Relationships between the parties upon the occurrence of an insured event. Insurance case

The definition of an insured event is given in paragraph 2 of Art. 9 of the Insurance Law. Insured event is recognized as an event that has occurred, provided for by an insurance contract or by law, the occurrence of which is associated with the emergence of the insurer's obligation to make an insurance payment to the policyholder, the insured person, the beneficiary or other third parties. Not recognized as an insured event circumstances that occurred as a result of the intentional actions of one of three persons - the policyholder, the beneficiary or the insured person. So, according to the norm of paragraph 1 of Art. 963 of the Civil Code, the insurer is exempt from paying insurance compensation or the insured amount if the insured event occurred as a result of intent policyholder, beneficiary or insured person. The law may provide for cases of exemption of the insurer from payment of insurance compensation under property insurance contracts upon the occurrence of an insured event due to gross negligence policyholder or beneficiary. However, there are exceptions to this rule, provided for in paragraphs 2 and 3 of this article. In particular, in accordance with paragraph 2 of Art. 963 of the Civil Code, the insurer is not exempt from paying insurance compensation under a civil liability insurance contract for causing harm to life or health, if the damage was caused through the fault of the person responsible for it. And according to clause 3 of this article, the insurer is not exempt from paying the insurance amount, which under the personal insurance contract is payable in the event of the death of the insured person, if his death was due to suicide And By this time, the insurance contract had been in effect for at least two years. This norm is imperative. Therefore, if a personal insurance contract excludes from insurance coverage the risk of death of the insured person due to suicide, this is not a basis for refusal to pay insurance compensation by virtue of the norm in question. The only sufficient basis for refusal of insurance compensation in the event of suicide of the insured is the validity of the insurance contract less than two years at the time of death.

Actions of the parties upon the occurrence of an insured event

Upon the occurrence of an insured event, the policyholder is obliged to:

• 1) take the necessary measures to prevent and eliminate the causes contributing to the occurrence of additional damage;
• 2) within the established period, notify the insurer about the incident;
• 3) submit a written application in the established form for payment of insurance compensation;
• 4) provide the insurer with all the necessary information about the damage, as well as documents to establish the fact of the insured event and determine the amount of damage. If he does not have such information, then the policyholder must assist the insurer in obtaining the necessary documents;
• 5) give the insurer the opportunity to conduct an inspection and examination of the insured object, as well as an investigation into the causes of the insured event and the amount of losses.

It is not necessary to report an insured event to the insurer itself. Norm Art. 961 of the Civil Code obliges to notify the insurer or his representative. Therefore, you should pay attention to the fact that the contract clearly indicates the representative of the insurer, who must be notified of the insured event in the event that the insurer itself cannot be notified. We must remember that Art. 961 of the Civil Code exempts the insurer from the obligation to make a payment if the policyholder or beneficiary, who is aware of the conclusion of an insurance contract in his favor, does not report the insured event.

The Civil Code contains a number of rules allowing impose certain obligations on the beneficiary. According to the general rule of civil law, enshrined in Art. 308 of the Civil Code, an obligation does not create obligations for persons not participating in it as parties. However, in ch. 48 of the Civil Code for insurance this prohibition is circumvented as follows. Firstly, in paragraph 1 of Art. 939 of the Civil Code states that the conclusion of an insurance contract in favor of the beneficiary does not relieve the policyholder from fulfilling obligations under this contract, unless otherwise provided by the contract, i.e. The parties may provide in the contract for the release of the insured from fulfilling his obligations. Secondly, according to and. 2 tbsp. 939 of the Civil Code, the insurer has the right to demand from the beneficiary to fulfill obligations under the insurance contract, including obligations that fall on the insured, but were not fulfilled by him, when the beneficiary submits a claim for payment. Thus, civil legislation actually allows the parties to the contract to shift the responsibilities of the insured to a third party - the beneficiary, without formally violating the rules of Art. 308 Civil Code. The beneficiary must remember this when making a claim for payment.

When an insured event occurs under an insurance contract, the policyholder or beneficiary is obliged to notify the insurer about it immediately or within the time frame and in the manner specified in the insurance contract; the policyholder taking reasonable and available measures under the current circumstances to reduce possible losses; if the insurance contract is concluded in favor of a person other than the policyholder, the insurer has the right to demand from the beneficiary, when presenting a claim for insurance payment, to fulfill those obligations under the insurance contract that lay with the policyholder, but were not fulfilled by him. In this case, the beneficiary is responsible for the consequences of failure to fulfill or untimely fulfillment of obligations.

