatory legal acts of the Russian Federation;
information about the bank account to which the insurance payment should be made if the insurer considers it necessary to satisfy the claim, or a message that the victim can receive funds from the insurance company’s cash desk;

If a claim has been sent to the insurer, but no response has been received

According to the law, the insurer is obliged to respond to the claim no later than 10 days.

The time is counted as follows:

When the applicant personally submitted the application at the company's office - from the day it was accepted;
When sent by post - from the date of acceptance of the letter and the corresponding signature confirming this fact.

In situations where the deadlines are not met, the victim has the right to appeal to the RSA or the Central Bank of the Russian Federation - however, he can also resort to the help of the judiciary by filing a claim with the insurer.

What to do if the insurance company has not responded to the claim?

What to do if the insurance company refuses to pay compensation for personal injury, read here.

How to sue an insurance company for non-payment under compulsory motor liability insurance

The best way to get money from the insurer is to file a claim with the courts. No one else but a judge has the right to make a decision to impose a fine for non-compliance with the Law of the Russian Federation “On the Protection of Consumer Rights”, and in addition, oblige to compensate for both damage caused to property and moral damage.

The right to appeal to the judicial authorities arises at the moment when the insurer refuses to satisfy the claim, or when no response is received at all.

To do this you will need the following steps:

Preparation of a claim, which will indicate what violations the insurance company committed, as well as an explanation on what basis the insurer’s actions are contrary to the law;
Payment of state duty;
Preparation of copies of all documentation supporting the applicant’s arguments. Their full list will be dictated by specific circumstances, but duplicates of papers sent to the insurer, a second copy of the claim and a response from the insurer must be submitted in any situation. In addition, if an independent examination is organized, there will be a need for a copy of the conclusion and copies of telegrams or other types of messages sent to the insurer. The original papers are presented to the court, and photocopies are attached to the case file;
Submission of the application to the judicial authority - by post or office workers.

During the trial, the plaintiff has the responsibility to prove his position. For this purpose, the Code of Civil Procedure of the Russian Federation gives him the right to use any evidence related to the process: documents, video recordings, photographs, testimony, examination data, etc.

When any evidence cannot be presented by the plaintiff on his own, he has the right to seek help from the court - in such a situation, the court may request evidence from its location.

After the case is considered, a judicial act is issued, in which the court either shares the position of the plaintiff and recovers money from the insurer, or decides to refuse his claims. If refused, the applicant has the right to appeal to a higher court, in accordance with the rules of the Code of Civil Procedure of the Russian Federation.

Grounds for refusal of insurance payments

Article 6 of the Law “On Compulsory Motor Liability Insurance” notifies the main circumstance upon the occurrence of which the insurer is released from the obligation to pay the insured amount. This occurs if liability arises due to the fact that harm was caused to a third party when the vehicles were operated.

Citizens who have taken out insurance, as well as victims, must remember that MTPL does not compensate for damage if:

damage was caused to a car for which there is no insurance;
the damage occurred within a period of time not specified in the insurance policy;
damage was caused to the health of an employee performing work duties, while he is covered by social insurance;
passengers were injured while transporting them by public transport, provided that the carrier insured its liability;
the cargo was damaged during loading or unloading.

An exhaustive list of situations that do not fall under the definition of an insured event, i.e., excluding payment under compulsory motor liability insurance, is fully included in the above article. Article 6 presents no difficulties in matters of interpretation.

Having analyzed unfounded refusals to pay the insurance amount, we can make a list of the main reasons:

Refusal to pay if the documentation listed in clause 3.10 of the OSAGO Rules is not provided. In addition to the application for payment of money, the victim must submit:

a copy of an identity document;
certificates of road accidents;
accident notifications;
a duplicate of the protocol on the administrative offense, if one was drawn up;
decisions in a case of an administrative offense;
determination that the initiation of a case of an administrative offense has been refused. In accordance with the Insurance Rules, the insurer has no right to demand from the victim documentation not mentioned in clause 3.10. insurance rules;

The insurer's refusal to pay when the car was not presented to an expert technician for inspection within 5 days from the day the claim for the insured event was submitted. The parties agree on where and when the inspection will be carried out via telephone or postal communication. The victim cannot be required to deliver the disabled vehicle to a location that is a long distance from his location. In this case, an expert must go to the address of the vehicle to be inspected. In case of failure to carry out an inspection in accordance with clause 3.11 of the OSAGO rules, the person is entitled to apply for an independent technical examination, based on the conclusion of which an insurance payment should be made;

Quite often, motorists are refused due to the fact that the damage to the car discovered during its inspection, which was carried out by a company representative, does not correspond to the circumstances of the accident (i.e., they are not related to the accident).

