Claim to the insurance company under compulsory motor insurance. Sample claim to the insurance company in case of an accident. But you can take reasonable steps to reduce your risk.

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Sample claims to the insurance company

ATTENTION! View the completed sample claim to the insurance company for payment of insurance compensation:

You can DOWNLOAD sample claims to the insurance company using the links below:

How to properly file a claim

Insurance companies often make mistakes when making payments. In this case, you must write a complaint addressed to the manager. It is quite possible that the deficiency was not intentionally made, and after verification, the organization’s employees will fulfill their duties in full.

A claim to an insurance company must be drawn up correctly, taking into account all the nuances. Otherwise, the application will not be considered, or a negative decision will be made on it. As a rule, employees of such organizations take advantage of citizens’ illiteracy by not performing their duties due to the inaccuracy of the document provided.

Compensation for losses is a significant blow to the budget of any organization. Insurance companies are trying to cut every claim. That is why they carefully examine each document and, after finding shortcomings, refuse to provide compensation.

To avoid getting into such a situation, you need to carefully study the contract concluded with the insurance company. Usually it clearly states all the rules for drawing up a particular document.

Another option is to download the document form from the company’s official website. In this case, there should be no controversial situations.

But even when filling out a ready-made form, it is necessary to reflect each item correctly, without errors from a grammatical and legal point of view.

Attention! A claim addressed to the head of the insurance company is drawn up in the following cases:

if signs of contract validity are detected, the client is denied medical services;
if an insured event occurs, the client is denied payment, or the amount of compensation is significantly underestimated;
the medical organization refuses to provide treatment and medicines free of charge;
payment of compensation occurred with a significant violation of the deadlines.

Before concluding a contract with an insurance company, be sure to carefully read each clause. Don't skip the fine print columns. This will help you avoid unspecified fees or any additional services.

Important! Before filing a claim, pay attention to the following important points, which are necessarily reflected in the document:

the claim is made exclusively in the name of the head of the insurance company;
the text of the claim reflects the essence of the dissatisfaction, it is expressed in the form of a demand to pay legal compensation;
the text of the document reveals in detail the road traffic accident, indicating the date, time, place, as well as the participants in the accident and the civil servants who drew up the protocol;
all demands are justified from a legal point of view, most often it is necessary to refer to the clauses of the contract;
The insurance policy number must be reflected, otherwise there is no way to determine the legality of the citizen’s claims;
Please note that if the head of the insurance company makes a negative decision, you will file a claim in court;
Copies of accompanying documentation can be attached to the claim, for example, examination results, a protocol from a traffic police officer, explanations of participants, etc.;
the list of attached papers must be included in the text of the claim, otherwise it is impossible to prove their provision;
at the end of the paper the filing date is indicated, as well as the personal signature of the compiler;
Please note that due to violation of the deadlines for submitting a claim, the insurance company will legally refuse to satisfy it.

Attention! Our qualified lawyers will assist you free of charge and around the clock on any issues.

If insurance company employees not only significantly underestimate the amount or refuse to provide it, but also treat the client with disdain, you can file a complaint with the Russian Insurers Association (RSA).

A completed claim can be sent by mail, registered mail with mandatory notification of receipt. An alternative option is to provide the document in person, against the signature of acceptance from the responsible person.

The claim is drawn up in two copies. One goes to the UK, the second remains with you. The signature of the person accepting the claim is placed on your sample. This will serve as a postal notification.

What needs to be included

When filing a claim, it is mandatory to attach a package of documents that can confirm the legality of the requirements by law.

Please note! Without it, although an insurance company employee reviews the application, the risk of receiving a negative decision increases several times:

a copy of the passport of a citizen of the Russian Federation - a client of the company;
photocopy of the client's driver's license;
documents confirming payment for insurance, as well as copies of the contract and insurance policy;
documents for the car, for example, technical passport, registration certificate, etc.;
papers confirming the examination, as well as its results;
all letters, reviews, responses from insurance company employees.

The above list is mandatory. In some cases, you will need to provide other papers that will help you achieve justice.

If an insured event occurs due to a collision with an object or animal, it is necessary to provide a report drawn up by the relevant employees.

