How to get a calculation (independent examination) from an insurance company

If the insurance company refuses to pay, or you receive less than you should, go to court. But first, be sure to send a pre-trial claim to the insurer.

Important! When filing a pre-trial claim under MTPL, use additional leverage over the insurance company.

You can contact:

• to the Russian Union of Auto Insurers (file a complaint);
• to the Bank of Russia (file a complaint);
• to the territorial department of Rospotrebnadzor.

What do you need to know about the claim procedure in order to receive a decent insurance payment and additional monetary compensation?

Why write a pre-trial claim under OSAGO

Since 2014, compliance with the pre-trial procedure for resolving disputes under compulsory motor liability insurance is mandatory by force of law (Article 16.1 No. 40-FZ). If you go to court immediately, the claim will not be considered.

Therefore, we write a complaint on any controversial issue. In particular, when the insurance company:

• refuses to pay or reduces the amount of insurance payment;
• violates payment deadlines;
• performs poor-quality repairs;
• attracts “its” experts and appraisers, which influences the results of the examination;
• makes incorrect calculations (bonus-malus coefficient, insurance amount);
• imposes additional services, etc.

But: writing a claim does not mean simply observing a formality. If the insurer voluntarily does not comply with the requirements, then you, as a consumer, will be able to recover through the court a fine in the amount of 50% of the amount assigned for collection (clause 6, article 13 of the Law on the Protection of Consumer Rights No. 2300).

That is, if the court awards 100,000 rubles in your favor, you will receive 150,000 rubles. The only thing you will need is evidence that you submitted the claim correctly (more on this later).

Required documents

The list of documents from the package of papers submitted to the insurance company is determined by the type of accident and the method of its registration. If the accident was registered according to the European protocol, then the following must be attached to the application for payment:

• notice;
• a car registration certificate or a sales contract confirming the right to own the car;
• passport of the policyholder acting as a beneficiary in this scheme.

If the accident was registered with the participation of traffic inspectors, then the insured must supplement the package of papers with copies of the protocol on the administrative offense and the resolution on the case. Persons injured in an accident must submit an expert opinion, certificates from a medical institution and a certificate of loss of ability to work, if relevant.

What other compensation can you demand?

In a pre-trial claim to an insurance company under compulsory motor liability insurance, you can demand payment (compensation):

• vehicle repair costs;
• loss of market value;
• tow truck services;
• road workers services;
• storage services for damaged vehicles;
• the cost of repairing road signs and fences;
• transporting victims to hospital;
• cost of examination,

as well as other expenses that arose in connection with the occurrence of an insured event (clause 50 of the Resolution of the Plenum of the Supreme Court No. 58).

Delay in fulfilling obligations under the MTPL agreement by the insurance company is compensated by a penalty in the amount of:

• 1% of the due payment amount;
• 0.5% of the repair cost for each day of delay.

We begin to count the days of delay: in the first case, from the 21st day, in the second, from the 31st day from the date when the insurance company received your application for insurance payment (repairs).

Additionally, you can only demand monetary compensation for moral damage and a consumer fine of 50% in court.

How to process an insurance claim payment

We will look at the insurance claim itself below. First, we will find out what the person insuring something should do in the event of an insured event.

Insurance companies sell a huge number of different insurance policies for all occasions. Receiving payments under different policies based on the policyholder’s application has its nuances, but we will consider the general procedure for receiving payments.

After the occurrence of an insured event, the policyholder must take the following actions:

1. Make sure that an insured event has occurred and you can contact the insurance company. This point will make many people smile, but there is nothing funny about it. The fact is that the insurer may regard what you perceive as an insured event differently. Carefully re-read the insurance contract and make sure that there is a reason to contact the insurer. If, for example, in a life and health insurance contract, the fact of illness or injury must be confirmed by a medical qualification commission, and you only have a certificate from the emergency room, it is premature to write an application.
2. Notify the insurer of the occurrence of an insured event. Once again, carefully read the insurance contract - it indicates the time frame within which you must carry out this action. In different companies and under different insurance policies, the terms may be different. Perhaps you should run to the medical qualification commission at a skip, otherwise you won’t have time to submit your application. Or, conversely, there is no hurry. However, it is better to start collecting all the necessary documents right away. The medical qualification commission is given here as an example, but filing an application necessarily requires confirmation of the fact of an insured event. It must be properly formalized by the required organization - the traffic police, the medical qualification commission, the fire department or another authority. Sometimes such confirmation is quite difficult to obtain, it can take a lot of time, and the documents must be submitted on time.

