Filing a complaint with a claim against an insurance company for CASCO in 2021

CASCO allows a citizen to receive compensation for damage to a car in the event of an insured event. In case of total destruction of property, the amount may cover the full cost of the car. However, not all companies fulfill their obligations in good faith. Attempts are often made to reduce the amount of the due payment under CASCO. Sometimes the insurer may refuse to pay compensation completely. If a person believes that his rights are being violated, he must first of all write a complaint against the CASCO insurance company

When can you complain about a CASCO insurance company?

The provision of CASCO insurance is carried out within the framework of the provisions of Federal Law No. 4015-1 of November 27, 1992 “On the organization of insurance business in the Russian Federation” and Chapter 48 of the Civil Code of the Russian Federation. The specifics of interaction between the parties are fixed in an agreement drawn up taking into account the above regulations. From the provisions of the current legislation, circumstances arise in which a citizen has the right to file a complaint against an insurance company under CASCO. This is possible if:

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1. When purchasing a policy, the insurer tries to impose additional services.
2. The organization refuses to conclude an agreement on unimportant grounds. Thus, it is considered unlawful to reject an application in a situation where the insurer reports the absence of forms, problems with the functioning of computers, lack of service in the client’s region, etc.
3. The organization refuses to provide compensation. Moreover, the reasons for this are far-fetched.
4. The company asks to provide additional documents, which are not needed in the current situation.
5. The amount of insurance payment was reduced unreasonably.
6. A citizen has the right to file a complaint against the insurance company under CASCO and on other grounds if he believes that his rights have been violated.

What to do if poor-quality repairs are discovered under CASCO

So, the insurance company has given you a referral to a service station, where repair work on your car should be carried out. There should be agreement between them on the cost of the services provided, after which the service station should call and invite you. As soon as the car is repaired, the service station will immediately notify you and, upon your arrival, provide a car for inspection of the work performed. After inspecting the vehicle, you saw poor quality repairs. What to do?

• To begin with, it is necessary to record the identified deficiencies, which you indicate in the acceptance certificate for the transfer of the car, all the defects in the repair identified during the external inspection. Be sure to request the drawing up of a transfer and acceptance certificate in two copies, signed by both representatives of the service station.
• Then you can try to resolve the issue amicably by contacting the insurance company with a claim, which is required to inspect the vehicle and voluntarily eliminate the identified deficiencies. As you correctly understood, you need to contact not the service station, but the insurance company where the car was insured under CASCO and which issued a referral for repairs at the service station. By virtue of Article 313 of the Civil Code of the Russian Federation, the insurer is responsible for the quality of restoration repairs carried out at the direction of the insurer by a technical service station within the framework of insurance compensation under a voluntary property insurance agreement.

The Supreme Court of the Russian Federation also draws attention to this point, in the resolution of the Plenum of the Supreme Court of the Russian Federation dated June 27, 2013 N 20 “On the application by courts of legislation on voluntary insurance of citizens’ property.”

If it is not possible to resolve the issue peacefully, all that remains is to go to court to protect the violated right. If the claim was not taken into account, you must seek help from a car lawyer and invite an expert to conduct an examination to determine the cause of the malfunction. In the future, this conclusion will be useful to you when going to court.

It is worth considering that in connection with the adoption and entry into force of the Federal Law dated 06/04/2018 N 123-FZ “On the Ombudsman for the Rights of Consumers of Financial Services” and the existing legal position of the Supreme Court of the Russian Federation regarding the procedure for its application, when going to court it is mandatory to comply with pre-trial procedure for resolving a dispute by filing an application with the financial ombudsman.

4. The consumer of financial services has the right to send an appeal to the financial commissioner after receiving a response from the financial organization or in the event of failure to receive a response from the financial organization after the expiration of the appropriate time frame for consideration by the financial organization of the application of the consumer of financial services, established by Part 2 of this article.

Art. 16 Federal Law of June 4, 2018 N 123-FZ “On the Commissioner for the Rights of Consumers of Financial Services”

By using a CASCO insurance policy, you automatically become a consumer, which means that in case of poorly performed work, you can safely refer to Article 29 of the Labor Code. All points of this article perfectly explain all the powers of the client-consumer and the responsibility of the car service for poor quality work.