If an insured event occurs due to the influence of third parties on the car, for example, theft, arson, etc., it is necessary to attach a ticket from the police about the initiation of a case and the occurrence of an insured event.

If the car burns down, an additional certificate from the fire station is provided. If the car is damaged due to a natural disaster, hurricane, flood, etc., an additional ticket is taken from the weather service.

The claim must be sent to the head of the parent body. It is sent to the main branch address. After receiving notification of acceptance, the client can expect to review it within ten days.

If after ten days, excluding weekends, you have not received a response from the insurance company, or it does not meet your needs, you have the right to file a claim in court.

You cannot go to court without having a pre-trial decision in hand. Independent conflict resolution is an important step in restoring your legal rights. Otherwise, the court may refuse to satisfy your claims.

How and where to submit

The claim is sent to the head of the company from which the client received the insurance policy. It is better to provide the document to the head office. However, if an organization no longer operates for some reason, for example, its license to operate has been taken away, an application is submitted to the Russian Union of Auto Insurers, abbreviated as RSA.

Remember! Without an attempt to resolve the conflict pre-trial, the court will not accept the claim or leave it unsatisfied, therefore it is most important to follow the procedure for filing a claim.

If the insurance company does not exist, contact RSA. Of course, you will not receive compensation, but you will have the opportunity to go to the second stage of proceedings.

If the magistrate's district court makes a decision not in your favor, you can appeal it unilaterally to the Supreme Court of the Russian Federation. The time specified when making the decision is given for this.

RSA will help you draw up a statement of claim correctly from a legal point of view. If there are several victims, filing a collective statement will help to unite them. As is known, such claims are more powerful and are more often subject to satisfaction.

A claim can be submitted to the RSA in several existing ways:

personally, through an authorized employee;
by mail, by registered mail with notification of acceptance.

An alternative option is to apply online on the company’s website. Now such complaints are considered official and are considered on the same basis as written ones.

ATTENTION! Look at the completed sample application for an insurance company in RSA:

In what case should you draw up

No one is immune from illegal and qualified actions of insurance company employees. Often they simply do not want to pay the required compensation in order to save the budget. However, you should not go to court right away. Contacting the leadership of the organization can bring more benefits.

Attention! The advantages of pre-trial conflict resolution include:

You can submit an application in a few minutes; clients often do this through the company’s official website;
filing a claim is free, in contrast to filing a statement of claim in court, where you are required to pay a state fee;
you can determine clear deadlines for fulfilling claims from the insurance company;
there is no need to be personally present during inspections and decisions.

A claim allows you to defend your rights without unnecessary costs and loss of personal time. It is quite possible that the organization’s management is not aware of the employee’s poor qualifications.

It is important to clearly know under what circumstances it is advisable to send a complaint to the head of the insurance company. After all, not in all cases the client’s rights were violated when making payments.

Often, with the help of a claim, issues of unlawful actions of insurance company employees are resolved:

negative decision in providing compensation for an insured event;
a small amount of insurance payment, which does not comply with the terms of the contract;
the penalty provided for by the terms of the contract was not provided;
untimely provision of compensation;
contemptuous treatment by a company employee, which led to a violation of the client’s rights.

The above cases are the most common. Disputes between insurance companies and their clients arise frequently. However, not everyone manages to defend their rights. Therefore, before filing a claim, carefully study all documents to avoid shortcomings and errors.

Watch the video. How to write a complaint correctly:

Document submission deadlines

Any client has the right to file a claim addressed to the head of the insurance company. Deadlines are most often specified in the contract.

However, the application is submitted:

after the insurance company refused to pay compensation;
if the insurance company has not made payments in full, which is documented;
if more than twenty days have passed after filing an application for payment for an insured event.

According to Supreme Court commentary, a customer has the right to file a claim the day after his rights are violated by the insurance company or the day after the customer learns that his rights are about to be violated.

Important! When determining the twenty-day period during which the insurance company is obliged to provide payments, holidays and weekends are not taken into account.

The claim must be submitted within three years from the date of discovery of the violation of rights. Otherwise, it will not be possible to compensate for losses, since the statute of limitations expires. Even the court in this case makes a decision not in favor of the client.