The insurer carries out a number of actions (liquidation of the consequences of the insured event): establishing the fact of the insured event (investigation of the circumstances of the incident, causes); calculation of the amount of damage and insurance payment; making insurance payments; taking measures to return amounts related to the insured event.

Grounds for releasing the insurer from the obligation to make insurance payment:

If the insured event occurred as a result of the intentional actions of the policyholder;

If the insured event under the property insurance contract occurred due to the gross negligence of the insured;

If the policyholder fails to notify the insurer or his representative in the cases established by law and within the stipulated time frame of the occurrence of an insured event, unless it is proven that the insurer learned about it in a timely manner without such notification or that the insurer’s lack of information about the insured event could not affect his liability make an insurance payment.

8. General characteristics of civil liability insurance

Liability insurance is a branch of insurance where the object of insurance is the liability of the insured to 3 persons (individuals and legal entities) who may suffer damage as a result of any action or inaction of the insured.

The immediate purpose of liability insurance is to provide insurance protection for the interests of policyholders as potential tortfeasors and third parties who suffered damage. The participants in liability insurance are the insurer, the policyholder and third parties not determined in advance.

Liability insurance provides the possibility of compensation for damage caused to both health and property of third parties.

Civil liability is of a property nature: the person who caused the damage is obliged to fully compensate the losses to the victim, i.e. to a third party. Through the conclusion of a civil liability insurance contract, this responsibility is transferred to the insurer. For the damage caused, the policyholder may bear criminal or administrative liability, i.e. be prosecuted by law for their illegal actions towards a third party. However, compensation for property damage caused to a third party is transferred to the insurer.

According to the terms of licensing of insurance activities on the territory of the Russian Federation, the following types of liability insurance include:

Civil liability insurance for vehicle owners;

Carrier civil liability insurance;

Insurance of civil liability of enterprises – sources of increased danger;

Professional liability insurance;

Liability insurance for non-fulfillment of obligations;

Insurance of other types of liability.

9.General characteristics of motor transport insurance: object of insurance, insurance risks, insurance period.

Objects of fear are transport vehicles that are subject to registration by the State Traffic Safety Inspectorate of the Russian Federation in the prescribed manner, i.e., these are light, cargo, and cargo-passenger vehicles; minibuses, including those with trailers; railway rolling stock; motorcycles, scooters, sidecars, snowmobiles, mopeds, tractors. Simultaneously with the transport medium m.b. stranded: driver and passengers; additional equipment and accessories to the transport system; baggage. If the fear is realized not only of transport equipment, but also of luggage, as well as the response of an auto driver, then this is called fear combined.

The main contract is for 1 year or from 2 to 11 months, the additional one is for the period remaining until the end of the main one. Transport risk insurance: full insurance (against all risks) - compensation to the insured for losses caused by loss or damage to the vehicle, physical injuries to people and damage to property of the 3rd party; transit insurance - up to 30 days, providing insurance coverage for the duration of the journey to the destination; insurance of drivers and passengers against accidents - the insurer pays the insured amount if, as a result of an accident, the insured is injured or injured, disabled or killed; cargo insurance - with liability for all risks, for a private accident, without liability for damage, except in cases of a crash.

Feature of the fear of cars The fact is that insurance does not compensate the victim for damaged parts of the car, but pays for the restoration of the damaged car, costs and expenses for the rescue, protection and delivery of the damaged equipment to place of repair. Ground transport facilities m.b. insurances in the amount of their actual amount, including the amount of the trailer, or for a lesser amount, if agreed upon by both parties. When concluding an insurance contract, a preliminary inspection of the vehicle is required. The policy is usually issued to the policyholder after he has paid the insurance premium according to the terms of the contract. When the fear of the dog is closed A preliminary inspection of the transport facility is required. The policy is issued to the insurer after he has paid the insurance premium.

Upon inspection and seal of agreement The insurance company is obliged to provide information about the vehicle: car make, model, chassis number, engine number, year of manufacture, engine power and volume, cost of the vehicle, etc. By agreement of the parties SKey m.b. provided fear protection against the risks of damage and destruction of transport equipment resulting from: a derailment, accident, collision or derailment; fire, explosion; disaster (flood, hurricane, rain, earthquake, landslide, snowfall, lightning, tornado, hail); illegal actions of third parties.. From the moment the contract is concluded and the first payment is made, the fear of the insurance premium and the insurance company begins obligations which they must comply with.