Clause 11 of Article 12 of the law states that if, assessing the circumstances of the accident and its consequences, the insurer and the victim do not reach an agreement, it is necessary to resort to appointing an independent technical examination.

The responsibility for organizing and paying for such a study rests with the insurer.

Often, in this case, insurance disputes are transferred to the courtroom. For victims who have lost their insurance benefits, this creates a difficult situation, since they are unable to prove the validity of their case. The reason for this lies in the fact that the purpose of examination in civil cases has its own characteristics.

Most often, insurers prefer to use the following arguments to refuse payment::

The culprit of the accident did not submit the damaged car for an independent technical examination;
At the time of the collision, the culprit was under the influence of alcohol;
The culprit is not mentioned in the insurance policy;
The policy is invalid;
Fraud of the insurance policy;
Termination of insurance policy status.

What to do if the insurance company does not pay OSAGO

A compulsory insurance policy allows motorists to compensate for the costs of vehicle repairs in the event of an accident. Unfortunately, the terms of the contract are often violated, and citizens have to try hard to get their money. What measures can an ordinary driver take if the insurance company does not pay for compulsory motor liability insurance? You will learn about this from the review below.

When are documents submitted?

After an accident, citizens must contact the company’s office and present their claims for damages. To do this, you need to write an application and attach a certain list of documents.

The insurer is obliged to consider the appeal and respond within 20 days

If a refusal to pay has been sent, it is necessary to check several points of the legality of such actions:

the notification is issued only on the company’s letterhead;
justified reasons for refusal must be indicated;
carefully study the Civil Code of the Russian Federation, the Law on OSAGO and the rules on OSAGO in order to understand whether there is a violation in the actions of the insurance company’s employees.

Companies will not violate established rules if they care about the company's reputation.

Reasons for refusal

In accordance with current legislation, the insurance company has the right to refuse payment in the following cases:

there is no certainty that the accident actually happened;
there is no way to check the amount of damage, since the owner partially repaired the damaged car or handed it over for recycling;
the citizen does not have a valid MTPL policy;
the accident occurred when the insurance policy expired;
the car owner did not notify the insurance company about the accident;
the culprit of the incident is the driver who committed a gross violation of traffic rules (driving a vehicle while intoxicated, driving into the oncoming lane, driving illegally);
transport was damaged due to unforeseen circumstances (natural disasters, riots on the street, military operations);
there are errors in the application;
copies of the required documents are not attached;
the case in question was not recognized as insured.

Any illegal actions of company employees must be challenged.

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What to do

If a negative response was received or 20 days have passed since the application, and no notification has been received from the company, you need to start acting on your own. Follow a certain algorithm of actions.

Independent examination

The conclusion of qualified specialists will confirm the amount of property damage. If there are victims, additional research needs to be conducted to assess the harm caused to their health.

You must notify the insurance company in writing of the date and location of the examination. If necessary, they will send an employee who will be present when it is carried out.

The car owner will have to pay for the services of the experts themselves. The result obtained will become irrefutable evidence in court.

Claim to the insurer

Before resolving the issue through the court, you need to contact the company to resolve the issue amicably. The notice shall indicate:

mistakes made by company specialists;
references to legal norms confirming the unfoundedness of the refusal;
calculation of the amount of damage;
present your demands;
indicate that you reserve the right to appeal to a higher organization;
list and attach supporting documents.

In this section you can familiarize yourself with the completed claim form.

The company is given 10 days to consider the issue. As a result, two possible responses are expected:

satisfy the applicant's requirements;
refuse payment indicating specific reasons.