A statement of claim can also be sent to the court within three years from the date of discovery of the defects. This rule is regulated by Article 966 of the Civil Code of the Russian Federation.

Time limits for consideration of a claim on its merits

When determining the time frame for consideration, the type of persons involved in the dispute should be taken into account. If the contract is concluded between an insurance company and an individual, then the period is 10 days from the date of registration of the application. Excess is a reason to appeal to the court.

When resolving disputes between a legal entity and the insurance company, the consideration period increases to two months. As a rule, insurers are reluctant to argue with organizations, since they have some qualifications and understanding of jurisprudence, so the review period takes no more than a month.

After reviewing the claim, the insurance company must pay compensation or send a notice of denial within five business days. For example, if citizen N, an individual, sent an application on September 1, then he should receive a response no later than fifteen working days, on September 20.

The delivery time of the letter should be taken into account if the notice is sent by mail. The insurance company is not responsible for late delivery. The main thing is that the departure stamp bears a date that does not contradict the specified deadlines.

When a driver has a conflict with an insurance company, it is necessary to know the basic provisions of the law in order to competently defend their rights and receive due payments. Since the laws of our country are constantly changing, you need to stay informed to ensure that everything you do is legal and has legal force. Therefore, today it is worth reviewing the sample claims presented to you by the insurance company and the basic rules for its preparation.

A claim to the insurance company (a sample will be discussed below) must be drawn up without fail if you plan to go to court. Previously, this stage was not mandatory, but now changed rules apply.

To give insurance companies a chance to resolve the conflict out of court, it is worth drawing up this claim and sending it to the office. The rules of compulsory insurance state that you can go to court when peaceful negotiations have not yielded results. To prove to the court that such negotiations took place, this claim is necessary.

Important! This document should be sent by registered mail with notification and a description of the attachment. As a last resort, you can bring a package of documents to the office in person, demanding that you put the date of acceptance of the document and a stamp on the second copy of the paper.

The insurance company has no right not to respond to such a request. No response or

An unsatisfactory response may serve as a legal basis for drawing up a statement of claim.
What situations may give rise to a claim?

A smaller payment amount has been received into your account.
The insurer, for unknown reasons, refused to pay.
The deadline for payments has passed, but there is still no money.

Relatively often, drivers have to deal with the small amount of payment. The insurer carries out its assessment of the damage, draws up a vehicle inspection report, and then calculates repairs at the lowest possible prices. In this regard, the victim receives such an amount for which it is impossible to carry out even the most basic repairs, let alone restore the car.

Before filing a claim on this issue, you need to do a little preparation. You should conduct your own independent examination with another company and attach a copy of this document to the claim. These documents will be a good help in case of going to court.

When the insurer completely refuses to compensate you, it is important to request a written refusal from them. Analyze the refusal, perhaps even consult a lawyer about this. As a rule, such refusals have no legal basis.

If the insurer conducted an investigative examination, which showed that the specified damage could not have been sustained in this accident, challenge this document if you are sure that you are right. You can also go to court about this.

If there are unjustified delays in payment terms, you must also file a pre-trial claim. Such actions are called in the law “artificial prolongation of deadlines.” Feel free to submit documents and if there is no response, go to court.

Recommendations for filing a pre-trial claim with an insurance company

What should a claim to an insurance company for CASCO look like (a sample is on the website)? This is an important question, because incorrect preparation of this document will lead to an unequivocal refusal. It is legal illiteracy that unscrupulous insurers take advantage of.

Certainly, For any insurance company, compensation for material costs is a significant loss. Therefore, they are looking for any excuse to protect themselves from economic difficulties. Typically, the rules for drawing up this document are contained in the insurance contract itself, and some insurance companies even provide ready-made forms. However, it is important that everything is legally correct and justified.

There is a list of cases when it is worth filing this claim:

if the victim was denied free medical care;
if the payment is underestimated or completely denied;
if the hospital refused to provide free treatment and necessary medications;
if the compensation deadlines are missed.

Important! Before you sign an insurance contract, always re-read it. Check that there are no illegal commissions or additional services.

What do you need to know to file a claim?