Normative base

Before filing a complaint against an insurance company under CASCO, it is recommended that you familiarize yourself with the provisions of the regulations governing the interaction between the insurer and the client. Knowledge of the laws increases the likelihood of a positive decision on the complaint, because a citizen can contact the authorized body when there are actually violations. Need to study:

1. Federal Law No. 4015-1 of November 27, 1992 “On the organization of insurance business in the Russian Federation” contains definitions of concepts and general provisions regarding the interaction of participants in a transaction. It also contains a list of institutions that monitor the activities of insurers.
2. Federal Law No. 2300-1 of February 7, 1992 “On the Protection of Consumer Rights” regulates the interaction of organizations providing goods and services and buyers. The regulation sets out how to act if the service provider does not fulfill its obligations.
3. Articles 929-930 of the Civil Code of the Russian Federation fix the features of property insurance.
4. Article 939 of the Civil Code of the Russian Federation determines the process of fulfilling the obligations of the parties to the transaction under the contract.
5. Article 940 of the Civil Code of the Russian Federation - approves the form of the insurance contract.
6. Article 942 of the Civil Code of the Russian Federation contains the essential terms of the contract.
7. Article 944 of the Civil Code of the Russian Federation - indicates the information that the policyholder is obliged to provide in the process of concluding a transaction.
8. Article 945 of the Civil Code of the Russian Federation - fixes the possibility of an assessment of insurance risk by the insurer.
9. Article 947 of the Civil Code of the Russian Federation determines the insured amount.
10. Articles 955-956 of the Civil Code of the Russian Federation determine the possibility of replacing the insured person and beneficiary.
11. Article 959 of the Civil Code of the Russian Federation - fixes the consequences that occur if the insurance risk increases during the validity of the contract.
12. Article 963 of the Civil Code of the Russian Federation - determines the consequences of the occurrence of an insured event due to the fault of one of the parties to the transaction.
13. Article 966 of the Criminal Code of the Russian Federation - indicates the duration of the period during which one of the parties can go to court if its rights are violated.

Procedure for filing a complaint

If a citizen is faced with a violation of rights by a CASCO insurance company, it is necessary to act in accordance with the following scheme:

1. Prepare a complaint against the CASCO insurance company in accordance with the rules and contact the organization’s management. Often, a violation occurs not because of the company’s internal policy, but because of the negligence or irresponsibility of the organization’s employees. Already at this stage the problem can be solved. If the appeal does not produce results, you will need to prepare documents and send them to other authorities.
2. The insurer is given 20 days to consider the complaint. If there is no response within this period, you will need to submit the document to the supervisory authorities. Today there is no single institution that controls the work of insurance companies. Therefore, it is necessary to select an organization, taking into account the essence of the issue. RSA, the Central Bank of the Russian Federation, FAS, Rospotrebnadzor, and the prosecutor's office can consider a citizen's complaint against an insurance company under CASCO.
3. If the insurer refused to pay, or the insurance payment was underestimated, it is recommended to immediately file an application with the court. The action can be carried out simultaneously with the procedure for filing a complaint against the insurance company under CASCO. However, before carrying out the action, it is taught to perform an independent assessment of damage to property. This will allow the citizen to confirm his position in court. Additionally, a documentary base needs to be prepared. The list of papers must include all written appeals to insurance and other documentation on the case. It is worth visiting a lawyer first. It is important that he specializes in such proceedings. Disputes with insurers represent a specific topic that not every lawyer can handle.

Examination of a car after poor-quality repairs

When a victim in an accident is dissatisfied with the result of a repair service station, a dispute arises between them, as a result of which one of the parties, usually the consumer, conducts an examination. Initially, the cost of the expert’s services is borne by the insurance company, which must organize it at its own expense, but if during the verification process it turns out that there were no violations, the cost of the services will be paid by the initiator. If the decision to conduct an examination was mutual, then the payment is divided in half.

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You can make a claim for poor work of auto repairmen within two years from the date of acceptance of the work performed (service rendered). If significant deficiencies are identified, the period is increased to 10 years. When the expert identifies all the shortcomings, the car owner can demand any of the following compensations:

• Free repairs (at the expense of the insurance company);
• Do not require additional repair services, but require a reduction in the cost of work performed;
• Reimbursement of expenses (if the repairs were carried out independently);

A reasonable time frame for completing repairs is set by the car owner, but if the contractor (insurance company) does not meet the deadline, he will have to pay a penalty. In order for the examination to be carried out, it is necessary to submit an application to the expert organization.