The insurance company is obliged to make reference to clauses of the law confirming the validity of the refusal

Complaint to regulatory authorities

One of the effective ways is to send a complaint to organizations that regulate and control the activities of insurers.

You can contact:

They will resolve issues in cases of obvious violation of the law. RSA also assumes obligations to pay damages upon liquidation of the insurance company. Institutions will not be able to help if a dispute arises about the amount of compensation. In this case, it is better to immediately go to court.

A uniform application form is used.

We suggest you study the completed sample; it will help you understand what points should be contained in the complaint.

Be sure to attach copies of supporting documents if you do not want to have your application rejected.

Going to court

If the car owner is not satisfied with the result obtained, there is only one option left - to go to court.

To do this you need:

write a statement of claim, indicate the reasons for the appeal;
pay the state fee if the amount of the claim exceeds 1 million rubles. In other cases, the state duty is not paid;
collect all necessary documents;
submit a complete set of documents to the court office in person or by mail.

The list of documents depends on the circumstances of the case, these may be:

information about the accident (European protocol, traffic police regulations);
forms confirming an attempt to resolve the issue out of court (submitted claims, complaints);
responses received from the insurance company and regulatory authorities, if institutions responded to the appeal;
results of an independent examination.

The statute of limitations for going to court is 3 years

You should not delay in writing a statement of claim, as there are some peculiarities in counting the deadline:

from the moment of receiving the refusal from the insurer;
The countdown begins from the next day, after the expiration of 20 days, when the company had to respond.

Compliance with deadlines will help achieve a fair decision in favor of the plaintiff. After satisfying the requirements, the citizen will receive a writ of execution; it must be submitted to the SSP or to the bank where the insurance company’s current account is located.

Having achieved justice, the applicant will receive the amount due to compensate for damages. In addition, the insurer will be required to pay a fine and reimburse all legal costs. If you are afraid that you will not be able to understand all the intricacies of the law, immediately contact a lawyer. The help of professionals will help to achieve a speedy resolution of the issue.

What to do if the insurance company does not pay for compulsory motor liability insurance

The insurer does not pay for compulsory motor liability insurance - this is a common case in the field of compulsory insurance. The reasons for refusal can be justified or unjustified. In the first case, there is no point in going to court. Unfounded reasons are often formal, so the policy owner can obtain payments in court.

Main reasons for refusal

In Russia, the relationship between the policyholder and the insurer in the field of compulsory motor liability insurance is regulated by Law No. 40-FZ “On compulsory insurance of civil liability of vehicle owners.” Also, the rights and obligations of the parties are set out in the agreement signed by both parties.

If you comply with all points of the document, you can eliminate as much as possible the grounds for refusal on the part of the insurance company.

In what cases does the owner of the insured vehicle not receive compensation:

The car owner does not have an MTPL policy or it is expired.
When applying for a policy, the vehicle owner deliberately provided incorrect information because he wanted to increase the amount of insurance payments.
The accident was caused by the driver (policy owner) being under the influence of drugs or alcohol.
The application for the occurrence of an insured event and the corresponding package of documents were submitted late. If the policy owner was unable to provide the necessary documents on time for a valid reason, you need to prepare a sick leave certificate, travel certificate or other document confirming the valid reason for the delay.
The policyholder submitted an incomplete package of documents after the occurrence of an insured event under MTPL.
The accident happened outside the Russian Federation.
The insurer went bankrupt and ceased to exist as a legal entity.
The vehicle was damaged or destroyed during a test, tournament or competition. Damage to a car in an accident that occurs while learning to drive is not an insured event.
The breakdown occurred due to the transportation of goods that did not correspond to the carrying capacity of the vehicle.
At the time of the accident, the insurance premium under the MTPL agreement had not been paid.
Damage to the condition of the vehicle was intentionally caused in order to obtain financial compensation from the company with which the contract was concluded.
While operating the insured car, the policy owner damaged or destroyed architectural and cultural monuments, as well as antiques.

A pre-trial claim under compulsory motor liability insurance submitted to the insurance company will not be satisfied in such cases, since the refusal of the insurance company in the above cases is justified.