The document is sent to the head of the insurance company.
The essence of the claim should look like a claim for compensation for damages due to an insured event.
The text of the claim must describe what happened, the circumstances of the accident and the measures that were taken by you and the insurer.
State your demands to the insurance company clearly and legally.
The policy number under which the dispute exists must be indicated.
Indicate that if you refuse, you plan to go to court.
Attach copies of documents to the document: protocols, resolutions, certificates, examinations.
Enter the entire list of attachments into the text of the claim itself.
Strictly adhere to the established deadlines for filing a claim.
Sign the document and date it.

Important! If, in addition to financial issues, you are faced with other illegal actions of insurers, it is worth simultaneously filing a complaint with the RSA or another supervisory authority.

When a claim to an insurance company under compulsory motor liability insurance (see sample below) has been drawn up, it can either be sent by mail or delivered to the insurers in person. It is very important to obtain their stamp and signature with the date of receipt.

Claim to an insurance company under compulsory motor liability insurance: sample

The sample for filling out a claim to an insurance company cannot be uniform. Each individual case has its own subtleties and circumstances that must be taken into account when drawing up the document.
If you are writing a claim to the insurer, it is important to refer to the articles of law that were violated by the company. It is also worth indicating who was responsible for the incident, after which compensation for damage is necessary.

Do not forget to keep for yourself all checks and receipts that you received for the examination, postage and other expenses. Firstly, this can become evidence of your communication with the insurance company, as well as the basis for a court decision to compensate all these losses from the insurance company.

Always keep copies of documents you submit to the insurance company or to the court. This will be a good hint for you to conduct business. If you decide to contact a lawyer, they will need this information to better understand your issue.

To avoid problems when receiving compensation or conducting an examination, it is recommended to save data after all technical work on car repairs. When filing a claim, be sure to indicate:

number of the policy under which the insurance case was opened;
registration data of cars involved in accidents;
the policy number of the person responsible for the accident;
copies of documents received from law enforcement agencies;
results of independent examinations.

Perhaps it will save you from litigation and put an end to the conflict with the insurance company!

Situations when the insurance company refuses to fulfill its obligations under the contract occur quite often. Therefore, it is important for every driver to know how to protect their rights. The first step to this is drawing up a pre-trial claim. How exactly to fill it out, in what cases is it necessary and what to do if the insurance company refuses to answer it - we will consider all these questions in detail in our article.

○ Claim to the insurance company under compulsory motor liability insurance.

If the policyholder, after being involved in an accident, was unable to obtain compensation from his insurance company or does not agree with the amount of the amount paid, he can challenge its decision. Previously, in such cases, the case was immediately sent to court. But after amendments were made to the Federal Law “On Compulsory Insurance...” dated April 25, 2002 No. 40-FZ (hereinafter No. 40-FZ), before sending a statement of claim to the court, the driver is obliged to try to resolve the case peacefully by filing a pre-trial claim.

“If there are disagreements between the victim and the insurer regarding the latter’s fulfillment of his obligations under the compulsory insurance contract before a claim is filed against the insurer arising from non-fulfillment or improper fulfillment of his obligations under the compulsory insurance contract, the victim’s disagreement with the amount of the insurance payment made by the insurer, the service station’s failure to comply with the deadline transfer of a repaired vehicle to the victim, violation of other obligations to carry out restoration repairs of the vehicle, the victim sends to the insurer a claim with documents attached to it and substantiating the claim of the victim, which is subject to consideration by the insurer within ten calendar days, with the exception of non-working holidays, from the date of receipt. During the specified period, the insurer is obliged to satisfy the demand expressed by the victim for the proper fulfillment of obligations under the compulsory insurance contract or send a reasoned refusal to satisfy such a demand (Part 2, Clause 1, Article 16.1 No. 40-FZ).”

Thus, a pre-trial claim is a document for resolving a conflict between a driver who does not agree with the procedure for fulfilling its obligations by the insurer and the insurance company.

○ Where and how to file a claim under MTPL?

Depending on the specific situation, a pre-trial claim can be sent to the insurance company, the culprit of the accident, or both at once.

To do this, you must file a complaint within the deadlines established by law. Thus, the insurer is given 20 days to transfer compensation to the policyholder based on the submitted documents. In case of disagreement with the established amount of payment, the policyholder may, within 20 days after the end of the established period, prepare and file a pre-trial claim. If this condition is not met, certain problems may arise when the case is considered by the court.