Actually, upon notification to the insurance company, the policyholder’s personal activities to obtain insurance should end. Then he must wait for payment according to his application. But notifying does not mean calling the insurance agent or sending him a telegram. This means collecting all the necessary documents and submitting them to the insurer's office. You will need:

1. Insurance policy and insurance contract.
2. Original and copy of passport or other document replacing it.
3. A package of documents confirming the occurrence of an insured event. The act of the medical qualification commission given as an example is a particular one; it is possible that several documents from different authorities will be needed.
4. Statement.

The insurance company may require you to provide documents not included in this list. They will have to be collected and brought.

How to correctly write a pre-trial claim under OSAGO

The requirements for a claim under compulsory motor liability insurance are described in detail in clause 5.1 of Chapter 5 of Bank of Russia Regulation No. 431-P.

A pre-trial claim to an insurance company under compulsory motor liability insurance must include:

• name and address of the insurer's company;
• Full name, address, bank account details of the victim (beneficiary);
• detailed requirements for the insurer with links to legislative norms and evidence from the list of appendices;
• Full name of the sender, position (if the claim is sent by a legal entity), signature;
• list of applications.

All your rights and claims must be supported by evidence. The claim must be accompanied by originals or certified copies of: the applicant’s passport, vehicle title document (PTS), MTPL policy. expert opinion, etc.

Important! The main thing is not to miss anything, otherwise the insurance company will ignore the claim, and the court will consider the pre-trial procedure not to be followed and refuse to collect a consumer fine of 50% of the amount assigned to be collected in your favor.

If you need help, we will help you correctly write a claim under MTPL and collect all the necessary documents (evidence).

When it is impossible to receive the payment of the TTS under compulsory motor liability insurance

The legislation of the Russian Federation provides for a specific and finite list of cases in which the insurer company receives the obligation to make payments for vehicle insurance.

You cannot receive this compensation if:

• the driver is in the status of the culprit of the accident;
• the vehicle does not meet the specified requirements;
• the policy does not make such payments;
• the driver has already applied before and received compensation;
• the driver did not make the appropriate request;
• the injured party carried out repair work independently.

In order to clearly understand when you can count on compensation payments, the car owner should carefully read all sections of the car insurance contract.

How to direct?

You can submit a claim using any method as long as it allows you to confirm delivery. The most reliable option is by registered mail with a list of attachments and acknowledgment of delivery.

You can take it personally to the office of the insurance company.

It is not necessary to contact the exact branch where the contract was drawn up. Contact the closest one to you, but provide information about previous requests (clause 22 of PP No. 58).

Be sure to ensure that the acceptance mark is given by an authorized person. If this is not the director, ask to see a power of attorney for the right to receive incoming documents.

The claim can be sent by e-mail if such a possibility is specified in detail in the contract. For example, a claim to Rosgosstrakh can be sent by e-mail

Important! The sender must prove that the message was sent and delivered (clause 67 of the Resolution of the Plenum of the Supreme Court No. 25).

The Supreme Court in one of the cases on compulsory motor liability insurance found that the pre-trial procedure was not complied with, although the plaintiff sent the claim to the address indicated in the Unified State Register of Legal Entities. Russian Post sent the letter back to the sender 9 days from the date it arrived at the post office, even before the letter’s storage period expired (30 days). And a month later the plaintiff received it. The plaintiff did not provide evidence to the court that the insurance company avoided receiving correspondence.

"AlfaStrakhovanie" - List of documents for receiving payment

Each document submitted must be completed correctly. Depending on the nature of the application, an application form is filled out, which is confirmed by a signature and transcript. Once completed, each form is marked with a date.

There is no standard list that would apply to all programs. It all depends on the specific case, the insurance product, and the injuries received by the insured person. Several examples should be given.

"Refusal of insurance"

Clients of the AlfaStrakhovanie organization have the right to terminate the contract concluded with the insurer within 14 days. In this case, you need to pay attention to 2 nuances:

• The period is calculated from the moment the insurance premium is paid.
• If an insured event occurs within 14 days, it will be impossible to cancel the policy.

When filling out the application, you should indicate:

• FULL NAME;
• registration address;
• contact phone number and email if available;
• insurance contract number;
• details for receiving the unused portion of the insurance premium;
• what documents are an integral part of the application.