This application must indicate a description of the event (the reason why the inspection is ordered), details of a legal entity or full data of an individual, and questions for the expert (time, place of the event and cause-and-effect relationship).

Each specialist is required to have state certification, otherwise his conclusion will have no force. This document from the expert technician will contain the following:

• Full information about the organization that conducts the examination;
• The time when the conclusion was drawn up and the number in the accounting register;
• The grounds on which the inspection was ordered;
• Customer data;
• Individual characteristics of the vehicle;
• List of literature that was used during the examination;
• List of studies that were conducted;
• Accurate justification of conclusions;

Complaint to the insurance company

Initially, you need to file a complaint with the insurance company that issued CASCO. The law does not define a specific form for filing a complaint against approval. Therefore, the document must comply with the general rules of office work. The paper will need to state the essence of what happened.

Don't give in to emotions. The text must be dry and free of errors and insults. Then you need to indicate the applicant’s requirements, as well as refer to the clauses of the contract that were violated, as well as refer to legal acts confirming the rightness of the citizen. A claim to the insurance company under CASCO must be submitted in several copies. One of them is provided to the insurer, and the second is registered as incoming documentation. This copy is affixed with the date of acceptance and the seal of the institution. A copy of the paper remains with the applicant. His presence confirms that the citizen actually filed a complaint with the insurance organization.

Who is responsible for poor quality repairs?

It is quite logical that the owner of the car would want to express his complaints to the service station employees, because... they did a poor job. However, the specifics of voluntary car insurance provide for a system of interaction between the insurer and the policyholder. According to the CASCO agreement, the insurance company takes responsibility for restoring the car. Consequently, a claim for poor-quality car repairs is written to the insurance company, and not to the service center.

Car restoration must be carried out not only with high quality, but also within the established time frame. Since delaying repair work can also be attributed to violations of obligations under CASCO.

Most often, the contract sets deadlines for repairs, which cannot be violated even due to the lack of necessary spare parts and components.

Most often, insurance companies set a period for car repairs of 15-30 days. If this period is not determined by the insurance contract, then you need to rely on the law “On the Protection of Consumer Rights”. In this case, service station workers must repair the car within 45 days from the date of delivery of the car.

Necessary documents for filing a complaint against insurance under CASCO

A complaint against a CASCO insurance company must be supplemented with a list of documents confirming the occurrence of an insured event. The list of papers is fixed by the rules, which are provided to the citizen along with the contract. Each insurer's list may vary. It also depends on the reason that became the reason for providing compensation. If the car was damaged, you will need to provide the following documents:

• the applicant's civil passport;
• driving license;
• CASCO policy;
• vehicle registration documents;
• protocol drawn up at the scene of the accident.

Additionally, you can attach to the list an invoice for the evacuation of the car, if it was carried out. When damage was caused by a natural disaster, a meteorological certificate is provided. If a car has been stolen, the list must include papers confirming the fact that a criminal case has been initiated as a result of the incident.

Step-by-step instructions for filing a complaint

In accordance with the Decree of the President of the Russian Federation dated July 25, 2013 No. 645, the Central Bank of the Russian Federation received powers in the field of insurance. The Central Bank of the Russian Federation can grant licenses and revoke them if gross violations are committed. This will lead to the forced termination of the company's activities. Article 23.74 of the Code of Administrative Offenses of the Russian Federation allows us to consider a whole list of cases on administrative offenses committed by insurers. This includes the issue of imposing additional services. Such a violation is provided for in Article 15.34.1 of the Code of Administrative Offenses of the Russian Federation. An organization that commits a violation may be subject to fines. Having decided to contact the Central Bank of the Russian Federation with a complaint against an insurance company under CASCO, a citizen must act as follows:

1. Prepare an application. The complaint is drawn up in any form. It is necessary to indicate that the current legislation or contract provision has been violated, and what it consists of. Additionally, you will need to provide personal data and details of the insurer. The complaint is supplemented with documents confirming the applicant’s innocence. Copies of papers are required.
2. Submit a complaint. The document must be sent to the territorial division of the Central Bank of the region in which the violation was detected. The action can be carried out via the Internet using the online reception located on the official page of the organization, or during a personal visit to the institution.
3. Wait for an answer. The Central Bank considers complaints within 30 days. The countdown begins from the moment of registration of the office paper of the institution. If additional verification is required, the period can be extended to 2 months. In practice, on average, the answer is given within 10-15 days.

complaints against the insurance company under CASCO can be found here.