The claim to the culprit of the accident is submitted via mail, by registered mail in cases where the insurance does not fully cover the repairs. You can also send a complaint to the company by registered mail or deliver it in person. In the latter case, it is necessary to have 2 copies of the claim, one of which remains with the insurer, and the second - with the policyholder, with a signature confirming acceptance of the document.

○ Types of claims:

There are several types of claims depending on the specific circumstances of the case.

✔ Simple claim.

In this case, we are talking about the first contact with the insurance company with a request for payment or a complaint about the illegal actions of the insurer. There are no established rules for drawing up a document. The essence of such a statement is to indicate the problem, describing in detail your requirements with justification for them.

An example of such a complaint can be found here.

✔ Pre-trial claim.

This document is already the basis for going to court in the event of a negative decision on its filing. Therefore, following the rules for filing a claim is critical. The legislation does not stipulate the form of document execution; it can be drawn up arbitrarily

As a rule, a pre-trial claim is filed in the following cases:

Underestimation of the amount of payments compared to the actual cost of repairs.
Refusal of the insurer to pay compensation.
Failure to comply with deadlines for payment of damages.

Each of these cases will be discussed in detail below.

✔ Claim to the insurance company for underestimation of the payment amount.

If the driver does not agree with the calculation of damage made by the insurance company, he must submit a pre-trial claim justifying his claims. The form of the document is free; it is important to indicate all the details of the policyholder and the insurer, describe the essence of the problem and state your requirements. To increase the chances of success, it is worth doing an independent examination and attaching its result to the document.

✔ Refusal to pay.

If the insurance company refuses to pay for the damage, the pre-trial claim is filed according to the same rules as the previous one. The application indicates the personal data of the policyholder and the insurer, describes the essence of the problem (it is important to refer to the provisions of the law) and states the requirements for payment. The document must be signed by the applicant personally.

✔ Delaying the payment of damage compensation.

In such a case, when applying, you should indicate this circumstance and demand to explain the reasons for delaying payments. When writing such a claim, you should not expect that the insurer will satisfy your requirements, but he will have to give some kind of explanation. If the company refers to failure to provide any documents, send them again by registered mail. After the start of the trial, all this will become a good evidence base for your rightness in the issue at hand.

○ Rules for pre-trial settlement of disputes under compulsory motor liability insurance.

In accordance with amendments to No. 40-FZ, the law now includes Article 16.1, which regulates the rules for pre-trial resolution of disagreements with an insurance company. According to this law, this step is mandatory before going to court.

These rules are mandatory for insured events that occurred after 09/01/2014 and apply even in cases where the defendant has been replaced.

○ Rules for drawing up a pre-trial claim.

Despite the fact that the form for drawing up a claim is not enshrined in law, there are requirements for the information that it must contain. So, the document must indicate:

Details of the insurance company and the full name of its director (indicated in the header of the document, in the upper right corner).
Full name of the applicant and his contacts (in the same header, below).
Title.
The text of the appeal is recommended to adhere to a business style: a brief description of the problem, the essence of the requirements and the policy number.
List of requirements and grounds for appeal (links to laws, preferably indicating a specific clause and article).
Signature and date.

○ Contents of documents attached to the claim.

In addition to correctly drawing up the application, it is necessary to collect a list of documents that are needed to file a claim. This:

The original of a valid insurance contract confirms that you are indeed a client of the company.
Passport for identification.
Documents for the car (registration certificate or PTS).
Documents about the accident filled out by traffic police officers indicating the details of the accident.
Results of an independent examination (if available).

This article will describe writing a claim to an insurance company to receive payments under compulsory motor liability insurance. However, the general principles apply to other cases.

In modern times, there are frequent cases of reduction of insurance payments or complete refusal. There are many reasons for this, perhaps the most obvious is the insurance company’s attempt to save money on people who do not have an active lifestyle.

If the insurer has reduced the payment or refused it, it is time to contact it with a corresponding claim. Amendments to the law “On Compulsory Motor Insurance” introduced at the end of October 2014, in our opinion, have made the task more difficult for the ordinary person. Since now the rules for pre-trial dispute resolution have become stricter. However, sanctions against the insurance company for refusing to satisfy the legal demands of the applicant (the policyholder, the beneficiary) through the claim (pre-trial) procedure have also become more stringent.

