According to Federal Law 40-FZ “On Compulsory Civil Liability Insurance...” the insurer (the company that provides insurance services) has only 5 days to consider the application for insurance payment, and 20 working days to respond to it. One day beyond the deadline is already a reason to demand a penalty from the insurer. Compensation can be obtained from the insurance company in the event of delays in the transfer of insurance compensation or incomplete payment. In practice, extensions of both response and payment deadlines are very common: it is more profitable for the insurer to delay making a decision than to delay the payment due under the contract.
What is a penalty under compulsory motor liability insurance?
OSAGO is an agreement between the owner of the vehicle and the insurance company. In this type of relationship, the penalty applies only to one party to the contract - the insurer.
If the insurance company does not fulfill its obligations (does not make payments, delays payment or repair), for each day of delay it is obliged to pay a penalty, which is calculated according to a certain formula.
A conflict with an insurance company can be resolved without going to court; if pre-trial proceedings do not help, feel free to go to court.
Grounds for payment of a penalty
There are several grounds for claiming a penalty:
- The insurance payment deadline has been violated
- The deadline for the return of the insurance premium has been violated
- Illegal refusal to pay insurance
- Payment was not made in full
- The deadlines for repair work were violated
Calculation of sanctions
There are several possible options when the insurance company pays.
This:
- unlawful refusal to transfer insurance;
- delaying the period for transferring funds;
- incomplete payment of the amount;
- improper fulfillment of obligations assigned to the company.
IMPORTANT !!! It is necessary to indicate the methods that are used to calculate the amount of the penalty. The amount of the sanction corresponds to the amount that has not been paid. IT needs to be multiplied by 0.01. The resulting value is then multiplied by the number of days during which the delay was allowed. If the insurer does not make a reasoned decision within the established time frame, then a sanction will be added.
In this case, the amount is 0.05 percent of the maximum insurance compensation. If the damage is caused to life, then the value is half a million, when property is damaged - 400 thousand.
The delay must be calculated from the day when the decision regarding payment for the insured event should be made. This lasts until the funds reach the citizen whose car was damaged. If the company has not made a decision, then the countdown begins from the moment the decision is formed by the judicial authority. The calculation will look like this: the maximum collection amount must be divided by 100 and multiplied by 0.05 and then by the number of days of delay. If damage to property is caused, 1 day will cost 200 rubles.
It is important to note that the legislator sets a limit on the amount - the sanction cannot be more than the amount of compensation. On the websites of many insurers there are special programs that can be used to simplify calculations.
Law on penalties under compulsory motor liability insurance
All relations between the policyholder and the insurer in this case are regulated by several legal acts:
- Civil Code of the Russian Federation. It clarifies the concepts of “penalty” and “legal penalty”
- Law on insurance in the Russian Federation. This law applies to any type of insurance companies
- Law on compulsory motor liability insurance. Here you can find information about the accrual of penalties and their amounts
- Federal Law of the Russian Federation No. 223 . Law on changes in legal acts on the calculation of penalties. Valid since 2014.
The main one among these documents is Federal Law No. 40 “On Compulsory Motor Liability Insurance”. This regulatory act considers all the details, both regarding the payment of insurance itself and the accrual of penalties.
According to the law, the deadlines for payment and consideration of claims for an insured event are as follows:
- 20 calendar days , not counting non-working days and holidays for those whose policy was issued after 01.01. 2014. For those who issued a policy before this date, the period is 30 calendar days . After this period, all due funds must be paid in full.
- 5 working days for consideration of the policyholder’s application
The deadlines can be changed only if the full package of documents is not provided or if the policyholder does not allow the insurance agent to inspect the vehicle. The deadlines also change if a criminal or administrative investigation is underway.
Rights and obligations of the insurer
The insurer's responsibilities include:
- Inform the policyholder of all insurance rules
- Maintaining the confidentiality of data that the policyholder provides to the insurer
- Quality control and timing of vehicle repairs. If the repair deadlines are violated or the vehicle has repair defects, the policyholder also has the right to demand a penalty. In this case, the insurer has the right to send the vehicle to have the defect repaired. In this case, the period increases.
- Within 20 days from the date of submission of the full package of documents, pay the full insurance amount or give a referral for vehicle repair
- Issue a duplicate of the policy if it is lost by the policyholder
Insurer's rights:
- When concluding an MTPL agreement, inspect the vehicle
- In the event of an accident, order an examination to identify the extent of damage and harm to the health of the insured
- Identify on your own the cause of the insured event; to do this, make requests to law enforcement agencies and other organizations that have the necessary information
- Demand termination of the insurance contract if the policyholder provided false information about himself
- Demand an increase in insurance premiums if the degree of risk has increased
- In the event that the insurance company has fully fulfilled its obligations, and the violation of deadlines was not due to their fault (but, for example, due to the fault of the policyholder or force majeure), the insurance company may be exempt from payment
- A penalty cannot be collected if the amount and grounds for which are not provided for by law.
- The insurer has the right to participate in negotiations with third parties who suffered through the fault of the policyholder to resolve the conflict
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Rights and obligations of the policyholder
Responsibilities of the policyholder:
- Truthfully report to the insurer all information that may affect the determination of the degree of risk
- Provide the insurer with the opportunity to inspect the vehicle and familiarize itself with all documents that relate to this vehicle
- Pay insurance premiums in accordance with the agreement, without violating the terms established in this agreement
- If an insured event occurs, the policyholder is obliged to follow all instructions of the insurer to reduce the amount of damage.