When fear of an event occurs, fearmust: take measures to save the car, passengers and luggage, prevent their further damage and eliminate the causes; in the event of an accident, fire, explosion, theft of the car, parts and accessories and luggage, immediately report it to the police, traffic police, fire inspection authorities ; report any fear in writing; present to the Investigative Committee the damaged car before it is repaired or the remains of it; submit a certificate from the traffic police confirming the occurrence of an accident. When insuring vehicles, the average amount of damage is and the amount of insurance compensation is determined on the basis of the insurance act and documents attached to it confirming the fact insurancecase(accidents, theft, theft, fire, unlawful actions of third parties, etc.).

Fear compensation for a destroyed, damaged or stolen vehicle, payment is made in the amount of damage caused, but not higher than the corresponding amount.

Fear has the right to pay insurance costs for the restoration of the tran-go facility in the amount of the actual costs for its repair according to the prepared calculation. Insurance does not compensate for losses, arising fromreasons: intent to fear, violation of fire safety rules, storage and transportation of fire and explosive objects, operation of a faulty vehicle; driving without a license, while under the influence of alcohol or drugs; using trans for training purposes or to participate in competitions; military actions and events, as well as popular unrest, arrest.

If after payment there is no feardisplacement For a stolen vehicle, the vehicle was returned to its owner for some time, the insurer is obliged to return the amount of compensation received to the insurer.

When concluding a loan agreement with any bank, you will by default also need to enter into an agreement with an insurance company. Often an insurance company is part of a single structure with a bank, thus being affiliated with it. Of course, based on the principle of voluntary insurance, you have the right to immediately terminate the contract, but this rule is only valid if you have a consumer loan. The conclusion of an insurance contract is, in fact, mandatory, and if the borrower terminates the insurance contract, the previous terms of the loan no longer apply to him, in particular, interest on the loan will be charged at an increased rate.

In addition, lending agreements are necessarily accompanied by insurance, and the borrower cannot refuse it for these types of loans. Mandatory insurance of the collateral for a mortgage is stipulated by Federal Law No. 102-FZ “On Mortgage”. When lending a car, the collateral (car) is insured using the Auto Casco insurance system in accordance with Art. 343 of the Civil Code of the Russian Federation (“the pledged property must be insured at the expense of the pledgor against the risks of loss and damage”).

Purpose of borrower insurance

In addition, the borrower can insure his own risks: the risk of loss of life, work, productivity and health. These measures are understandable; they are aimed at insuring the borrower from negative changes in his situation, for example, from losing his job, health, etc. These are insured events, upon the occurrence of which the insurance company undertakes to pay compensation to the bank, thus taking on part of your obligations. But what if the insurance company does not pay when an insured event occurs? Go to law?

In recent years, classic insurance for bank loans has begun to be replaced by so-called “financial protection programs.” In essence, this is the same insurance, only under a different guise. In any case, the borrower, when taking out insurance, expects that if an insured event occurs, he will be insured, and the bank will receive appropriate compensation. However, even the most extensive insurance will not give you confidence that the occurrence of an insured event will necessarily result in compensation from the insurance company.

Interestingly, this situation, when an insured event occurs, but no payments are made by the insurer, is observed precisely with credit insurance. In such a situation, the question seems reasonable: isn’t credit insurance a useless tool if it is not able to protect the borrower in a difficult situation when, instead of receiving compensation from the insurance company, he still owes the bank?

Let's try to figure out what to do if the insurance company refuses to pay when an insured event occurs on the borrower's loan.

According to the terms of the insurance contract, the occurrence of an insured event is not the only condition for receiving compensation payments from the insurance company. In addition, the borrower is obliged to contact the insurance company only in accordance with a certain procedure and comply with additional formalities. However, even if all necessary conditions are observed, the borrower is faced with the fact that the insurance company seeks by all means to delay the fulfillment of its obligations or to reduce the amount of payments to a minimum. Knowing these features of the behavior of unscrupulous insurers, it becomes necessary to know your rights and obligations when executing a loan agreement.

The first thing you should do when an insured event occurs is to check the insurance contract and make sure that your case is actually covered in it. In general, of course, you should read the contract before signing it, but with regard to the insurance contract, few people follow this rule, since the insurance contract is usually signed simultaneously with the lending contract, and, as a rule, there is not enough attention to all the details of both contracts. You may find in the insurance contract that your case:

• Present and clearly and clearly marked.
• Absent at all.
• It seems to be present, that is, the wording in the contract is so vague and unclear that it can be interpreted in several ways.