What is the main difficulty in writing a claim or how to correctly submit a claim to an insurance company?

The main, main rule is the validity of the payment. We will talk about this in more detail in other articles; now we will superficially explain the operating principle of many organizations.

With the introduction of uniform methods for calculating RSA (Russian Union of Auto Insurers), receiving monetary compensation for restoration repairs is calculated by all insurance companies in approximately the same way. True, there is no guarantee that everyone strictly adheres to these methods.

In practice, the insurance company inclines a person to, so to speak, understate payments already at the stage of inspecting the vehicle. When, during the inspection process, the insurer (an expert on his behalf) reduces the amount of damage included in the inspection report. Usually, hidden damage and parts that, although subject to replacement, are subject to repair according to the inspection report are not taken into account.

I’ll say right away that if the amount of damage is more than 50,000 rubles, it makes sense to conduct your own independent examination. It is this that will subsequently form the basis of the claim. In cases where the amount of damage is less than the above amount, it is necessary to carefully calculate the damage.

If the expert approaches this issue formally, a situation may arise in which he will calculate an amount less than what the insurance company paid. I think this situation will not suit you very much.

Therefore, it is advisable to write a claim to the insurance company with specific requirements and support them with documents and legislation.

In what cases is it necessary to write a claim?

Unreasonable refusal or reduction of payments is the main reason for filing claims against the insurer. The main thing is not to confuse an application for receiving payments under compulsory motor liability insurance with a claim for making this payment. The application is written during the initial application when an insured event occurs. A traffic accident occurs, the injured party receives a certificate of the accident and, with it and other documents that are required to be presented in order to receive payment, an application for insurance compensation for damage is written.

We consider the case of refusal after such a statement has been written. Since October 2014, significant changes have been made to the law “On Compulsory Motor Liability Insurance” and the relevant rules.

The claim to the insurance company is written in accordance with the provisions “on the rules of compulsory insurance of civil liability of vehicle owners”, then simply the rules.

Chapter 5 of these rules regulates the procedure for resolving disputes. A careful study of these documents allows us to conclude that this process is unusual and several circumstances may be to blame.

Firstly, a person who has problems with an insurance company does not always know why the insurance company paid a particular amount. If the insurance company refuses to pay, this is one situation, it is required by law to notify the applicant.

Cases where the insurance company did not pay enough are more complex. The reasons for underestimating payments are not always known. And now, according to the law, in order to comply with the pre-trial procedure, it is the applicant’s responsibility to submit all the necessary documents and, moreover, regulatory confirmation of the legality of the claims.

In practice, everything is not so serious, nevertheless, the law is the law.

How to write a claim to an insurance company?

One of the important criteria is compliance with all the details of such a document. Name of the organization to which the claim is addressed, full name of the applicant, his address and contact details. In this case, the claim can be addressed either to the central office, which is usually located in Moscow, or to a regional representative office.

The claim must indicate the requirements. The specific wording of your request. Let’s say – make a payment in the amount of 400,000 rubles to the applicant’s bank account indicated below. Yes, the claim must include an indication of how exactly the buyer wants to receive the benefit. You can do it at the insurance company’s cash desk, or you can do it non-cash by transferring funds to the applicant’s account. In this case, details must be provided.

If the claim is related to understatement of payments, you will have to attach a copy of the independent expert’s opinion. The situation is more complicated in case of refusal of payment. You must rely on the insurance company's response. There are frequent situations where payments are refused on a formal basis. Let's say there are 3 cars involved in a traffic accident. The one who is not at fault for the accident does not have an insurance policy or has any problems with the protocol. Reason for insurance to request such documents.

In this case, you can write a complaint, not a claim. The insurer has no right to request documents not provided for by the above rules.

Shadow cases are even more complex. The insurance company did not pay enough and the fault was the way in which it made its calculations. The Law “On Compulsory Motor Insurance” states that in the event of loss of property, the person is paid the difference between the usable balances and the actual value of the property at the time of the accident. Even many lawyers do not insist on conducting an examination to determine the value of the car at the time of the accident before the trial. And these are one of the main criteria for the advisability of filing a claim in court.

