Regulations for the settlement of losses. Basic research. What is loss settlement

Now let's look at the loss settlement process (Figure 8-9). The first event is a customer request. The client must provide a contract or insurance policy, as well as the necessary certificates about the insurance event.

Regardless of the type of insurance, the scenario for performing the loss settlement process does not change. I decided not to model the process scenario diagram because there is no difference in the execution of the scenarios.

At an early stage of processing a request, it is possible that the insurer finds out that the case is not insured and the process ends with a refusal to pay compensation to the client.

If the case really corresponds to the insurance risk, an expert examination is appointed to assess the damage. This is followed by an assessment of the harm caused, with the possible participation of an expert. This process also requires agreement with the client about when the examination of the property will be carried out.

Figure 8. Claims settlement process (part 1).

At this stage, it is also possible that additional circumstances of an insured event are identified in which the company has the right to refuse compensation for damage. Otherwise, an invoice is generated that must be agreed upon with the client.

If the client agrees with the amount of payment, then payment is made and the loss is considered settled.

At the time of agreeing on compensation with the client, the number of his contacts with the company is at least three. If the company has difficulties in contacting the policyholder, then the matter is delayed and inconvenience arises on both sides.

The stage of contact with an expert is a weak point, since the insurance company is not always able to assess the amount of damage caused. This requires the involvement of an independent expert with the participation of both parties - both the client and the insurer.

There are cases when the client does not agree with the established amount of compensation. Then the company should agree on further actions, the result of which could be: re-examination of the case, cancellation of the application, or the client going to court. The outcome of a lawsuit may be a dismissal of the client's claims or an order for damages followed by payment of damages. This completes the process.

The weak point in the claims settlement process is the excessive number of contacts with the client. In some cases, this is necessary and unavoidable, however, in the typical process of receiving compensation (for example, with car insurance - CASCO), it would be nice to reduce the number of such interactions to a minimum. An excessive number of approvals with the client can be considered as duplicating functions, although in fact, approval is required only to approve the amount of payment, and even then not in all cases. For example, when receiving insurance compensation for car insurance (CASCO), the beneficiary is the car service center that repairs the client’s car. Thus, the client ultimately receives a repaired car and it does not matter to him how much this repair cost.

If the case goes to court, it is in the interests of the insurance company not to delay the process, since this may negatively affect the reputation - it is unlikely that the client will want to return later and will not go to competitors.

The claims process is modeled in the event chain diagram in the appendix. Such a diagram will allow us to solve our problems. Thus, I do not see the need to create a model surrounded by functions; the level of detail of the EPC model was sufficient.

The analysis showed the following disadvantages of the existing process:

A large number of approvals with the client. It is impossible to accurately predict when a response from a client will be received.

The client may be refused after an examination is carried out - a costly process. It would be desirable to determine the cause of the incident in advance, but this is not always possible.

Option to improve the personal insurance process.

Let's consider insurance for citizens traveling abroad. A special feature of this type of insurance is the ability to issue a policy remotely or in any department or agency of the organization. This opportunity is achieved through the use of a front office system. However, before the policy takes effect, payment must be received from the client. The specifics of the accounting program at the main office of the organization require, first of all, to enter the agreement into the information database, and then attach a payment document. The weak point is the function when we receive payment from the client, since in fact at this moment the policy comes into force. Since the number of policies issued per day can reach several thousand, the cost of an input error can be high.

Transferring data to an accounting program slows down the overall time that passes from the moment a client's application is processed until the policy is actually issued to him.

In my opinion, the problem can be solved as follows:

Prepare a daily report on the division's policies sold. Only include paid and issued policies in the report.

Transfer the responsibilities for transferring data to one employee-operator, who will enter data into the database daily. This way, it won't slow down the sales processes.

Payment will also be received according to acts and linked to the corresponding documents in the database.

Let's look at what problems may arise. Regarding the first two points, there may be a slight delay in transferring data to the main accounting program. This does not play any role in reporting, however, problems may arise when the policy began to operate on the day of issue and an insured event occurred on the same day. The problem can be avoided if the dispatcher is given access not only to the back office database, but also to the front office system, where he can see all customer requests.

It is worth noting that such cases are extremely unlikely, since policies for those traveling abroad are almost never issued on the start date of their validity. But even in this case, the problem is solved by providing access to the sales database of the divisions.

Another problem may be excessive workload or downtime for the operator. In my opinion, such a situation is unlikely, since the volume necessary work will be reduced by reducing the number of errors made. Functions for working with data will be transferred to individual employees who will have much more experience interacting with reports and will cope with the task faster.