It is clear that if your case is not specified in the contract at all, then you will not receive payment from the insurance company. It is more interesting with the option when the case is not clearly defined. In this case, the best thing you can do is contact an insurance lawyer who specializes in credit insurance. He will help you understand what is written in the contract and advise how you can apply this knowledge in a conversation with the insurance company.

Let's assume that your case is actually indicated in the insurance contract as an insurance case. What to do?

• First of all, you review the contract again to clarify the procedure for contacting the insurance company with initial notification in the event of an insured event and, most importantly, the timing of the complaint.
• If this information is clear, all we have to do is prepare the initial notification to the insurance company. Often, under the terms of the contract, the period for recourse in the event of an insured event is limited to several days, most often one or two days. During this period, you must draw up a notice and deliver it to the office of the insurance company in person or through an authorized representative. Try to get a mark confirming your acceptance of the document; the receiving person must put this mark on your copy of the notice, which remains with you.

The insurance company, having accepted your notification, will explain to you what documents it expects from you to confirm the occurrence of the insured event.

Usually this point does not cause complications. So, in case of death, a death certificate is presented, in case of illness or accident - medical certificates, and in case of loss of work - a copy of the order of dismissal for certain reasons.

If the insurance company refuses to pay compensation, what should you do?

Upon receipt of all documents from you, the insurance company begins checking the information provided. The inspection lasts for a certain time, established by the terms of the contract and internal work regulations. Based on the results of the inspection, during which the insurance company verifies the occurrence of the event specified by you in the notification, its proof and the possibility of recognition as an insured event, a decision is made on payment of compensation, its amount or refusal to pay (partial payment).

You receive a notification about the results of the inspection; if the insurance company refuses to pay compensation, it indicates in the notification the rationale for its decision to refuse.

You should review this document. Further actions will depend on the grounds specified by the insurance company for the refusal. The most common reason for refusal to pay insurance compensation, which is used by insurers, is failure to recognize the incident as an insured event. This argument may be due to various reasons. Often this happens precisely because of the vague wording of the definition of an insured event in the contract itself. Also, a limitation may occur if the contract specifies additional conditions, only upon the occurrence of which the event is considered insured.

For example, the dismissal of a borrower at his own request or for a disciplinary act is unlikely to be assessed by the insurance company as an insured event. That is, some reasons for dismissal are considered as limiting conditions under which compensation is not paid. If the borrower presents, for example, his disability in the initial notification of the occurrence of an insured event, the insurance company may refuse due to the fact that the onset of disability occurred before signing the contract, while the borrower, knowing about his disability, did not inform the insurance company about it at the time signing the contract.

If the insurance company has refused to pay insurance compensation, you can immediately go to court, since it is obvious that even if you present all the documents confirming these circumstances, the insurance company has already made its choice, and instead of wasting time trying to - to prove, it is better to immediately transfer the dispute to the judicial level. Moreover, you must pay loan obligations that are not removed from you, despite the obvious occurrence of an insured event.

In order to comply with the necessary procedure for pre-trial dispute resolution, the first step is to send a written claim to the insurance company, in which, listing the circumstances that you interpret as the occurrence of an insured event, you must demand that the insurance company fulfill the terms of the contract on its part.

Also, the insurance company may agree to pay, but pay it not in full or with a delay, or refuse to pay compensation in full, or simply not give you any response to your appeal within the prescribed period. In all such cases, you must also promptly submit a written claim to the insurance company, thereby officially beginning the pre-trial phase of the proceedings.

Along with your claim to the insurance company, you have the right to send official complaints to other authorities, for example, to Rospotrebnadzor and the Bank of Russia, as the main insurance supervisory body. Such complaints, even if they do not directly contribute to the payment of insurance compensation from the insurance company, will nevertheless be additional evidence that you are right in court and will put some pressure on the insurer.

In addition, legal assistance is provided, to which you can also send a complaint about the actions of the insurance company.

Make sure you have evidence of filing a claim with the insurer. If you are submitting a claim in person, try to get a mark of acceptance of the document, which should be placed on your copy of the claim by the official who accepted the claim from you. If you are submitting your claim by mail, send it by certified mail with return receipt requested and a description of the attachments.