By loss is meant the same or excess of the cost of repairs in relation to the value of the car. Perhaps a forensic examination will correct this defect, and if not.

Along with the necessary documents, you may have to attach a power of attorney from the representative if he signs the claim. The claim must be signed otherwise it will not be considered. A response to a claim under the new legislation must be given within 5 working days.

I also remind you to comply with the deadlines; the insurance company is obliged to make the payment within 20 working days. Therefore, it is more advisable to write claims after this period has expired.

It is advisable to indicate in the claim to the insurer the circumstances under which the traffic accident occurred, if there is a case number assigned upon the initial filing of the application.

The most difficult thing in this procedure is to indicate the detailed regulatory framework, specific articles of legislation. Today there is an opinion that RSA, the Russian Union of Auto Insurers, insisted on the introduction of these amendments in order to reduce the number of claims against insurance companies so that citizens could independently protect their rights in pre-trial proceedings.

In the claim, you can indicate the calculation of the penalty in accordance with No. 40 of the Federal Law “On Osago”: 1% per day of late payment. The calculation takes into account 20 working days from the date of application for payment.

However, the strict requirements for writing a claim and the tricks of insurance companies when inspecting a car indicate the opposite.

Why file a claim with the insurance company?

Subsequently, the court, in case of failure to comply with the pre-trial procedure for resolving the dispute, has grounds to leave the statement of claim without progress, or the court will not collect penalties and legal costs.
The first step is to receive a payment or an additional payment to an existing payment. This is also psychological pressure on the insurance company in order to protect the rights of the applicant without going to court.

The problem is that experienced insurance company lawyers will try to minimize their costs.

Attached to all of the above is a sample claim to the insurance company.

If you need individual advice or assistance in this matter, check out our services here.

It is a natural desire of insurance companies to reduce the amount of payment under compulsory motor liability insurance, which is why such facts occur very often in practice. At the same time, the client has every right to demand that insurers fully fulfill their obligations under the contract. The first step towards collecting the required amount of insurance is a pre-trial claim under OSAGO.

Legal requirements for the procedure

Pre-trial settlement is not only an opportunity for the client to defend his rights, but a mandatory procedure in case of disagreement with the amount of payment under compulsory motor liability insurance. From September 1, 2014, the law on compulsory insurance introduced a requirement for pre-trial resolution of disputes under compulsory motor liability insurance policies. This requirement applies to all MTPL contracts concluded after 09/01/2014.

According to Article 16.1, a statement of claim is filed in court only after a claim has been drawn up and submitted to the insurance company. If this requirement is not met by the client, the court may legally refuse to accept the application. Revealing the fact that there is no pre-trial claim may cause the case already being considered in court to be stopped (Article 222 of the Code of Civil Procedure). According to the Civil Code of the Russian Federation, the client must attach a document confirming attempts to voluntarily resolve the conflict with the insurance company to the statement of claim to the court (Article 132).

In this regard, a client who is not satisfied with the actions of the company must draw up a pre-trial claim under OSAGO and send it to the insurers. Practice shows that drawing up a pre-trial claim is an effective way to resolve conflicts under compulsory motor liability insurance, since subsequent recourse to court brings even greater costs to insurers compared to the payments requested by clients.

The procedure for pre-trial settlement of disputes under compulsory motor liability insurance

When an insured event occurs under a compulsory motor liability insurance policy, payment for damage to property or health is made on the basis of an examination carried out by the insurer. The amount of payments does not always correspond to the actual cost of the damage caused, and in this case the insured person may express his own disagreement with the company’s prices.

The conflict situation that has arisen is resolved by filing a pre-trial claim under OSAGO. The policy dispute resolution process is governed by the Arbitration Procedure Code. It contains the procedure and conditions for filing a pre-trial claim. According to this document, a claim is a primary document drawn up in the event that the client disagrees with the implementation of certain clauses of the insurance contract.

A pre-trial claim under compulsory motor liability insurance is submitted to the insurance company in three cases:

Underestimation of the amount of payments compared to the actual cost of damage.
Refusal to pay the insurance amount.
Delay in payment of compensation for damages.