Thus, the process of selling policies for those traveling abroad will be somewhat different from other processes of personal insurance. The graphical representation of the process will remain largely unchanged, but performance measurements at the payment receipt stage, which involves entering data into the database, should show an improvement. This will allow the process to proceed faster, and therefore will reduce the total time spent on selling the policy to the client.

Designed individual approach To this species personal insurance is designed to improve the turnaround time of the sales process. For the process of insuring citizens traveling abroad, a new eEPC model has been modeled, which shows how the process should proceed taking into account the proposed changes. The processes for selling other types of insurance have not changed and remain the same, thus, in the new diagram it will be possible to exclude the option of the event when the client needs a temporary insurance policy.

Let's look at the loss settlement process. If you evaluate the process from the client’s side, you can see that he takes part in many functions that can take a lot of time. This can cause serious inconvenience to the company's customers. The client base is extremely important, since according to statistics obtained from the annual report, a significant part of the contracts are extensions of previous ones.

CASCO is a voluntary element of car insurance, but purchasing a policy helps to avoid significant financial losses in the event of a traffic accident.

Many vehicle owners think they won't need insurance. Therefore, when they arise, they are lost in the registration procedure and receipt of compensation.

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In order to avoid unpleasant situations arising due to your own ignorance, it is necessary to carefully analyze all the nuances and features of the procedure for settling losses under CASCO.

General overview of the procedure

When a traffic accident occurs, it is necessary to follow a certain algorithm of actions in order to resolve the situation as quickly and safely as possible. First of all, you need to contact the appropriate service: traffic police, Ministry of Emergency Situations, Department of Internal Affairs. The choice depends on the circumstances of the accident. The second mandatory step is to call the insurance company.

The main role in the procedure is played by design. necessary documents. Without them, it is impossible to receive compensation payments. Full list mandatory information is reflected in the insurance contract or on the company’s website.

Many nuances depend on the type of policy and related additional services. For example, the insurer can provide its own tow truck or a commissioner from the company who will help with paperwork.

It is important to remember that after the occurrence of an insured event, you should immediately notify your company, since the time frame for filing a claim is limited.

Main parameters of the service

Document requirements

Documenting an insurance event is a necessary step in receiving insurance payments. Correctness of preparation, completeness of the package of documents, deadlines for submission - all this influences the insurer’s decision. Therefore, it is worth carefully examining the issue regarding documents.

In particular, for registration you will need the following:

policy and receipt for its payment;
passport vehicle or certificate of registration;
in some cases they require a vehicle inspection certificate;
driver's license of the person who was driving at the time of the accident;
certificate from the traffic police.

In addition, depending on the characteristics of the accident, the following may be requested:

power of attorney from the owner of the car;
certificate from the hydrometeorological service;
certificate from investigative authorities;
if you have compulsory motor liability insurance, you will also need a copy of the notice;
certificate from the fire service.

Only after collecting all the necessary documents can you submit an application to your insurance company to compensate for the damage received

Procedure

The correctness of the actions of the insured person after the accident largely determines the further course of the case in the insurance company.

Knowing the steps will help ensure the efficiency of both the insurer and its client:

At the scene of the accident, call the traffic police or other necessary services to document the incident. Receive completed papers and certificates from employees.
After an accident, visit the insurance company branch to submit an application with a complete package of documents.
When considering the application, a company employee makes a decision on the need to inspect the vehicle. If the car is running, the examination is carried out directly in the insurer's parking lot. Otherwise, the specialist agrees on the time and place with the client for the inspection.
During 10 days From the moment the application is submitted, the insurance company is obliged to determine whether to pay compensation or refuse. If a decision has been made not to satisfy the request, then the client must be notified of the reasons for the refusal.
Payments are made no later than 5 days from the moment of approval of the insured event. can be carried out by bank transfer, at the bank's cash desk or through restoration at the station Maintenance.

The client has the right to independently choose his preferred compensation option.

Common mistakes

Settlement of losses under CASCO has its own characteristics, which are often missed even by experienced car owners. Because of this, the insurance company may underestimate the amount of compensation or even refuse to pay.