Rights of the policyholder:
- On the conditions provided for by the legislation of the Russian Federation and directly by the insurance contract, it may terminate the contract early.
- Has the right to complain about the insurer to the control body. By law, the Central Bank of the Russian Federation must control the activities of insurance companies. A complaint can be submitted via the Internet – the reception desk of the Central Bank. This saves time. A sample complaint can be found on the same resource.
Calculation of penalties under compulsory motor liability insurance
The calculation is made depending on the reason for which it is reimbursed. For example, if a penalty is imposed for non-payment of insurance or for violation of payment terms, the calculation is made as follows: 1% of the amount of insurance payment for each day of delay.
If the insurer was supposed to pay 170,000 and delayed payment by 20 days, then the penalty will be: 170,000 x 0.01×20 = 34,000 rubles.
Important! The amount of the penalty should not exceed the amount of compensation. If the vehicle repair period is delayed, the penalty is calculated based on the cost of repairs and wear and tear.
The penalty is calculated only for the underpaid amount. For example, if the policyholder was supposed to be paid 240,000 rubles, but was paid 180,000, then the penalty is calculated for the remaining 60,000 rubles.
From what day is the penalty calculated?
If the insurance company motivated the refusal due to non-payment, but for some reason did not send it to the policyholder, the penalty is charged until the day the refusal is received, in the amount of 0.5% of the expected payment amount for each day.
The penalty is calculated from 21 days (if the policy was issued after 09/01/2014). Count from the day all documents are provided to the insurance company. The last day is when the settlement with the policyholder was made, including this day.
Minimum and maximum amounts of penalties
By law, the minimum amount of accrued payment for delay is limited to 0.2% for each day of delay of the insurance amount. The maximum amount is 90% of the total payment amount.
All other charges will be canceled by the court. According to Federal Law No. 40, maximum insurance amounts are established - 500,000 for compensation for damage to life and health and 400,000 for damage to property.
Court decisions
Fraudulent attempt to recover part of the damage from the culprit of the accident.
The culprit of the accident fled the scene of the accident.
The driver is trying to avoid responsibility
Car dealer paid compensation for ruined weekend
Accident with oncoming traffic: a drunk driver fled the scene of the accident
Accident at a pedestrian crossing
Rules for filing a claim
Then a conflict situation arises between the insurer and the policyholder; the law provides for pre-trial settlement. To do this, a written claim is sent to the insurer. It can be sent by mail or delivered in person.
It is important to note that when going to court, the existence of a pre-trial settlement is taken into account. If you immediately contact the judicial authorities, your claim will not be accepted.
When can payments be denied?
It is worth considering that there are a number of legal grounds on which an insurance company can refuse a policyholder:
- An incomplete package of documents was provided
- The terms of the contract were violated or false or incomplete information was provided
- This case is not insured as provided for in the contract.
- The fact of fraud on the part of the policyholder was recorded
- The deadline for submitting documents has passed
In some cases, not only insurers, but also judicial authorities can refuse to pay a penalty.
Procedure for delaying payments by the insurance company
When the application and documents are submitted on time, the car is submitted for examination, but the insurance company is not going to pay compensation and does not explain this in any way, you must perform the following steps:
- sending a pre-trial claim to the insurance company;
- filing a complaint with the Central Bank of the Russian Federation;
- filing a claim with the court at your place of residence.
Judicial practice shows that financial sanctions applied to the insurer are an exception. Usually it is enough to fulfill the conditions of the first paragraph for the insurance company to give an intelligible answer or order a payment. Therefore, a pre-trial claim is first filed, and if the insurer still does not make contact, it is necessary to proceed further. Consideration of the claim and a written response must be given no later than 10 days from the date of receipt of the claim by the company.
It is worth noting that after a court decision is made in favor of the plaintiff, the defendant must pay the amount of insurance compensation along with a financial penalty. If the insurance company gives the client only the insured amount, this is grounds for filing a second claim.
The procedure for collecting penalties through court
If the pre-trial claim is rejected or not considered by the insurance company, you must go to court to recover. To do this, we draw up a statement of claim and submit it to the court. This can be done by mail or delivered in person.
The application must indicate:
- Name of the judicial authority where the application is submitted
- Details of the plaintiff, details of his representative (if any), address and telephone number, also place of work and position
- Details of the defendant, including the address of the organization and all its contact details
- Describe the circumstances of the accident with all the details
- Indicate the amount of the penalty and the reasons why the defendant must pay it
- List the documents that are attached to the application
- Plaintiff's signature with transcript. Exact date (the date of compilation and the date of submission must match!)
The statement of claim can also require the defendant to pay legal fees and a fine for violating consumer rights. It is worth taking into account that if the insurer voluntarily makes all payments, no fine will be imposed.
Attach a copy of your passport and all possible documents regulating the relationship between the plaintiff and the defendant to the statement of claim. Be sure to attach a copy of the pre-trial complaint and the response to it.
If the policyholder fulfills the terms of the contract in good faith and an insured event occurs, the company is obliged to pay the insurance. If the insurance company does not fulfill its duties, we file a claim against it and demand a penalty.
The main thing is to clearly calculate the amount of payments, attach all documents, and be sure to carry out pre-trial conflict resolution. The courts mostly side with the insurers.
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