When does the insurance company compensate for damage?
The occurrence of an insured event within the framework of the law entails an obligation for the insurer to compensate for the costs incurred or the loss caused. This is precisely the meaning of compulsory motor third party liability insurance. So, according to Article 1 of Federal Law No. 40, the insurance company of the person responsible for the accident compensates for damage to a third party who was injured during the road accident.
If the policyholder was the victim of an accident, the costs of repairing his vehicle will also be covered by his insurance company.
Then the funds spent on car repairs will be recovered from the insurer of the person responsible for the accident. Thus, in almost any situation, policy owners are confident that losses incurred during an accident will be compensated based on the terms of the insurance contract.
How to recover money from the culprit of an accident
To begin with, it is advisable to try to resolve the situation through negotiations. The culprit of the accident can be provided with a written request describing the actual damage and the required amount. In this case, the victim of an accident must have in his hands an assessment of the cost of repairs and a valid OSAGO policy.
If the person at fault for the accident agrees to pay the missing amount, this must be recorded (preferably in the format of a regular receipt). However, if the person responsible for the accident refuses to resolve the conflict peacefully, then it is worth going to court.
Before going to court, the victim is required to prepare a package of documents:
Dear OSAGO? Restore KBM now
and stop overpaying insurers!
The service will send an application to RSA. Recovery time for KBM: from 12 hours. Find out more
- a copy of the passport of the victim (the person who files the lawsuit);
- expert opinion on the real cost of vehicle repairs;
- a receipt confirming that part of the amount has already been paid by the insurance company.
Basically, the court remains on the side of the victim. However, the culprit of the accident, in addition to paying for repairs, spends his money on defense in court.
Cases when the insurance company does not compensate for damage under compulsory motor liability insurance
By virtue of Article 12 of Federal Law No. 40, the policyholder has the right to expect compensation for losses incurred within the limit determined by Article 7 of Federal Law No. 40, that is, no more than 400 thousand rubles when restoring a car and 500 thousand when compensating for damage to health. However, in a number of cases the insurer has the right to refuse payment, in particular:
- if the repair or disposal of the car was carried out before the inspection of the damaged property by the insurer;
- if the policyholder or the victim did not provide a complete package of documents;
- if, based on the results of an independent technical examination, it is impossible to determine the amount of damages;
- if the policyholder has not fully fulfilled the terms of the contract upon the occurrence of an insured event.
Important! Regardless of the number of victims, the insurance payment is made jointly and severally within the limit. That is, if 4 people were injured in an accident, a payment of 500 thousand will be divided between them.
What to do when the payout limit is exceeded?
After an accident, insurance does not always work correctly. In accordance with the legislation of the Russian Federation, a certain limit on payments by companies is established. This threshold is an obligation for them, but they are not responsible for exceeding it.
What indicators should you know?
- When paying 1 participant up to 120 thousand rubles;
- When paying several participants, the total amount is up to 160 thousand rubles.
If the insurance company does not cover the damages of the accident, the maximum amount is often exceeded. When evaluating expensive foreign cars, you can be convinced of their insignificance, because even partial body repairs cannot always be done on them. When the damage becomes critical and urgent replacement of parts is required, experts come to the conclusion that the available funds are not enough. The company transfers the specified funds, and the driver has to find the rest of the money on his own.
Exceeding the payment limit should be discussed with a lawyer. Only his knowledge is enough to find a way to solve the problem. When insurance does not cover damage from an accident, he will tell you how to reduce your own costs. The difference in the amount may be significant, so it is not possible to pay it off. To do this, you will have to calculate the damage again, and then be sure to meet with the victim.
Why does the insurance company not fully compensate for the damage?
Repairing a car in some situations requires huge costs, which are not comparable to the cost of a new car of the same brand, which is why a technical examination is carried out. In this case, the expert must also determine the scope of repair work, and the insurer, in accordance with the Regulations on a Unified Methodology, must approve the amount of expenses taking into account the wear of damaged parts and issue a referral to a service station in the manner specified in clause 15.1 of Article 12 of Federal Law No. 40.