Therefore, it is necessary to carefully disassemble typical mistakes most vehicle owners:

The provided description of the event does not correspond to the data of the competent authorities. Such discrepancies can have a negative impact on the client.
Certificates from government services do not apply to the insured event. You need to know the purpose of the various competent authorities, since an “incorrect” certificate can become a reason for the insurance company to refuse. The traffic police should be called when an accident occurs. The police are needed when there is damage to third parties or when a vehicle is damaged due to natural disasters and fire. And only after this is it possible to apply for certificates from other authorities: the Ministry of Emergency Situations, the fire service, the hydrometeorological center.
One of the most common erroneous situations is entering into the claim damage that was received before the event.
The wording “under unknown circumstances” can bring significant inconvenience to the policy owner, since the company can interpret these words in its favor: it is possible that the event was not insured at all.
Before submitting a package of documents, you must carefully check each certificate for inaccurate or incorrect data. In particular, it is worth paying attention to the correspondence of the place, time and circumstances of the incident. In particular, quite often this situation is typical for witness testimony.
Refusal to file an application or indicate in it the insignificance of damage. It is always worth insisting to traffic police officers on an official statement defining all the details, even in the case of minor damage. If the culprit is known, he should always be identified. Otherwise, the insurer may lose the right to subrogation.
Incorrect information about the event. A very unpleasant situation, since the company may see such actions as fraud. As a result, other insurance companies will be notified, which will affect both their loyalty and the policy cost ratios.

Knowing mistakes allows you to avoid them in the future. At the same time, the vehicle owner will significantly save not only money, but also nerves and time.

Remote settlement of losses under CASCO

Remote settlement of losses under CASCO is spreading quite quickly among car owners. The advantages of this procedure are obvious: convenience and saving valuable time. This is due to the fact that after registration by the traffic police officer and notification of the company about the occurrence of an accident, you can immediately send the vehicle to the dealer for restoration repairs.

But it is worth considering that remote settlement carries a considerable number of nuances and features that significantly reduce the positive effect.

It is worth looking at this issue from two sides:

Settlement of losses remotely from the car dealership

This procedure is very beneficial for car dealerships for one simple reason - the inspection of vehicle damage is carried out by a service technician. The specialist includes in the estimate the maximum amount of damage to the vehicle, as he lobbies the interests of the management of his organization. His actions increase the degree of damage received and significantly increase the amount of compensation.
Obviously, insurance companies are not satisfied with this situation. Therefore, an examination by a salon technician occurs only in case of minor damage. In other cases, the presence of a specialist from the insurance company is necessary. But then it turns out that the time savings tends to zero. Thus, it turns out that in case of serious damage it is better to immediately contact the insurer.

Settlement of losses remotely from the insurance company

The essence of this option is for an emergency commissioner to go to the scene of the incident. He inspects the car, records the damage, and then coordinates with the vehicle owner a car service for further restoration repairs.
The procedure is overshadowed by the fact that the car is checked thoroughly, down to the slightest chip of the enamel. As a result, the insurance company has the right to refuse compensation to its client for certain details, based on the fact that the damage occurred before the insured event occurred. Therefore, you have to pay for some of the repair work yourself.
When considering this option, it becomes clear that it is necessary to seek advice from the appropriate insurance specialist before purchasing.

Knowledge of the key subtleties of processes in vehicle insurance allows you to ensure efficiency in completing the procedure and subsequent receipt of compensation payments

Advantages and disadvantages

Each procedure has its own disadvantages and advantages:

Minuses

Remote settlement of losses under CASCO is subject to the following restrictions:

Although this program greatly simplifies the activities of clients in the event of an insured event, companies still limit its distribution. This is due to the risk of fraudulent activities and forgery of documents.
Obviously, the insurer's expert will underestimate the cost of repairs. While the service technician, on the contrary, inflates the price tag. Such actions affect the company's activities, which leads to a slowdown in the development of the program.
At the moment, remote settlement is possible only if you are sent for restoration work to an official dealer or service partner of the insurance company.

pros

At the same time, the option under consideration has a number of important advantages that allow it to stand out favorably against the background of a conventional settlement:

Significant reduction in procedure steps allows for significant savings in waiting time for restoration repairs.
The usual form of the procedure assumes that upon the occurrence of an insured event, the owner of the vehicle is obliged to come to the company’s branch to document the damage. But the personal presence of the car owner is not always possible. For remote settlement, it is enough to place in personal account copies of documents and photographic evidence of damage received.
Previously, registration of CASCO insurance and provision of a package of documents took place only directly at the branch of the insurance company. Now it is possible to send copies of documents via the Internet to the official mail of the company.