Along with the application you must have with you:

• identification document of the applicant;
• insurance policy;
• receipts indicating payment of the duty.

Providing these papers will speed up the procedure for returning lost amounts. The maximum period for consideration of a client’s request and transfer of funds to his account is no more than 10 days.

All documents must be presented in originals. At the end of the visit, each client should have a copy of the form with an acceptance mark. A copy of the application will be useful if the insurance company for any reason delays payment or refuses to transfer money.

Important! When terminating the MTPL agreement, the reason shall be additionally indicated. Within the framework of the law, return is provided only in case of sale of the vehicle, disposal, or death of the owner.

"Property"

Individuals and legal entities can insure both personal and commercial property. Apartments, houses, non-residential buildings, garages and cottages are accepted for insurance.

Immediately after the occurrence of an insured event, you should contact the insurance office with a statement indicating:

• who acted as the policyholder under the policy, indicating personal and passport information;
• registration address;
• the address within which the protection was issued;
• the nature of the insured event;
• by whom and when the inspection was carried out;
• details for transferring compensation payments for carrying out repair work.

If an insured event occurs related to housing, you need to collect the following documents:

• Application, the link to the form is posted above.
• Certificate of insurance.
• Passport or any other document proving the identity of the applicant.
• Papers indicating that the applicant has ownership of the affected residential premises.
• A check, receipt or other document proving that the insurance premium has been paid.

The insurer gives the client no more than 3 days to notify him of the incident. You can use the hotline: 8-800-333-0-999.

"Life"

Every citizen can insure the most valuable thing he has - his life. At the same time, within the framework of the program, accumulative insurance occurs, thanks to which you can earn money. Interest is accrued on the insured amount under an investment life insurance contract.

The application form is the same for all programs. The form should indicate:

• personal data of the insured person;
• the amount of the insured amount;
• contract number;
• telephone and email address;
• the nature of the insured event;
• details of the payee and personal account details;
• documents that are an integral part of the application.

Application forms for the program:

"Compulsory health insurance"

To receive free medical care, every citizen of the Russian Federation is required to fill out a free compulsory medical insurance form. Thanks to it, you can use all the services of public medical institutions.

To receive assistance under compulsory medical insurance, you do not need to collect any documents. It is enough to provide the policy itself at the medical institution. If we are talking about preparing this document, you will need to collect the following papers:

• SNILS.
• Passport or other identification document of the applicant.
• Documents for the child (birth certificate, etc.).
• Refugee certificate (for persons with such status).
• Foreign passport, employment contract (for citizens of other states working in Russia).
• Resident card.

Upon receipt of the form, you will need to fill out the following application:

If a citizen’s representative is involved in the registration of compulsory medical insurance, you will also have to prepare a power of attorney. The latter must be drawn up in the name of the applicant.

How long should I wait for an answer?

If within 10 days from the receipt of the claim by the insurer, payments have not been received into your account, you can go to court.

But in general, it’s better to wait a month: until the letter arrives, until it is received (up to 30 days correspondence is stored - track the movement of the letter on the Russian Post website using the track number), then 10 days for a response and 3-5 (sometimes more) days for delivery of a letter from the insurance company.

If you take it personally, then wait 10 days, and you can go for an answer.

A written refusal, partial payment, ignoring a claim - all this is a reason to go to court to protect your rights and recover all due monetary compensation.

"SOGAZ" - Where to submit documents about an insured event?

First, you need to inform SOGAZ employees about what happened. This can be done by phone or form on the official website. After this, you will need to collect the documents described above and transfer them to one of the company’s offices. You can find your nearest branch as follows:

1. Go to the official website using the link: shop.sogaz.ru .
2. Select item "Offices".

3. On the page that opens, select the city.

The user will see a list of all offices located in the selected locality. The branch description contains a contact phone number and opening hours.

SOGAZ has more than 600 offices throughout the country. You can submit a written application to the company's representative office in a specific city. You can easily find out the branch address on the company’s website by entering the desired city in the search box.

Also, written applications are sent to the head office of SOGAZ at the address: 107078, Moscow, st. Academician Sakharov Avenue, 10. You can report an insured event by calling 8-800-333-0-888, or by filling out a special form on the website.

Thus, in order to receive insurance payments from, you must download and fill out an application. Additional papers are attached to it, the list of which is given above. Documents are submitted to one of the offices of the insurance organization. You can find out the location of branches and their opening hours using the UK website.