There are formal reasons for refusing to pay compensation, and they can be challenged. These include:

the person who caused the accident did not have the right to drive due to the lack of a driver’s license;
violation of the procedure for informing the insurer about an accident.

In what cases is it necessary to contact the insurance company with a pre-trial claim:

the company did not compensate for the damage within 30 days (this is the legally established period for paying compensation to the owner of the MTPL policy);
the insurer paid an insufficient amount of compensation, which does not compensate for the damage;
the company refuses to pay the insurance amount in a case recognized as insurance.

A properly completed pre-trial claim must be submitted to the insurance company as soon as possible. The complaint is also supplemented with a package of documents, including:

copy of passport;
copies of documents for the vehicle;
original policy;
certificates of registration of road accidents;
the conclusion of an independent expert who assessed the amount of losses;
additionally: medical certificate of damage to health, receipt of payment for the tow truck and more.

When filing a claim with the insurance company, the policy owner does not go to court. The insurer reviews the document within 10 working days and makes a decision on payment or makes a justified refusal.

If the company refuses to compensate for the loss or does not take any action, it is necessary to contact the organization that controls the activities of insurers. In this case, the claim is reviewed within 1 business day.

Litigation under compulsory motor liability insurance

If filing a pre-trial claim does not produce results, you should collect a package of documents for the court. At this stage, it is recommended to seek help from an experienced lawyer.

First you need to calculate the amount claimed. It is necessary to add the amount of material damage determined during an independent examination with the amount of loss of marketable value of the car. The costs of conducting an independent examination and the cost of state duties are added. If the insurer has already paid any amount, it must be deducted from the result obtained.
The claim is drawn up in 3 copies. The first is for the court, the second is for the insurer, the third is to indicate that the insured’s documents have been received by the court. Each is accompanied by a package of copies of documents necessary to substantiate the claim. The claim must indicate the full name of the applicant, the full name of the insurer, policy number, and place of permanent registration.

The date of filing must be recorded in the claim. This factor plays a key role in counting the limitation period. In this case it is 3 years.

What you need to prepare for the trial:

notification of an accident, drawn up on official letterhead and signed by both parties to the incident;
copies of the protocol, resolution and certificate issued by the traffic police officer at the scene of the accident;
a copy of the MTPL policy;
a copy of the application for the occurrence of an insured event, submitted to the company;
the result of the vehicle examination;
a copy of the insurer's report indicating the amount of damage.

The collected documents are submitted in person or by registered mail to the court at the place of registration of the policy owner and the registration of the owner of the vehicle injured or destroyed in an accident.

It is important to document the filing of a pre-trial claim before going to court. 30 days are allotted for making a decision from the date of submission of documents. During this period, the policy owner receives consent or refusal to indemnify losses.

If the court ordered the insurer to pay compensation, the wait to receive compensation may take from several days to several years. If the claim is fully satisfied, the injured party is paid not only the specified amount, but also a penalty accrued for each day of delay in payments.

How to avoid violations of obligations by the insurer

To avoid litigation related to the insurance company’s refusal to pay compensation under compulsory motor liability insurance, you need to follow simple recommendations:

Before signing, carefully read the clauses of the contract;
you need to choose a large insurance company with a good reputation;
When applying for a policy, you should provide only reliable information.

It is important to monitor the validity period of the policy. If at the time of the accident it is overdue by at least 1 day, you will not be able to receive compensation from the insurance company.

If you have any questions, you can ask them free of charge to the company’s lawyers in the form provided below. An answer from a competent specialist will help you make the right decision.

The insurance company does not pay for compulsory motor liability insurance

A long-term analysis of the reasons why the insurance company does not pay under compulsory motor liability insurance allows us to distinguish two groups - justified and unjustified. The first, as judicial practice shows, are legitimate, so in most cases there is no point in challenging them. The exception is situations in which the basis for the decision was the results of the examination. If they are doubtful, then after they are refuted by an independent study, the insurance company (IC) will have no arguments left for a negative decision.

As for the second group of reasons for refusal, they are usually of a formal nature, so they can easily be overcome in court. Knowledge of such nuances of the work of insurance companies will help every driver understand what to do so as not to be denied payment under compulsory motor liability insurance and how, even in this case, the situation can be corrected.