The article discusses the importance of the loss settlement process in the formation of the financial results of an insurance company, its role in ensuring investment development insurance sector of the economy. The algorithm of actions for settling losses in insurance is described, and a clarified concept of “loss settlement” is given. The article uses performance indicators of PJSC Rosgosstrakh. It contains data on the organizational structure of loss settlement units of the regional division - the branch of Rosgosstrakh PJSC in the Republic of Mordovia. A sequential process for settling losses is outlined. Options for submitting documents for damages are described. The author provides a classification of participants in the insurance claims settlement process and characteristics of each of the presented groups. The article reveals the features of determining the amount of damage and insurance payment for different categories of insurance. The author provides factors and features that influence the amount of insurance payments for personal, property and liability insurance. The article creates a formula for calculating the amount of insurance compensation for property insurance. The types of damage, conditions and features of their compensation are considered. The author makes conclusions and proposals for optimizing the claims settlement process in insurance and its further improvement.

insurance

loss settlement

amount of damage

insurance payment

insurance market

personal insurance

property insurance

liability Insurance

personnel policy

1. Kuznetsova, E.G., Kuznetsova, T.E. Fundamentals of insurance: educational method. allowance; Saran. co-op Institute of RUK. – Saransk: YurExPractik, 2016. – 80 p.

2. Kuznetsova T.E. Underwriting system in modern conditions of the Russian insurance market // Bulletin of the Volga University named after V.N. Tatishcheva. – Togliatti: VUiT, 2016. – T. 2, No. 2(36). – P. 55–60.

3. Kuznetsova E.G., Kuznetsova T.E., Khairov R.R. Professional communication culture: tutorial Saran. co-op Institute of RUK. – Saransk: Print-Izdat, 2017. – 44 p.

4. Kuznetsova T.E. Insurance in the Republic of Mordovia: problems and positive development trends // Integration of education in an innovative economy: materials of the International. scientific-practical conf. (Saransk, April 8–9, 2014): at 2 o’clock; Saran. co-op Institute of RUK. – Saransk: YurExPractik, 2014. – Part 1. – P. 160–163.

5. Kuznetsova E.G., Kuznetsova T.E. Formation of professional competence of students when studying the discipline “Insurance”: active teaching methods: educational method. allowance; Saran. co-op Institute of RUK. – Saransk: Print-Izdat, 2014. – 52 p.

“Insurance, as a system for protecting the property interests of citizens, organizations and the state, is a necessary element of modern society. It provides guarantees for the restoration of violated property interests in the event of natural and man-made disasters, as well as other unforeseen phenomena. Insurance allows not only to compensate for losses incurred, but is also one of the most stable sources of financial resources for investment.” The timeliness of compensation for losses and the size of investment activity depend on the effectiveness of the mechanism for generating financial results. Underwriting and the claims settlement mechanism are activities that affect the performance of the insurance company as a whole. Underwriting is actions aimed “at determining the degree of risk deviation from the statistical average, in order to ensure the possibility of offering an insurance service according to the contract parameters that satisfy both the insurer and the policyholder, as well as protecting the insurance portfolio by type of insurance.”

Rice. 1. Insurance loss settlement process

The claims settlement process, like underwriting, has a significant impact on the financial results of an insurance company. The desired financial result of the company largely depends on how it is organized and what specialists take part in it. In the economic literature, the concept of “loss settlement process” is described in sufficient detail. Although there is no consensus on the definition of this concept, there are still common approaches to understanding this category. Having analyzed a large number of scientific sources, we will clarify the definition of loss settlement in insurance. We believe that the settlement of losses in insurance is the process of determining the amount of damage in an insured event and compensation for this event, the purpose of which is to satisfy the client’s interest in receiving an insurance payment.

Let us analyze the mechanism for settling losses using the example of Rosgosstrakh PJSC, namely the regional branch in the Republic of Mordovia. Today, the insurance company Rosgosstrakh has a developed network of settlement points throughout the country (403 branches), including in the Republic of Mordovia. All of them are equipped with the most modern software in Europe called “GURU”. It is established in all organizational units of the company's claims settlement. Currently, the organizational units of loss settlement of Rosgosstrakh PJSC are represented by:

Regional Loss Settlement Centers (RLCS);

Interregional Loss Settlement Centers (MRCLC);

Loss settlement points (CLCs).

Through the GURU software, claims are settled for absolutely all mass types of insurance. In any of the above regulatory divisions, uniform work standards apply to ensure high level customer service. The functions of the RCCU, MRCUU, and PUU include accepting documents from clients, organizing an inspection of damaged property by an independent expert organization, and providing all information during the consideration of an insured event. The insurance claims settlement process provides several options for submitting documents:

Directly to one of the settlement points;

To any insurance agency;

Through the Unified Dispatch Center.