However, in pursuance of this norm, service station employees do not have the right to install used parts and assemblies, which of course affects the total amount of repair costs. Thus, even if restoration is carried out within the limit or less, the insurance company compensates for damage only within the amount approved on the basis of a technical examination. The difference between the invoice issued by the service station and the insurance amount will be paid at the expense of the policyholder.
If an accident occurs, what is better to choose: cash payment or car repair?
Clause 15 Art. 12 40-FZ establishes the procedure for compensation for damage in the event of an accident by the culprit. However, until April 28, 2021, two options were possible:
- restoration of the car at the expense of the insurance company;
- full compensation by the insurer for the amount of damage in cash.
Please note that passenger cars owned by a motorist were excluded from this article of the insurance law, so insurance payments lost priority over repairs for this type of vehicle.
In the first case, there were the following requirements:
- the car must be restored to the condition before the incident, the spare parts are selected and installed by the repair company, the car owner does not take part in this, receiving a repaired car;
- The selection of the contractor is carried out by the auto insurer.
If the victim chose money, then the organization of restoration fell on his shoulders, but the insurer was obliged to compensate the amount of damage. In this case, the amount of compensation is determined based on the results of an independent examination organized by the insurance company.
The choice of the procedure for compensating for damages under compulsory motor liability insurance: repairs or money, was made by the injured party by submitting a personal application.
Note! The choice of the nature of compensation for damage was made based on the personal application of the owner of the damaged car.
Which method to choose and what is preferable: payment or repair under compulsory motor liability insurance - the decision was up to the car owner, but several factors played a role here:
- a list of service station representatives who will be entrusted with the work, what is their reputation;
- if you have a qualified specialist who can restore the car at a lower cost and in a shorter time, with better quality, then, of course, money is preferable;
- how damaged the car is - if this is serious, then it is better to choose restoration at the insurer’s service station, with a guarantee of complete completion of the work.
Both methods are equally profitable, so the choice of which is preferable: auto repair under compulsory motor liability insurance at the insurer’s service station or money for independent repairs had to be approached individually. It should be taken into account that the repair time for compulsory motor liability insurance at the insurance company's car service center was obviously long, so if you could not do without a car for a long time, it was better to choose money.
The insurance company demands compensation for damages under compulsory motor liability insurance.
By virtue of Article 14 of Federal Law No. 40, the insurer that has made compensation charges in relation to its client recognized as a victim in an accident receives the right to claim recourse against the culprit of the accident or his insurance company.
Thus, the insurer of the victim may demand compensation for expenses incurred if:
- the harm was caused intentionally;
- the driver was intoxicated;
- the person driving the car did not have a driver’s license or was not included in the contract;
- the person responsible for the accident fled the scene;
- the car was scrapped or sent for repairs before inspection by insurers and technical expertise.
Important! When calculating the cost of an insured event, the amount of losses includes not only the costs of repairs, but also the costs of conducting a technical examination, as well as other costs incurred in the course of fulfilling the terms of the insurance contract.
Procedure if payment under compulsory motor liability insurance does not cover repairs
The obligation to compensate for the difference between the maximum payment under compulsory motor insurance and the damage caused rests with the person at fault for the accident. In this case, the victim has the right to recover the amount of damage both immediately after the accident and for another three years after the actual accident. There are several options for the development of events: the culprit can independently offer to reimburse the costs, you can come to an agreement with him, or you will have to go to court. The most popular option is to draw up a pre-trial claim, which can resolve the controversial situation. And providing it to the culprit is a mandatory step towards resolving the conflict.
Does the insurance company compensate the person at fault for the accident?
Drivers found guilty of an accident almost always face a situation where the insurance company demands compensation for damage. However, the company does not always have the right to claim recourse payments. So, if an accident occurred as a result of the failure of one of the units after a technical inspection that confirmed the complete serviceability of the vehicle, the operator who issued the diagnostic card is held liable.
