The insurance company paid little money under compulsory motor liability insurance. What to do

Basic facts on compulsory motor liability insurance

OSAGO is a civil liability agreement aimed at compensating damage to third parties injured as a result of an accident caused by the fault of the policy owner. Depending on the number of victims, the total amount of insurance payment can range from 120 to 160 thousand rubles.

To receive funds to repair a damaged car, a motorist must comply with the following conditions:

• In the situation of a road traffic accident, you must immediately call representatives of the insurance company so that they can record the damage received (if there is no time to wait for employees of the insurance company, then it is allowed to record the damage caused in a photo or take an independent video, and then present the collected material);
• After the insurers familiarize themselves with the vehicle breakdowns, the driver must receive an appropriate conclusion, based on which further payments are made;
• TK cannot be repaired until compensation is received;
• At the time of the accident, the citizen found to be at fault cannot be under the influence of drugs or alcohol;
• The traffic accident must occur due to the negligence of the insurance company client (intentional damage to the health or property of citizens will not be paid).

If all of the above points are met, but the insurance company has counted few funds, or has completely refused compensation to the client, then you will have to act according to a non-standard algorithm. But before filing a complaint about additional payment, you also need to make sure that the organization does not have compelling reasons for such a decision.

"Pitfalls" of such a situation

When preparing to file a claim and write a pre-trial claim, it turned out that the expert who examined my car did not take into account several damages. Of course, it is impossible to prove that he did it intentionally; everyone will always claim that it happened by accident. In addition, the expert took prices out of thin air, and not from real directories (the RSA directory did not exist in nature at that time). In the same way, the expert applied the cost of an hour of work, which was unusual for the market for repair work on my car. This is how it turned out that the insurance company calculated little under compulsory motor liability insurance.

When conducting my independent examination, I notified the insurer by telegram of the date, time and place of the inspection, since quite expectedly I knew that there would be a dispute in court about the number of parts damaged as a result of the accident. I knew how to fight back in such a situation. The accident certificate for the insurance company contained a complete list of damages, and it corresponded to the list indicated by my independent expert.

My pre-trial claim was ignored by the insurer. They just threw me another handout in the amount of 10% of the amount that I demanded in the claim.

Procedure for payment of insurance compensation

According to the law of the Russian Federation on the protection of civil liability, consideration of a risk case and further compensation for damage by the insurance company must occur in the following established order:

• The insurance owner collects a minimum package of documents regarding the accident that occurred, which clearly describes the circumstances of the tragedy, the number and condition of the victims, and the quality of the damaged cars. The prepared papers (and the contract attached to them) are sent for examination;
• Within 14 days, the application from the injured client is considered by the company’s specialists, and only after a thorough study of all materials is a final verdict on compensation payment made;
• If there are no grounds for refusing compensation for damage, the organization is obliged to pay the citizen the amount of money specified in the policy, or part of it, if the cost of repairing the vehicle is less than 120 thousand rubles;
• If the agreed recovery is not transferred to the car owner within one month (in cash or using bank details), then every subsequent day the company undertakes to pay an additional penalty in the amount established by current legislation.

This is exactly how the standard procedure for compensation of damages is carried out in all insurance companies, Tinkoff, Rosgosstrakh, etc.). What to do if you do not agree with the insurance payment under MTPL and where to file such a claim, we will find out below.

Going to court - is there any point?

Without a doubt, there is!

A lawsuit provides a chance to receive significantly more money from the insurer than just fair compensation.

For example, let’s say that according to your independent examination, the amount of damage to the vehicle was 100 thousand rubles. You can add to it:

• 50 thousand court fine for underpayment;
• 60 thousand penalties for 2 months of non-payment (we take the minimum) - 1% of 100 thousand for each day.
• 5 thousand compensation for moral damage (we take the minimum).

Total: 215 thousand! But we have not yet calculated the loss of marketable value, which can be included in the claim if the parameters of the car allow it.

Of course, the amount of all legal and out-of-court costs related to your claim will also be taken into account and paid.

As you can see, on such ships you can not only get your way, but also earn extra money.

Attention! For 2021, the maximum amount of insurance compensation under MTPL for material loss is 400 thousand rubles.

What documents will be required for the court?

For the trial, you will need all the documents that I listed in the section on pre-trial claims, but the following may be added to them:

• Notification of a traffic accident (copy);
• Protocol on administrative offense (AP) (copy);
• Resolution on the AP - if available (copy);
• Power of attorney to conduct business – if required (original);
• Other documents that may be useful - for example, witness statements, etc.

In addition, you need all the papers confirming the fact of costs associated with the insured event.

This may include:

• Agreement on independent examination;
• Receipts of payments for reimbursement from the insurance company;
• All other receipts and contracts for material costs.

Which court should I go to regarding underpayment from the insurer?

Our issue can be resolved in two courts:

• District
• World

In most cases, cases of underpayment under compulsory motor liability insurance are considered by magistrates' courts. Why? Because it is they, according to the Civil Procedure Code, who are responsible for litigation on property disputes (Civil Procedure Code of the Russian Federation, Article 23, paragraph 5).