The most rare cases of filing pre-trial claims are when insurers delay the transfer of monetary compensation. Meanwhile, the law determines specific deadlines for transferring payments to the client, which insurers simply forget about.

In accordance with the law, for each day of delay, the client has the right to recover from the insurance company a penalty in the amount of 1% of the amount of the assigned payment per day. Therefore, sluggishness on the part of the insurance company should not go unnoticed by the client, and he may demand compensation in a pre-trial claim under OSAGO.

Where and how to file a claim under MTPL

Depending on the situations that arise and the nature of the demands put forward, the claim is submitted to the insurance company, the person at fault for the accident, or both parties at the same time.

The timing of pre-trial claims under compulsory motor liability insurance is regulated by law. The document must be submitted within twenty days after the expiration of 20 working days, during which the company must fulfill its obligations to pay the insured amount . If the client does not meet these deadlines, the pre-trial settlement procedure is considered violated and it becomes impossible to count on satisfying the claim even through the court.

In the event of a clear violation of the deadlines for resolving the issue of payments by insurers, a claim can be filed before the end of the 20-day period.

The claim to the culprit of the accident, in case of incomplete coverage of the damage by insurance payments, is sent by registered mail with notification at the place of its registration. The document is delivered to the insurance company in person or sent by registered mail.

To submit a claim to the insurance company in person, you need to make two copies of it. The employee receiving the document puts a date and signature on the client’s copy. As an option, in this case, you can file a claim on a special form, which will be issued by an employee of the insurance company.

Rules for drawing up a pre-trial claim

There is no strict form of claim under MTPL, but there is a certain procedure for drawing up and mandatory content. The document is drawn up in an official business style, without florid and overly long sentences overloaded with complex speech patterns.

The claim must contain the following points:

Information about the parties to the insurance contract, the details of the document and the circumstances of its conclusion.
Client data (full name, registration address, passport details).
Details for transferring funds.
A detailed description of the essence of the claim with references to the violated clauses of the contract, expert opinions. This part of the claim is the most important, so its preparation must be approached with special responsibility.
Justification for the amount specified in the claim.
Payment requirements and deadlines for their fulfillment.
Statement of the consequences of failure to comply with requirements.

ADVICE. In order for the claim to be drawn up in compliance with legal norms, it is advisable to seek help from a qualified lawyer. A sample pre-trial claim under MTPL can be downloaded at the beginning of the article.

Composition of the application package for the claim

Correctly drafting the text of the claim is half the battle. To comply with procedural rules, you must carefully prepare a package of attached documents. The package includes:

Copy of the passport.
Copies of documents for the car.
Certificate of an accident (or notification of an accident when issued without the traffic police).
Violation decision.
Medical certificate about damage to health.
The conclusion of the investigative examination plus a receipt for payment.
Account details for collecting funds.

In case of subsequent filing of a statement of claim in court, the package of the application to it is identical.

IMPORTANT. Conducting an independent examination and issuing a conclusion that meets the requirements of the Central Bank of the Russian Federation is a mandatory condition for filing a claim with the insurance company. If this document is not in the package, insurers legally leave the pre-trial claim under MTPL without consideration.

Response time from the insurance company

Legislative norms provide for consideration of claims under compulsory motor liability insurance 5 working days. Within these deadlines, the claim is satisfied or rejected, but only by sending a response letter to the applicant.

If the deadline for a response from the insurance company is violated during subsequent legal proceedings you can demand payment of a penalty in the amount of half the difference between the amounts paid and the required compensation. Collection of these funds is possible only if the court rules in favor of the client.

REFERENCE. A client who is not satisfied with the insurers’ response to a pre-trial claim can file a complaint with Rospotrebnadzor, the Central Bank and RSA. According to statements from citizens, these organizations are obliged to check the circumstances of the case and evaluate the actions of the insurance company. In this case, the case may be resolved in favor of the client even before going to court. Controlling organizations have the right to deprive an insurance company of its license if they are found to have violated the law, so contacting them is an effective measure.

A client of an insurance company who is confident that he is right has the right to seek compensation for the damage caused to him in all the ways described. But according to the law, he must begin by filing a pre-trial claim under OSAGO directly to the company with which he has an agreement.