How to defend your rights?

Having discovered poor-quality car repairs, the owner must send a written claim to the insurer in order to resolve the issue out of court.

The company must consider the claim within 5 days, after which the insurer must take measures to eliminate the deficiencies or refuse. In the second case, the car owner can file a claim in court. All documents confirming the plaintiff’s case will need to be attached to the claim.

Step-by-step instructions for filing a complaint against an insurance company under CASCO to Rospotrebnadzor

The state has entrusted Rospotrebnadzor with the responsibility to protect consumer rights. The person who purchased the CASCO insurance policy acts as a consumer. Therefore, it has the right to contact Rospotrebnadzor and demand that measures be taken against the culprit of the incident. It is recommended to contact an institution with a complaint against the CASCO insurance company if the insurance company does not want to enter into an agreement, refuses to provide payment or underestimates the amount of compensation, and also tries to impose additional services. The process of contacting the institution is standard. The citizen will have to:

1. Prepare a complaint. A sample document is not enshrined in current legislation. The paper is drawn up according to classical rules. If a person finds it difficult to independently file a complaint against a CASCO insurance company with Rospotrebnadzor, it is better to use a ready-made sample.
2. Submit the complaint to the authorized body for consideration. You must contact the central office or regional office of Rospotrebnadzor. In the first case, the paper will still be forwarded for consideration to the department at the location of the violation. You can contact the organization electronically or in paper form. In the first case, the process is carried out through the official website of the organization or the State Services portal.
3. Wait for an answer. The paper will be accepted for consideration within three days from the date of its receipt in electronic or paper form. From this date the standard monthly period is calculated. If necessary, the review period is extended to 2 months. If the period is extended, the citizen will be notified. The message is sent in writing.

complaints about CASCO insurance to Rospotrebnadzor can be found here.

How to prepare and submit a CASCO claim

A CASCO claim is made in writing addressed to the insurance organization specified in the contract or its director. The text of the claim indicates the applicant's information for feedback, the actual circumstances of the case, and the reason for filing the claim. It is necessary to describe the result that the applicant intends to achieve by filing a claim.

Documents confirming the basis for filing are attached to the claim. These can be expert reports, a technical inspection report (when representatives of the insurance company claim that the vehicle was faulty at the time of the accident), etc.

It is best to send a claim by registered mail with notification and a list of attachments. You can submit it to the claims department of the insurance organization (which usually exists). Make sure that on the second copy the employee who accepted the claim puts not only a signature, but also a transcript, position and date.

Refusal to satisfy a CASCO claim or failure to receive a response to the claim will be grounds for filing a claim in court. This may be a claim for the recovery of a penalty for violation of payment terms, or for the protection of consumer rights.

Claim to the Federal Insurance Supervision Service

The Federal Insurance Supervision Service or Rosstrakhnadzor was an executive body. He maintained a unified register of enterprises engaged in the insurance sector, issued licenses to companies carrying out similar activities, and controlled tariffs and the solvency of institutions. Additionally, the organization was involved in issuing permits to open branches of a company with foreign investments, to carry out transactions with shares with the participation of foreign persons, as well as to authorize an increase in the volume of authorized capital by raising funds from other countries. On July 25, 2013, Decree of the President of the Russian Federation No. 645 a was issued, abolishing the organization. Its powers were transferred to the Central Bank of the Russian Federation.