If the client does not have the opportunity to come to the settlement department, he can submit a claim for an insurance event at any insurance department. This application will be forwarded to the nearest settlement office.

The client can also report an insured event to the Unified Dispatch Center (UDC), via a toll-free hotline, and only then bring all the documents to the nearest settlement unit. Detailed Process loss settlement in insurance is shown in Fig. 1.

Participants in the claims settlement process are represented by employees of the insurance company and external partners of the insurer. Let us consider in more detail each of the above categories, taking as a basis the personnel policy of the branch of Rosgosstrakh PJSC in the Republic of Mordovia.

Internal insurance company employees involved in the claims settlement process are represented by the following seven job groups. These include EDC specialists who provide round-the-clock customer support by telephone, inform the client about the procedure for the client in the event of an insured event, and also register the loss in a unified database and administrators, whose functionality includes accepting claims of loss and informing the client about the progress of the settlement process losses.

The third group of employees involved in the loss settlement process is represented by payment specialists from the Unified Payment Center. They are engaged in reviewing, in accordance with current methods of loss settlement, documents for an event that has characteristics of an insurance claim. Next, EVC payment specialists prepare draft decisions on recognizing the case as insured, as well as on making or refusing an insurance payment.

The fourth group of internal employees of the insurance company consists of specialists from the UAU (Loss Analysis Department), who are involved in the consideration of insurance cases with signs of fraud.

The fifth group includes specialists from the PD (Legal Department). Their responsibilities include providing legal support at all stages of loss settlement, defending the company’s interests in court, and exercising the insurer’s subrogation rights.

UOOK (Customer Appeals Processing Department) specialists, belonging to the sixth group of employees involved in the loss settlement process, carry out activities to receive and process customer requests and complaints. They initiate a review of the loss by payment specialists and formulate a response to the received request or complaint.

The seventh group consists of operational accounting employees. Their functionality includes identification of an insurance policy through operational databases. The second stage of their work in the loss settlement process is to enter information about the results of the payment into the operational databases.

We present the characteristics of the insurer's external partners involved in the claims settlement process in the table.

External partners of the branch of Rosgosstrakh PJSC in the Republic of Mordovia participating in the loss settlement process

		Functional
		Represents the policyholder or his trustee, acting on the basis of a notarized power of attorney (when the policyholder is an individual) or a letter of administration (when the policyholder is a legal entity)
	Emergency commissioner	A person who has the status of an individual or legal entity who is engaged in documenting the circumstances of an insured event by visiting the scene of the incident or the location of the damaged property/vehicle
	Surveyor	An expert who, at the request of the policyholder or insurer, inspects damaged property (most often when insuring ships and cargo). Survey services include: diving inspection, counting or weighing of cargo, sampling, etc.
	Tow truck	The functionality includes the evacuation of the client’s vehicle from the scene of the accident (in auto insurance)
	Independent expert	A person with special knowledge and skills in assessing objects, processes and phenomena. May be involved in investigating the causes and circumstances of the insured event, determining the amount of damage, assessing the nature of the damage, etc. Represents a specialized organization or individual
	Reinsurer	Represents a reinsurance company involved in compensating the insurer's losses (if the risk is reinsured)
		Assistance companies, medical institutions, car service stations, etc.

Rice. 2. Features of determining the amount of damage and insurance payment in the branch of PJSC Rosgosstrakh in the Republic of Mordovia

When considering the features of determining the amount of damage and insurance payment for personal insurance, it should be taken into account that for most of its types, insurance coverage is mandatory and is paid regardless of the fact that the policyholder, insured person or beneficiary is also due payments for other types of insurance. These include amounts received from social insurance, social security, and also in compensation for harm. Moreover, the amount of insurance coverage depends on the specific type of insurance, is determined only by the terms of a specific contract and is directly related to the insurance amount established by the insurance contract. Human life is absolutely priceless, therefore the insured amount under personal insurance contracts can be as high as desired, and insurance coverage will be paid under all insurance contracts, no matter how many of them are in force at the time of the insured event. Having studied the mechanism for settling losses for personal insurance in the branch of Rosgosstrakh PJSC in the Republic of Mordovia, in Fig. 2 we present schematically the composition of personal insurance and the features of calculating damage and the amount of payment for each of the presented groups.