After receiving a response from the insurer, or even if the insurer ignored your claim and did not respond within the prescribed period, you can file a claim in court. In the application, you must express a claim on your behalf in favor of the creditor bank, because under the insurance agreement it is the bank that is the beneficiary. The requirements you express in your favor should be:

1. Demand to recover from the insurance company: court costs, expenses for legal assistance, interest for the use of other people's funds and compensation for moral damage.

If your claims relate not only to the insurance company, but also to the bank, and you express a demand to terminate the loan agreement and involve the insurance company and the bank as defendants, your demands may be as follows:

1. Demand that the event be recognized as an insured event.
2. Demand that the refusal of the insurance company to pay insurance compensation in favor of the bank be declared illegal.
3. Demand to oblige the insurance company to fulfill its obligations under the insurance contract in full by paying compensation to the bank.
4. Demand that the bank be obliged to use the received insurance amount to pay off the loan debt.
5. Demand that the loan agreement be recognized as terminated, and if the agreement contains a pledge, the pledge agreement be recognized as terminated.

You should check with your lawyer for a specific list of requirements that will be specific to your case. It will depend on the terms of the loan agreement, on the grounds that the insurance company has put forward for refusing to pay the insurance, and on your goals in the process. Without legal assistance, it will be difficult to achieve the desired result, so before you take action, find a lawyer who specializes in insurance issues when lending.

The process of settling claims of policyholders and its task. Payment of insurance compensation.

In accordance with the current legislation in Ukraine, all disputes under contracts, including insurance contracts, are subject to resolution in court.

In the event of early termination of the insurance contract, at the request of the insured, the insurer returns to him insurance payments for the period that remains until the expiration of the contract with the deduction of the standard costs of conducting the business determined when calculating the insurance tariff, actual payments of insurance amounts and insurance compensation made under this contract insurance. If the insured's claim is due to the insurer's violation of the provisions of the insurance contract, the latter shall return to the insured the insurance premiums paid in full.

In the event of early termination of the insurance contract, at the request of the insurer, the insurance premiums paid in full will be returned to the policyholder. If the insurer's requirement is due to the insured's failure to comply with the terms of the insurance contract, then the insurer returns to the insured the insurance payments for the duration of the contract with the deduction of the costs of conducting the business, determined by the standard in the amount of the insurance tariff, payments of insurance amounts and insurance compensation that were feasible under this insurance contract.

In the event of early termination of the insurance contract, the return of funds in cash is not allowed if payments were made in non-cash form.

When concluding insurance contracts, the Law of Ukraine on Amendments and Additions to the Law of Ukraine “On Insurance” provides for special conditions for resolving refusals in matters related to the payment of insurance amounts (page indemnities), and the basis for the insurer’s refusal to pay insurance amounts may be the following:

1) intentional actions of the policyholder or the person in whose favor the insurance contract is concluded, aimed at the occurrence of an insured event. This norm does not apply to actions related to the performance of civil or official duties in a state of necessary defense or protection of property, life, health, honor, dignity and business reputation;

2) the commission of an intentional crime by the insured - a citizen or other person in whose favor the insurance contract was concluded, which led to the insured event;

3) submission by the policyholder of deliberately false information about the object of insurance;

4) receipt by the insured of full compensation for losses under property insurance from the person responsible for the damage;

5) untimely notification by the insured of the occurrence of an insured event without important reasons for this or the creation of obstacles for the insurer in determining the circumstances, nature and amount of losses;

6) other cases provided for by the legislation of Ukraine.

The decision to refuse to pay insurance amounts is made by the insurer within a period not exceeding that provided for by the insurance rules, and is communicated to the policyholder in writing with justification for the reasons for the refusal. The insurer's refusal to pay the insurance amounts may be appealed by the policyholder in court.

When an insured event occurs, the policyholder is obliged to take reasonable and available measures under the circumstances to reduce possible losses. When taking such measures, the policyholder must follow the instructions of the insurer, if they are communicated to the policyholder. If the insured deliberately failed to take reasonable and available measures to reduce possible losses, the insurer is released from the obligation to compensate for losses arising as a result of such failure to take measures by the insured.

The policyholder must promptly notify the insurer of the occurrence of an insured event. If the insurance contract provides for a period and method of such notification, it must be done within the agreed period and in the manner specified in the contract. Timely information about an insured event will allow the insurer to establish the cause of the occurrence and the nature of the circumstances necessary to recognize the event as an insured event. Failure to fulfill the obligation to notify the insurer gives the insurer the right to refuse to pay insurance compensation.