Reasoned reasons for refusal under MTPL

In addition to the current legislation, the main regulatory document that regulates the relationship between the insurer and the policyholder is the contract. It sets out the rights and responsibilities of the driver and the insurance company. In many cases, strict adherence to its provisions makes it possible to exclude reasoned reasons for the insurer’s refusal to pay under compulsory motor liability insurance in the event of an accident. Damage is not covered by the company if:

The vehicle does not have an MTPL policy.
The claim for compensation is submitted late. If there is a good reason and there are supporting documents (sick leave, travel certificate, summons, etc.), the period can be extended.
Compensation for moral damage is required.
The damage occurred during driving training, at competitions and tournaments, as well as during vehicle testing.
The cause of defects and breakdowns is the impact of the transported cargo.
Compensation for harm is required, which must be compensated by the employer through the social package.
The car damaged cultural and architectural monuments, antiques and other similar things.

These are cases in which there is no point in going to court to challenge the decision of the insurance company, since everything is clearly stated in the contract. There are other situations when refusal to pay under compulsory motor liability insurance is justified and completely legal:

The victim did not submit all documents. In this case, there cannot be a complete refusal of payments, but the case will be suspended until all necessary documents are received.
The insurance company has gone bankrupt and cannot meet its obligations. Then the victim must contact the RSA, which fulfills the obligations of the Investigative Committee.
The insurance policy form was found to be counterfeit. This issue can be resolved by involving law enforcement agencies (contacting the police) and writing a corresponding appeal to the RSA.
When it is proven that the victim cheated in his relationship with the insurance company in order to receive a certain benefit.
If the drivers are both at fault, the insurer significantly reduces the amount of payment or even refuses it.
If you receive damage in an accident outside the country, the MTPL policy is valid only within the borders of the Russian Federation.
When the collision occurred not while driving, but in a parking lot. This point may also be contested.
If the policyholder at the time of the accident has not yet paid the insurance premium under the MTPL agreement.
In cases where, even before the technical examination, the damaged vehicle was repaired.
If the parties to the accident resolved their mutual claims on their own and the victim received compensation from the perpetrator.

Formal reasons for refusal to pay, which can be disputed

Of particular importance are formal or illegal reasons for the refusal of the insurance company to repudiate its obligations. Some of them:

the damage to the vehicle was caused intentionally or the driver was in an affective state (due to alcohol or drugs);
the person responsible for the collision did not have the right to drive the vehicle;
the second participant (the culprit) fled the scene;
at the time of the accident the MTPL agreement was not valid;
the culprit of the accident was not allowed to drive a car under a valid MTPL agreement;
non-compliance with the procedure for notifying the insurance company and actions at the time of the occurrence of an insured event;
non-compliance of the insured event with implicit and ambiguous definitions given in the insurance contract.

It is illegal for an insurance company to claim that it cannot pay compensation for one of the above reasons. Art. 14 Federal Law No. 40 (as amended on September 25, 2017) regulates the right of recourse, that is, the insurance company filing a claim against the person who caused the harm. In accordance with this article, malicious intent, alcohol or drug intoxication, lack of the right to drive a vehicle, fleeing the scene of an accident and other circumstances of the culprit of the accident cannot serve as grounds for refusal to pay. Instead, the insurance company that has compensated the victim receives the right to demand the appropriate amount from the person responsible for the damage.

How can you protect yourself from a possible refusal of payment by the insurance company for formal reasons? A few simple tips will help with this:

you need to carefully read the provisions of the contract that you will sign;
when choosing large and well-known insurance companies, you reduce the risk of refusal, but there remains a high probability of a significant underestimation of the amount of compensation due;
Include in the contract the maximum possible ways of using the insured vehicle, and indicate this in specific, unambiguous phrases;
Understand the list of exclusionary terms of the agreement and try to understand how specific they are and whether you understand them as well as your insurance agent.