If the driver causes a traffic accident due to traffic violations or due to inattention or due to intoxication, the insurer will not compensate him for the damage. In such a situation, the insurer, on the contrary, has the right to deduct from the culprit the costs incurred in paying compensation to the victim and his insurance company.
Algorithm of actions: what and how to do if insurance does not cover damage
There are two reasons why the insurance payout is not enough to pay for the actual repairs to the car:
- the insurance company purposefully reduces the final payment amount, understanding in fact the actual damage caused;
- The vehicle's total repair costs exceed the permissible insurance limit. They are even limited by law - no more than 400,00 rubles.
And then in more detail about each situation. Read more about: “How much damage is covered by the compulsory motor insurance policy in the event of an accident.”
What insurance will cover damage from an accident if compulsory motor liability insurance is not enough?
MAIN THING IN THE ARTICLE: It is better to buy OSAGO and DoSAGO policies from one insurer. There are policies that include free bonuses
Nikolay Miroshnichenko , UNP correspondent
An MTPL policy is only a partial guarantee that the person responsible for a road accident will not have to pay for the damage caused out of his own pocket. In case of serious accidents, the insured amount under a standard policy may not be enough. In this case, a voluntary liability insurance policy (DoSAGO) will help.
REMINDER. The maximum that an insurance company will reimburse under compulsory motor liability insurance is: 160,000 rubles – if the accident causes harm to the life or health of the victim, 160,000 rubles – if the property of several victims is damaged and no more than 120,000 rubles – if the property of one victim is damaged (Article 7 of the Federal Law dated April 25, 2002 No. 40-FZ).
What types of DoSAGO policies are there?
DoSAGO policies are sold by all insurance companies. Therefore, today there are a lot of offers for every taste and budget. Typically, insurers' offers start from 300,000 rubles of insurance coverage and reach several million rubles. But it hardly makes sense to buy a DoSAGO policy with a multi-million dollar amount. All these millions will be required only if the driver gets into an accident with a whole convoy of executive cars. The likelihood of such an accident is low, and the annual cost of a policy that can cover the corresponding damage is several thousand rubles.
On the insurance market you can find very attractive offers for voluntary insurance policies with a liability limit of 1,000,000–3,000,000 rubles. In addition, some insurers offer useful bonuses: a free call to an emergency commissioner, free evacuation of the car to a service center and free legal services (see table).
What to look for when purchasing a policy
A DoSAGO policy can be purchased from any insurance company, but it is better to do this at the one where the OSAGO policy is issued. This will help you avoid running around to different insurance companies.
In addition, you need to find out from the insurer how the policy is issued - for the car or the driver. In the first case, payments under DoSAGO will be available to all persons driving a car, and in the second case, only the person for whom the policy is issued.
What kind of compensation can you expect?
Payments under the DoSAGO policy begin only when the capabilities of the OSAGO policy have been exhausted. For example, if in an accident the damage to the victim’s car amounted to 200,000 rubles, then they will pay 120,000 rubles at the expense of OSAGO and 80,000 rubles at the expense of DoSAGO.
Offers of some insurance companies for DoSAGO
Insurance Company | Damage compensation limits, rub. (minimum-maximum) | Cost of DoSAGO, rub. (minimum-maximum) | Additional services when purchasing DoSAGO | ||
Emergency commissioner | Legal assistance on actions after an accident | Free evacuation to service | |||
Renaissance insurance | 1 000 000 | 500 | Services are included in the price of DoSAGO | ||
ROSNO | 750 000– 3 000 000 | 1500–2300 | Services can be purchased for an additional fee | The price of DoSAGO includes one free evacuation | |
RESO Guarantee | 300 000– 1 000 000 | 750–3600 | Services can be purchased for an additional fee | ||
"MAX" | 300 000– 10 000 000 | 360–6500 | Services are not provided | ||
Ingosstrakh | 500 000– 30 000 000 | 900–13 750 | Services are not provided |
Source: websites of insurance companies