District courts can also consider such cases, but only if the amount of the claim is over 500 minimum wages (minimum wages), and this is unlikely for compulsory motor liability insurance.

Which magistrate's court should I go to?

According to Art. 28 (Civil Procedure Code), the plaintiff must file a claim in court at the place of registration of the defendant. However, according to Art. 29, paragraph 2 (Civil Procedure Code), if there are branches of the defendant legal entity in the plaintiff’s locality, the claim can be filed at the location of this branch, i.e. at the plaintiff’s place of residence.

Who should you trust to handle the business?

It is advisable to place the case of additional payment under compulsory motor liability insurance in reliable hands, since the amount of additional compensation depends on this. It is better not to immediately agree to an offer of services by an individual or a law firm, but to find out about their reputation and professional level.

In terms of business format, you have 4 possible options:

• Fighting on your own is a completely unnecessary economy. Why? Because if your business is worthwhile, then you won’t have to pay anything to have it run by a professional.
• Representative – It is best to hire a legal representative. Because usually in cases of compulsory motor liability insurance they do not take advance payments, and often even agree to remuneration based on a positive result or a certain percentage of it. The representative will do everything for you - all you have to do is receive the money in your hands. How much do these specialists charge? Today the average is 7-15 thousand rubles, depending on qualifications.
• Lawyer – hiring a lawyer who has a higher procedural and professional status is only worthwhile in complex cases, but in essence there is no particular difference between a representative and a lawyer.
• Case buyers - this option may be of interest to those who are ready to cede their litigation to independent professionals who make money by inflating all kinds of compensation. You will not participate in the case at all. Usually these are legal companies and they will offer you money directly from their own pockets, in exchange for a power of attorney to conduct a claim and receive all compensation. You are actually selling them your headache. Reviews about such schemes are quite positive.

How to file a claim?

The statement of claim is the main document of your case, and it must be drawn up as competently as possible. It is better to entrust its writing to a specialist.

But it will still be useful for you to know in what order it is compiled.

So, first comes the head of the document, in which you indicate:

• To whom the application is addressed - to such and such court (depending on the value of the claim and territorial jurisdiction).
• From whom the claim was received - your name and address.
• Name and addresses of the defendant – usually a legal entity has several addresses.
• The amount of the claim - the state duty is indicated separately from the amount of the claim.

Next comes the title (Statement of Claim), subtitle (On recovery of part of the insurance compensation) and the body of the statement. The body of the claim must include:

• The circumstances of the accident;
• Status of the accident – ​​whether there were administrative violations;
• The culprit of the accident and the grounds for his guilt;
• Consequences of an accident;
• Information about the insurer of the person responsible for the accident;
• Data on compensation paid;
• Grounds for underpayment - data from an independent examination;
• Legislative justification for the required additional payments - article of law, paragraphs, section;
• Calculation of the main compensation for underpaid insurance;
• Calculation of additional payments;
• Calculation of required penalties;
• Calculation of incurred costs.

In the final part, a subtitle is placed (I ask) and under it a demand for recovery of the calculated amount is expressed.

Below is a list of attached documentation, and the claim ends with a date signed by the plaintiff.

Expert opinion

Zakharova Irina Avgustovna

Legal experience 33 years. Of these, 25 years in the prosecutor's office in the positions of Art. investigator, Art. assistant prosecutor. Since 2005, I have been representing the interests of citizens in civil courts and arbitration courts. https://www.9111.ru/urist-6835464/

In accordance with the requirements of the law, a statement of claim against the insurance company, accompanied by documents confirming the circumstances on which the plaintiff bases his claims, is filed according to the number of persons participating in the consideration of the claim (defendant, 3rd parties). The statement of claim can be filed in person, or through a representative to the court hearing the case, or sent by mail. It is advisable for the court to make a note on the copy of the claim that it has accepted the statement of claim. It is better to send the statement of claim by registered mail with a list of the attachments and a notification of delivery to the addressee.

Sample statement of claim

A sample statement of claim can be downloaded from this link.

On the basis of what laws are court decisions regarding underpayment under compulsory motor liability insurance made?

In conclusion, I will list the main legislative acts according to which legal proceedings for underpayment under compulsory motor liability insurance are carried out.

First of all this:

• Federal Law on Compulsory Motor Liability Insurance (Federal Law No. 40);
• Civil Code of the Russian Federation (Federal Law No. 51);
• Law on the Protection of Consumer Rights (Federal Law No. 2300-1);
• Civil Procedure Code (Federal Law No. 138);
• MTPL rules (PS No. 263).

How to calculate the amount to file a claim in court?

It is not worthwhile to independently calculate the amounts for a lawsuit, because you may not be able to cope with the numbers or not take into account some parameters due to ignorance.

I recommend leaving this to a specialist. If he works with a direct interest in the result and amount of the claim, then rest assured that everything will be counted down to the last detail.