When insuring property - in the event of its loss (damage) due to unlawful actions of third parties, as well as if there has been a burglary or theft of a vehicle, the policyholder must immediately report to the police. The policyholder does not have the right to begin inspection of the property without a representative of the insurance company and law enforcement agencies. In the event of loss or damage to the insured property, the policyholder must provide the insurance company with copies of the protocol, act, as well as relevant documents from the competent authorities necessary to establish the causes of loss or damage to the property and determine the amount of losses. The policyholder must store the damaged and surviving property in the same form as it was after the insured event until the arrival of the insurance company representative.

The policyholder is obliged to provide the insurer with subrogation, i.e. ensure the possibility of filing claims against the person responsible for losses compensated as a result of property insurance. The policyholder is obliged to transfer to the insurer all documents and evidence and provide him with all the information necessary for the insurer to exercise the right of claim transferred to him. If the insured (beneficiary) has waived his claim against the person responsible for the losses compensated by the insurer, or through his fault it has become impossible for the insurer to exercise this right, the insurer is fully (or in the relevant part) exempt from paying insurance compensation.

8.9. Emergency commissioner: concept, responsibilities.

When an insured event occurs or an event that can be preliminarily judged as an insured event, it is necessary to collect all the information in order to make the payment of insurance compensation as fully and quickly as possible. For this purpose, insurance practice has developed over the centuries a special mechanism called the emergency commission.

The activity of the accident commissioner is to establish the causes, nature and amount of loss on the insured property (such actions of the accident commissioner are often called an investigation of the insured event, or insurance investigation), documenting the insured event and preparing material for consideration of the policyholder's application for insurance payment (such a statement from the policyholder is traditionally called a policyholder's claim).

Due to the fact that a significant part of the property insured by any insurance company is geographically remote from it, it is often difficult for the insurance company to carry out damage assessment work on its own due to the variety of insured events and the small number of employees. In addition, not every insurance company can afford to have employees who are specialists in various fields of activity.

The accident commission departments, previously created on the basis of insurance companies, were transformed into separate independent survey companies.

The insurance company enters into a special agreement with the accident commissioner (survey company): either by exchanging letters between them, or by signing a single document that stipulates the responsibilities of the parties. As a rule, the insurance company is not obligated to use the services of this particular accident commissioner for each insured event in a given territory. It can choose to use the services of other survey firms specializing in narrower areas (for example, in the field of petrochemicals, shipbuilding or agriculture).

To better serve their clients, insurance companies place a list of their accident commissioners on the back of the insurance policy, and on the front side instructions are given for the policyholder to contact the accident commissioners named in the policy.

According to the agreement with the insurer, the accident commissioner has the right:

1) determine the forms and methods of fulfilling obligations on the basis of legislation and the terms of the contract;

2) with the permission of the person or body conducting the investigation, familiarize himself with the investigation materials, be present during the investigative actions and file a petition regarding the circumstances and reasons for the occurrence of the insured event;

3) receive the necessary explanations in writing or orally from the parties involved in the occurrence of the insured event;

4) answer questions from the Authorized Body for Supervision of Insurance Activities, as well as investigative bodies, with information about the circumstances and reasons for the occurrence of the insured event and the loss caused.

The responsibilities of the emergency commissioner include:

1) inspect the damaged property;

2) investigate the circumstances of the occurrence of the insured event;

3) take measures to save property and reduce losses;

4) make a conclusion whether this event relates to an insured event, i.e. whether it is subject to insurance protection;

5) carry out, if possible, an assessment of the damage;

It is not difficult to assess the damage if we are talking about piece goods, and the damage is obvious. And it’s difficult if, for example, complex equipment is damaged. In this case, an assessment by a specialized expert organization is required, which gives its opinion. The amount of damage is generally determined as the difference between the market value of the damaged property and its value in an undamaged condition.

When assessing damaged property, the accident commissioner may be given the following powers by the insurance company:

Only a description of the damage without a material assessment of losses; in this case, the insurance company undertakes further management of the case, including resolving the issue of attracting expert organizations;

Description of the damage, its assessment in material terms, involvement of expert organizations;

The above, supplemented by the right to enter into an agreement with the policyholder on behalf of the insurance company on mutual fixation of the degree of discount; in this case, the emergency commissioner is given the authority to negotiate with the insured on a compromise basis on the amount of damage; after concluding such an agreement, the insurance company must pay compensation in the amount of the discount;

The above, supplemented by the right of the emergency commissioner, with the consent of the insured, to sell the damaged property; in this case, the policyholder receives insurance compensation as if for the loss of all property, and the proceeds from the sale go to the insurance company.