The amount of insurance compensation for property insurance depends on the amount of actual damage suffered by the policyholder as a result of the insured event, but it should not exceed the insured amount specified in the contract. In this case, losses caused to the insured property are considered damage. If the policyholder has entered into a property insurance contract with several insurers for an amount exceeding the total insured value, then each of the insurers pays compensation proportional to the ratio of the insured amount under the relevant contract to total value insurance amounts for all contracts concluded in relation to this object (consequences of “double insurance”).

In the amount of insurance compensation, the insurer must include costs associated with reducing losses from an insured event, in cases where these costs are necessary or are made to comply with the instructions of the insurer, even if these measures were unsuccessful. Such expenses are reimbursed in proportion to the ratio of the insured amount to the insured value, regardless of the fact that, together with compensation for other losses, they may exceed the insured amount.

The following must be deducted from the amount of damage when determining the amount of insurance compensation:

The amount of deductibles established by the insurance contract;

Depreciation of property (if provided for in the contract);

Insurance premiums unpaid by the policyholder, if the insurance contract provided for payment of the insurance premium in installments and the insured event occurred before the next payment was received from the policyholder;

In the event of the loss of property, the insurer has the right to deduct the remainder suitable for further use if the damaged property remains with the insured.

Summarizing the above information, we will draw up a formula for calculating the amount of insurance compensation for property insurance:

B = U - F - Mon - I - O + P,

where Y is damage,

F - franchise,

Mon - unpaid fees,

I - depreciation of property,

O - good leftovers,

R - expenses (tow truck, etc.) agreed with the insurer.

In accordance with the Civil Code Russian Federation a liability insurance contract for causing harm is considered to be concluded in favor of persons who may be harmed. The insurance contract, as a rule, provides for the obligation of the policyholder (the insured person) to inform the insurer as soon as possible about the circumstances related to the object of insurance. For example, about causing harm to third parties, about filing claims from victims, about starting an investigation in connection with the harm, about initiating a criminal case against the policyholder (insured), scheduling a trial, etc. .

Damage subject to compensation to injured clients of the insurance company is divided into damage associated with damage or loss of property, and damage arising from harm to life or health individuals.

In case of damage associated with damage or loss of property, the payment of insurance compensation is determined, as a rule, similarly to the calculation of payment in property insurance.

Damage arising from harm to the life or health of individuals requires a special approach to calculating the amount of insurance coverage. The main document regulating such calculations is the Civil Code of the Russian Federation.

In modern Russia, the formation of a civilized insurance market is relevant, which ensures the need to further improve the process of settling losses in insurance. The latter is impossible without frames with professional competencies and the availability of highly qualified specialists from insurance companies with in-depth knowledge of the theory and practice of insurance.

Bibliographic link

Shilkina T.E. SETTLEMENT OF LOSSES IN INSURANCE AND FEATURES OF DETERMINING THE AMOUNT OF DAMAGE AND INSURANCE PAYMENT // Fundamental Research. – 2018. – No. 5. – P. 136-140;
URL: http://fundamental-research.ru/ru/article/view?id=42157 (access date: 03/20/2020). We bring to your attention magazines published by the publishing house "Academy of Natural Sciences"

The policyholder/assignee wants to recover insurance payment under compulsory motor liability insurance instead of organizing and paying for vehicle repairs

The assignee wants to recover underpaid insurance compensation

The assignee wants to recover the costs necessary to eliminate the defects of the restoration repair

The assignee wants to recover insurance compensation that was denied

The policyholder wants to recover underpaid insurance compensation under MTPL

See all situations related to Art. 14.1

1. The victim makes a claim for compensation for damage caused to his property to the insurer who insured the civil liability of the victim, if the following circumstances exist simultaneously:

a) as a result of a traffic accident, damage was caused only to the vehicles specified in subparagraph “b” of this paragraph;

B) a traffic accident occurred as a result of the interaction (collision) of two or more vehicles (including vehicles with trailers), the civil liability of the owners of which is insured under a compulsory insurance contract in accordance with this Federal Law.

2. The insurer, which insured the civil liability of the victim, assesses the circumstances of the road traffic accident, set out in the notification of the road traffic accident, and, on the basis of the submitted documents, provides compensation to the victim at his request in accordance with the rules of compulsory insurance.

3. The exercise of the right to direct compensation for losses does not limit the right of the victim to contact the insurer who insured the civil liability of the person who caused the harm, with a claim for compensation for harm caused to life or health, which arose after the presentation of the claim for direct compensation for losses and about which the victim did not knew at the time the claim was made.