Despite such precautions, the likelihood that the insurance company will not pay compulsory motor liability insurance or will underestimate its amount is high. What if it's for illegal reasons? The best way would be to go to court. It is worth considering that even if the outcome of the trial is positive, your claim may not be satisfied in full. With this in mind, indicate in it the maximum possible amounts in your case. This will help cover the actual costs even if the claim is partially satisfied.

Since the legal arguments will take several weeks, begin the process immediately after receiving the refusal. This will allow you to achieve your goal faster. Specialists of the Honest Law Bureau perform technical examination of vehicles and the damage they received. The research results have legal force and can be used in courts. Competent support of claims against insurance companies allows our clients to receive decent compensation.

Documents required for legal proceedings

Most car owners avoid proceedings due to lack of sufficient time, unclear prospects and ignorance of their rights. But the victims’ claims are often satisfied – partially or in full. So it's worth a try. Especially if we are talking about significant amounts, which are much more than legal costs.

Despite the help of a competent specialist who will take on the lion's share of routine work, the applicant will need patience. The process requires the following documents:

notification of an accident, drawn up and signed by both drivers on official letterhead;
copies of the Protocol, Resolution and Certificate received at the scene of the incident from the traffic police officer;
a copy of information from the MTPL policy of the person responsible for the accident;
a copy of a written application to the insurance company, which notifies it of the occurrence of an insured event - with a note from the insurer confirming acceptance of the document;
results of an independent examination of a vehicle damaged during an accident;
a copy of the insurance company's report indicating the amount of damage.

These documents accompany the written claim to the insurance company. It is submitted to the court in person or by registered mail. The text of the claim consists of a justified appeal from the victim with a description of the violations committed by the insurer, references to the legislation, and an explanation of the situation for which it was necessary to go to court.

The amount of the claim includes:

insurance compensation based on expert assessment of damage caused;
cost of state duties;
costs of conducting an independent examination;
other expenses that the plaintiff had to bear.

If the insurance company does not pay under compulsory motor liability insurance and the company is found guilty of illegally refusing to pay under compulsory motor liability insurance and the claim is fully satisfied, in addition to the amount specified in it, the victim will be paid a penalty for each day of delay.

Thus, despite the objective difficulties associated with the trial, its conduct is in the interests of the injured vehicle owner. Thanks to this, legal costs, as well as damage incurred during an accident, will be covered by the insurance company in the amount established by the court.

What to do if the insurance company does not pay compulsory motor liability insurance? Detailed instructions for receiving payments.

The introduction of compulsory motor liability insurance made it possible to solve many problems with compensation for damage in road accidents. However, everyone loves to receive money, but few people like to pay. Insurance companies are no exception. Too often, drivers are faced with the fact that insurers either delay the timing of payments or even refuse them under a far-fetched pretext. What can someone who is faced with this problem do?

○ Problems with payments from the insurance company.

First of all, you need to figure out exactly how compensation for damage with the help of compulsory motor liability insurance “works” from the point of view of the law. In what cases can a company refuse to pay under the law, within what time frame must the money be transferred, and what amount must insurers reimburse.

✔ Refusal to pay.

All cases where the insurer actually has the right to refuse payment on legal grounds are listed in the following regulations:

Civil Code of the Russian Federation.
Federal Law “On compulsory civil liability insurance of vehicle owners” (hereinafter, for brevity, the Federal Law on Compulsory Motor Liability Insurance).
Rules for compulsory civil liability insurance of vehicle owners, approved by Bank of Russia Regulation No. 431-P dated September 19, 2014 (hereinafter referred to as the MTPL Rules).

In accordance with these regulations, the company has the full right to refuse payment of funds for damages in the following cases:

The company cannot be sure that the insured event occurred at all, or cannot accurately determine the amount of damage. This is possible if the owner of a car damaged in an accident hastened to completely repair it or managed to sell the car for scrap.
There was no policy issued for the car.
The accident occurred during a period when the MTPL policy was not in effect.
The owner did not report the accident to the company.
The car owner is trying to recover lost profits from the insurer.
We are talking about recovery of moral damages (including for suffering suffered due to injury during an accident).
The accident occurred during training driving, auto racing or while testing a new car design - provided that the training, competition or test took place in a specially designated place.
The damage was caused due to the special nature of the cargo that was transported by car - provided that the transportation was insured under another type of compulsory insurance.
The driver himself caused the accident or somehow caused damage to his car.
Causing harm during loading operations on a vehicle.
The harm was caused to employees in the performance of their official duties, if this harm should be compensated under another type of insurance (for example, compulsory medical insurance).
Damage was caused to the life, health or property of passengers, if the damage must be compensated by compulsory insurance for passenger transportation (this is another type of insurance).
Damage was caused to cultural monuments, antique property, religious and religious objects and some others specifically identified in Art. 6 Federal Law on compulsory motor liability insurance for types of property.
The harm consists of pollution of nature (for example, a spill of fuel from a fuel tanker during an accident is not compensated by OSAGO).
There is “force majeure” - that is, the damage was caused during a war, riots, natural disaster and other circumstances that could not be foreseen and which the person responsible for the damage could not influence in any way.

In fact, the above list is exhaustive. The insurance company should not allow refusal in other situations.

✔ Violation of the payment deadline.

In addition to an unjustified refusal, another example of a violation of the law on the part of insurers is delay in payments. What are the rules regarding this?

According to the MTPL Rules, to consider the issue of compensation to the insurance company, the following is given:

20 days – in general.
30 days - if, under the MTPL agreement and with the consent of the company, the victim began to repair the car in a workshop with which the insurer has concluded a corresponding agreement.

Deadlines are calculated in calendar days, but do not take into account weekends and holidays. During this time, the insurer is obliged to:

Or pay a refund.
Or give a written and reasoned refusal to pay, which the victim can then appeal in accordance with the procedure established by law.

✔ Not paid enough.

Finally, in addition to complete refusal and delay, there is a third trick of insurers - underestimating the amount of payments. How much do they have to pay by law?

Federal Law on OSAGO in Art. 7 indicates that the insurer is liable within the following amounts:

If damage is caused only to property - 400 thousand rubles.
If people were injured or killed – 500 thousand rubles.

Moreover, if the damage is more than these amounts, the missing amount can already be recovered from the culprit directly.

The amount of compensation that the insurer must pay is determined in two ways:

According to strict standards established by law. For example, if a person dies in an accident, the insurance company is obliged to pay relatives 475 thousand and reimburse funeral expenses within 25 thousand.
According to the assessment of damage caused by the insurance company.

It is in the latter case that problems usually arise: insurers, taking advantage of the fact that damage is an assessment category, try in every possible way to underestimate the amount of payments. Any methods are used - from “undetected” damage to denying the connection between the decrease in property value and the insured event.

The best way to avoid understatement is to conduct an independent examination with the involvement of a representative of the insurance company.

○ Procedure for pre-trial decision.

To avoid problems with payments, the victim needs to take some measures. So what can he do?

✔ Independent examination.

If the insurance company’s assessment of damage is in doubt, it is necessary to contact an independent expert appraiser and order an examination of the damage caused from him. This is done as follows:

The victim enters into an agreement with an expert bureau or with an individual licensed expert.
The time for the examination is agreed upon.
The insurance company is notified of the place and time when the inspection and assessment of the damaged property will take place. The best way to do this is to send a telegram notifying them. If you use this method, then in the event of a court there will be no disputes about whether the insurance company knew about the very fact of the examination.
If a representative from the insurance company appears, he can participate in the inspection, observe the actions of the appraiser and ask him questions. If not, but there was a notification, then the examination is still considered legal and completed. Practice shows that in most cases, judges agree with the position of an expert not associated with the company, and not with the assessments of the insurer itself.
A properly prepared and certified report (with attached photographs of the damage and copies of the expert’s own documents) is sent to the insurance company when filing a claim. As a rule, experts make two certified copies of the report for this purpose: one goes to the insurer, and the second remains with the victim and can be presented in court.

✔ Insurance company claim.

The legislation establishes that before going to court, a victim who does not agree with the actions of the insurance company must file a claim. The complaint indicates the essence of the errors made by the company (illegal refusal, underestimation of the amount, late payment, etc.), as well as the requirement to correct them.