6) collect all documents related to the event;

7) provide the insurance company with the opportunity to file a claim by subrogation against the persons responsible for the occurrence of the insured event.

Subrogation is the transfer to the insurer of the right of claim that the policyholder has against the person responsible for the loss. This right extends to the insurer only to the amount of insurance compensation actually paid by him.

Based on the research and collected documents, the emergency commissioner draws up an emergency certificate. In the case where the inspection of damaged property is carried out directly by employees of the insurance company, it is usually called an insurance report. These documents must contain comprehensive information about the insured event. The emergency certificate is drawn up in two copies, one of which is issued to the insurer (policyholder), and the other is kept by the accident commissioner. The collected materials (certificates, examination reports, diagrams) are given as an appendix to the emergency certificate.

According to the legislation of Ukraine, an emergency commissioner can be a person who:

has a higher education and is a bachelor, specialist or master, respectively;

has special qualifications confirmed by a certificate (certificate) of an educational institution that trains emergency commissioners;

has practical experience in the specialty for at least three years.

Every three years, the emergency commissioner must undergo certification as an expert in this specialty.

An insured event under compulsory motor liability insurance is considered to be the occurrence of civil liability of the car owner for causing harm to the life, health or property of victims when using the car, entailing the obligation of the insurance company to provide insurance compensation (Article 1 of the Law of April 25, 2002 N 40-FZ).

If an insured event occurs under compulsory motor liability insurance, we recommend adhering to the following algorithm.

Step 1. Complete the primary actions provided for by the traffic rules

In case of an accident, its participants must take measures and fulfill the obligations provided for by the traffic rules (clauses 2.5, 2.6, 2.6.1, 7.2 of the Russian Federation Traffic Regulations; clause 3.1 of the Rules, approved by the Bank of Russia on September 19, 2014 N 431-P).

It should be taken into account that, depending on the actual circumstances of the incident, traffic regulations provide for different rights and obligations of drivers involved in an accident. Thus, traffic regulations prescribe different procedures for drivers (clause 2.6, paragraph 1, 3, clause 2.6.1 of traffic regulations):

• if there are victims as a result of an accident;
• if as a result of the accident only cars were damaged and no agreement was reached between the participants in the accident about the circumstances of the incident;
• if the parties to the accident reach agreement on the circumstances of the incident.

Step 2. Complete the actions provided for by the insurance rules under the MTPL agreement

1. Inform other participants in the accident information about the compulsory insurance agreement, including the number of the compulsory insurance policy, as well as the name, address and telephone number of the insurer (clause 1, article 11 of the Law of April 25, 2002 N 40-FZ; clause 3.2 Rules N 431-P).

2. Fill out the notification of an accident issued by the insurance company, if any (clause 7, article 11 of Law N 40-FZ; clause 3.5 of Rules N 431-P).

3. Notify your insurance company about the incident in the manner and within the time frame provided for by the insurance rules (clause 2, article 11 of Law N 40-FZ; clause 3.3 of Rules N 431-P).

Step 3. Complete documents about the accident

Documents regarding an accident are drawn up depending on the circumstances of the case, which are determined during the commission of the initial actions in the event of an accident, with or without the participation of a traffic police officer.

Step 3.1. Complete documents about an accident without the participation of a traffic police officer

Together with the other participant in the accident, fill out the accident notification forms (clause 284 of the Administrative Regulations, approved by Order of the Ministry of Internal Affairs of Russia dated August 23, 2017 N 664).

In this case, the circumstances of the harm, the diagram of the accident, the nature and list of visible damage must be certified by the signatures of both drivers. To do this, each driver signs both sheets of the accident notification on the front side. The reverse side of the notification of an accident is prepared by each driver independently (clause 3.6 of the Regulations, approved by the Bank of Russia on September 19, 2014 N 431-P).

After this, you can leave the scene of the accident and take the actions provided for.

Step 3.2. Complete documents regarding an accident involving a traffic police officer

To do this, you need to call a traffic police officer, wait for the documents about the accident to be processed, take part in the consideration of the case (if necessary) and receive documents from the traffic police to apply to the insurance company for insurance compensation.