Complaints about CASCO insurance to the Russian Union of Auto Insurers

The Russian Union of Auto Insurers is a non-profit organization that unites all companies that provide CASCO or OSAGO services. To become a member of the institution, you must work in this field. RCA has certain levers of pressure that give it the opportunity to influence the companies that are part of it. You can complain to the institution if the company has lost its license and is unable to compensate for the damage caused, violates the direct settlement procedure, or there are violations related to the European protocol. In order for an organization to agree to consider a client’s complaint against an insurance company under CASCO, it is necessary:

1. Prepare the document. The paper is drawn up according to classical rules and has a pattern enshrined in law.
2. Make a complaint. The process can be completed using 1 of 3 methods. So, a citizen will be able to visit the management department. It is located in Moscow. The complaint can also be sent by mail. In this case, the document must be supplemented with other documents confirming the applicant’s correctness. You can also contact via the Internet. However, the citizen must be prepared to be asked to provide supporting documentation in paper or electronic form.
3. The period for consideration of a complaint is regulated by the rules for protecting the rights of policyholders. They were approved by the RSA Presidium in 2004. The appeal is considered within 1 month. However, clause 3.9 of the rules provides for the possibility of extending the period if an audit is to be performed or additional paperwork is required. In this case, the review will be extended by the time it takes to receive the documentation.

Sample complaint against an insurance company for CASCO in RSA.

Step-by-step instructions for filing a complaint against a CASCO insurance company in court

The court is the last resort to which you can turn in case of violation of rights. He will agree to consider an application with a citizen’s complaint against the insurance company under CASCO if the funds were not provided in full or were not paid at all. In such a situation, you need to immediately file a complaint rather than waste time contacting supervisory authorities. A complaint can also be sent to court if a person previously contacted the insurer with a claim, but it was ignored. A similar rule applies if the supervisory authorities for any reason refuse to satisfy the applicant’s request. Appeal to the court is carried out according to the following scheme:

1. The citizen prepares an application. The process of going to court is carried out in accordance with the norms of the Code of Civil Procedure of the Russian Federation. Here are the specifics of filing a claim. An appeal against the actions of an insurance company is carried out on the basis of the norms of the CAS of the Russian Federation.
2. Apply. After receiving the documents, representatives of the institution will review it and check for errors. If they are missing, the application will be sent for revision, indicating any inaccuracies.
3. Wait until the trial is scheduled. The citizen will be notified.
4. Take part in the proceedings. During the process, a person will be able to substantiate his position and provide evidence of a violation of rights.
5. Appeal the decision if it does not suit the applicant.

Litigation takes a lot of time. They may take several months. The exact period depends on the specifics of the situation. You can file a complaint against an insurance company under CASCO in court here.

Example of a CASCO claim

CASCO claim

On 06/05/2016, a voluntary insurance agreement was concluded between me and your organization for a vehicle, namely a Volvo XC90 car, 2013 model year, which I own, state number A523AA 97, for a period of 1 (one) year. The contract was concluded on the terms of providing me with an installment plan to pay the insurance premium by depositing funds quarterly.

On December 12, 2016, a traffic accident occurred, which is confirmed by a certificate from the traffic police, as a result of which the above vehicle received damage, the list of which is also indicated in the certificate.

Since this fact is an insured event, I contacted your organization with an application in the prescribed form in order to receive payment of insurance compensation. All documents, the list of which is established by the agreement, are attached to the application.

Your organization refused to pay the insurance compensation, about which I received a written response, due to failure to pay part of the insurance premium within the period established by the contract (December 2016).

In accordance with Art. 309 of the Civil Code of the Russian Federation, obligations must be carried out in the proper manner and unilateral refusal and change of conditions in accordance with Art. 310 of the Civil Code of the Russian Federation are not allowed, except in cases established by law. I was not notified of the termination of the contract due to late payment; mechanical damage as a result of an accident is an insured event, therefore, the payment of insurance compensation was unreasonably refused. Grounds for refusal to pay, enshrined in Art. 961, 963 and 964 of the Civil Code of the Russian Federation, are absent.

Based on the above, I demand payment of insurance compensation in my favor in the amount of 115,000 rubles, calculated on the basis of the report of an independent expert), within 10 days from the date of receipt of this claim. If this claim is refused, I will be forced to go to court with a statement of claim, incl. with a demand for a penalty, compensation for moral damage and compensation for legal expenses incurred.

1. Independent expert report No. 19745367 dated December 26, 2016

December 27, 2016 Tarasov E.V.

Time limits for consideration of a complaint under CASCO

The period for considering complaints against an insurance company under CASCO is determined by the provisions of Federal Law No. 59 of May 2, 2006 “On the procedure for considering appeals from citizens of the Russian Federation.” The period it will take to complete the action, depending on the organization, is presented in the table below.