According to Art. 16.1 of the Federal Law on Compulsory Motor Liability Insurance (MTPL) the insurer has 10 working days to respond to the claim. After this period, he is obliged to:

Or correct the violations.
Or give a reasoned written refusal. This refusal can already be appealed in court.

✔ Complaint to RSA.

An effective measure to put pressure on an unscrupulous insurer is a complaint to RSA, an organization that must include all insurance companies selling MTPL policies. To do this, you must prepare a written complaint and, attaching supporting documents, send it to the RSA.

However, we must remember: the RSA deals only with cases where a gross violation of the law occurs. For example, if a company refuses to pay without specifying any reasons, or requires documents not provided for by the MTPL Rules, RSA can help. RCA also takes over payments in the event of bankruptcy of an insurance company. However, if we are talking about a dispute regarding the amount of compensation, it is better to immediately go to court.

✔ Complaint to the Central Bank of the Russian Federation.

You can also appeal the actions of the insurance company to the Central Bank of the Russian Federation. The fact is that it is the Central Bank (aka the Bank of Russia, Central Bank) that is the supervisory authority that controls companies operating in the financial sector. The powers of this body also include supervision of insurers.

However, the problem here is the same as with the RSA: the Central Bank reacts to a direct violation of the law - but does not resolve disputes between the insurer and the policyholder, where formally the insurance company operates within the law.

○ Procedure of court decision.

A lawsuit is the best way to recover unpaid money from the insurance company. It is within the competence of the court to collect fines for violation of the Law of the Russian Federation “On the Protection of Consumer Rights,” as well as compensation not only for property damage, but also for moral damage.

You can go to court at any time after the insurance company either refuses to satisfy the claim or fails to respond to it within the period established by law. To do this you will need:

Prepare a statement of claim indicating the violations committed by the company and justifying why the actions of the insurer are unfounded and illegal.
Pay the state fee.
Prepare copies of all documents proving the plaintiff’s position. Their exact list will depend on the circumstances of the case, however, copies of documents submitted to the insurance company, claims, and response from the insurance company must be attached in any case. Also, if an independent examination was carried out, a copy of the conclusion and copies of telegrams or other notifications to the insurance company will be required. Original documents are presented at the meeting, and copies are attached to the case file.
Submit the claim to the court - by mail or through the office.

At the trial, the plaintiff must prove his position. To do this, in accordance with the Code of Civil Procedure of the Russian Federation, he can use any evidence related to the case: documents, video recordings, photographs, testimony of witnesses or experts, etc. In the event that the plaintiff cannot present any evidence himself, he can ask the court for help - and the judge in this case can demand the necessary evidence from where it is located.

Based on the results of the consideration, the court makes a decision - and either agrees with the plaintiff’s arguments and recovers money from the company, or refuses. The refusal can be appealed to a higher court in the manner prescribed by the Code of Civil Procedure of the Russian Federation.

○ Advice from a lawyer:

✔ A claim was sent to the insurance company and they do not respond.

By law, the insurer must respond to the claim within 10 business days. The period is counted from the day the claim was filed:

If personally by the applicant through the company’s office - from the date of receipt of the claim.
If sent by mail, from the date when the company accepted the letter and signed the notification.

If the deadline is missed, the citizen can file a complaint with the RSA or the Central Bank of the Russian Federation - but can also immediately go to court with a claim against the insurance company.

✔ Moral damages for the insurer’s refusal to pay.

According to Part 2 of Art. 16.1 of the Federal Law on Compulsory Motor Liability Insurance, the norms of the Law of the Russian Federation “On the Protection of Consumer Rights” are applied to relations under this type of insurance. This law provides for the possibility of recovering moral damages.

However, it must be borne in mind that this type of harm, that is, physical or mental suffering due to late payments or denial of them, must be proven and convincingly motivated in court. As judicial practice shows, courts are not very willing to collect the entire claimed amount - and often either provide compensation or underestimate the amount of moral damage.

What to do if the insurance company does not pay for compulsory motor liability insurance. Denis Trofimov, a representative of the company “Grani Riska”, will talk about this.

Published by: Vadim Kalyuzhny , specialist of the TopYurist.RU portal