Step 3.2.1. Provide explanations to the traffic police officer and wait for the report to be completed

After you (or the traffic police officer) carry out the initial actions at the scene of the accident, the traffic police officer draws up a protocol, to which is attached a diagram of the location of the accident (clause 273,

If you disagree with the data set out in the accident report and diagram, be sure to indicate exactly what you disagree with.

Participants and witnesses of the accident provide explanations to the traffic police officer (clause 51, Administrative Regulations).

Note!

Your explanations are evidence in the case, therefore errors and contradictions in their content may negatively affect the outcome of the consideration of the case ( Part 1, Art. 2 26.2 Code of Administrative Offenses of the Russian Federation).

When submitting explanations in writing, you must:

1) indicate the date, time, place of the incident (address);

2) describe the road situation on the specified section of the road;

3) indicate the presence of markings, the condition of the road surface (wet, dry, presence of potholes, etc.);

4) describe the events that preceded the accident (in which lane, at what speed you and (or) other participants were moving, the actions of other drivers involved in the accident, maneuvers, traffic lights, etc.);

5) describe the measures you took to avoid an accident (reducing speed, emergency braking, etc.);

6) describe the event itself (impact, displacement of the car, etc.);

7) express your opinion regarding the guilt of one or another participant in the accident;

8) if there are eyewitnesses, indicate their details in the explanation. If necessary, insist on calling and interviewing said eyewitnesses. Such a request can be stated directly in the explanation or on a separate sheet.

Written explanations may be accompanied by a registrar's note or photographs (if available). Witness testimony, video recordings and photographs can prove your innocence.

If you refuse to give an explanation, a corresponding entry is made in the protocol on the administrative offense (clause 138 of the Administrative Regulations).

Note. If there is a dispute about guilt in an accident, before giving written explanations, we recommend that you contact a specialist for qualified legal assistance.

Step 3.2.2. Receive documents from the traffic police officer

Depending on the circumstances of the case, the traffic police officer draws up a protocol or issues a resolution on the case of an administrative offense or a determination to refuse to initiate a case of an administrative offense (clause 289 of the Administrative Regulations).

Note. As of October 20, 2017, the issuance of traffic accident certificates by traffic police officers has been stopped, since the relevant information will be briefly reflected in the primary procedural documents (protocols, resolutions or determinations) ( item 273 Administrative regulations, approved. Order of the Ministry of Internal Affairs of Russia dated August 23, 2017 N 664; Information Ministry of Internal Affairs of Russia dated October 20, 2017).

When it is impossible to establish the elements of an administrative offense, it is necessary to conduct an examination or other procedural actions that require significant time, a determination is made to initiate a case of an administrative offense and conduct an administrative investigation (clause 289 of the Administrative Regulations).

Step 3.2.3. Take part in the consideration of an administrative offense case

The time and place for the consideration of the case is determined by the traffic police officer after the initial registration of documents about the accident.

The consideration of the case by the accident investigation team and the preparation of other documents takes place in the regional traffic police department at the scene of the incident.

When considering the case, you may need legal assistance, in connection with which you have the right to submit a written request to postpone the consideration of the case (part 1 of article 25.1, part 2 of article 25.2 of the Code of Administrative Offenses of the Russian Federation).

After considering the circumstances of the case and examining the evidence, the traffic police officer determines the presence or absence of an administrative offense in the actions of any of the drivers, draws up a protocol and issues a resolution on the case of an administrative offense or a determination to refuse to initiate a case of an administrative offense (clause 289 of the Administrative Regulations ).

Step 3.2.4. After the case has been reviewed by the accident investigation team, you will receive the documents from the traffic police department.

After considering the case at the traffic police department at the scene of the incident, you must obtain the following documents:

1) a copy of the protocol on the administrative offense indicating the circumstances of the traffic violation. Upon receipt, check the correctness of the data stated in the protocol and the presence of the signature of the traffic police officer;

2) a copy of the resolution in a case of an administrative offense or a ruling on the refusal to initiate a case of an administrative offense. Upon receipt of the specified documents, check for the presence of the stamp of the traffic police department and the signature of the traffic police officer who compiled them.

Note. Since October 20, 2017, the requirement to submit a certificate of an accident when the insurer is considering a victim’s application for insurance compensation or direct compensation for losses for an accident that occurred starting from the specified date is unlawful ( step 3.1, must be handed over or sent to the insurer no later than five working days after the accident. The victim sends his copy of the notice along with the application (clause 2 of article 11.1 of Law No. 40-FZ; clauses 3.8, 3.9 of Regulations No. 431-P).

Useful information on the issue