I have already listed above what may be included in the amount of a lawsuit. And here I’ll clarify that problems may arise in collecting penalties from the insurer, depending on the composition of the court.

When preparing a statement of claim, a hired specialist must draw up an addition to it with calculations and justifications for the amount of penalties in a separate document. If the penalty is subject to collection at all, of course.

Due to different interpretations by the courts of the provisions of Art. 7 of the Law on Compulsory Motor Liability Insurance there are several formulas for calculating penalties, which I will not present here so as not to complicate the reading with unnecessary details. Just know that the amount of the penalty, despite its seemingly easy calculation (1% per day of delay), may differ significantly from the expected one.

Statutory payment limits

At the end of the article, I will announce the current limits on MTPL insurance payments for 2021.

Currently the maximum payout amounts are:

• For material loss to each victim in an accident - up to 400 thousand rubles.
• For material loss under the European Protocol to one victim - up to 50 thousand rubles.
• For damage to the health and life of each victim - up to 500 thousand rubles.
• Compensation to close relatives of the deceased - up to 475 thousand rubles.
• Compensation to distant relatives of the deceased - up to 50 thousand rubles.

Basis: Federal Law No. 40 and Federal Law No. 223.

Reasons for underpayment

In accordance with the regulations of the Central Bank, all calculations for compensation payments must occur according to a single algorithm. But in practice, citizens very often encounter cases of underpayment of monetary assets necessary for vehicle repairs. The reasons for this phenomenon are usually the following three criteria:

• Insufficiently qualified specialists conducting an examination of the damaged car;
• Undetected hidden damage inherent to body elements;
• Lack of preliminary preparation for inspecting the car (cleansing the vehicle of dirt, installing the correct lighting, collecting equipment, etc.).

However, such grounds cannot be called legitimate, since in the listed situations the culprit in carrying out incorrect diagnosis is solely the IC. Therefore, the client will be able to appeal the reduced payment without problems, through the court. But there are also a number of circumstances in which it will not be possible to challenge understatement of compensation. These include:

• Exclusion of work on restoration of paintwork, provided that the area of ​​the damaged area occupies more than 25%;
• Accounting for parts, components and assemblies of a vehicle that have increased wear and tear (all elements requiring replacement are paid at half the price);
• Refusal of the insurance company to pay for the commodity value of the car.

What to do if the insurance company paid little money under compulsory motor liability insurance, citing one of the listed reasons, we will find out later in the article.

How to find out if the amount is insufficient

You need to understand that the driver’s assessment of damage is usually subjective. You can identify underpayments using the following methods:

1. The service center could make a settlement in an amount greater than the insurance agent. For example, using different spare parts codes;
2. A unified method for calculating spare parts, which can be used on the RSA website, will help to identify the insurer’s intent.

The amount to be reimbursed is calculated using a unified methodology for determining the amount of costs for repairing damaged vehicles, approved by the Bank of Russia. In accordance with Article 12 of the Federal Law “On Compulsory Motor Liability Insurance”, the amount of costs for the purchase of spare parts is determined taking into account their wear and tear that must be restored. But for such components, assemblies and parts, wear cannot be charged more than 50%.

A review of the practice of courts considering cases related to compulsory motor liability insurance of vehicle owners, approved by the Presidium of the Supreme Court of the Russian Federation dated June 22, 2016 No. 22, established that the calculation of the amount of harm compensated by the causer is carried out using a Unified Methodology. Therefore, no other calculations will be taken into account by the court. In addition, the calculation should be based on expert research.

Algorithm of actions in case of underestimation of compensation

Having received money under a civil liability protection agreement, do not rush to transport your car to the nearest service station for restoration. First, carefully recalculate the amount of funds issued and find out whether it will cover your repair costs. If not, then you will have to act according to the following algorithm:

• Contact the insurance company in order to receive a written estimate for compiling a compensation payment;
• Conduct a re-examination of the car by an independent appraiser;
• Write an application to the insurance office with a request to pay the remaining debt (a conclusion on the secondary diagnostics of the vehicle must be attached to this application).

Advice! If during pre-trial proceedings the client is refused payment of the remaining amount of compensation, then the claim must be sent to the court, since it is this body that is capable of making a final verdict.

Receiving payment calculations

According to standard regulations, the insurance company is obliged to issue the client a copy of the settlement document within three days from the date of the incident. If this does not happen, then you need to apply for an estimate yourself by visiting the company’s office.

Once you receive the form in your hands, you should pay special attention to the amount to be paid indicated on it. After all, if it is calculated without taking into account worn-out parts, and the estimate for repairing the vehicle exceeds it by less than 10%, then there will be no need to file a claim with the court. In such a case, the plaintiff will most likely be denied additional payment of material damage.

Independent examination

In case of categorical disagreement with the established amount of compensation, the car owner, in order to further challenge the decision of the Investigative Committee, will need an evidence base in the form of a conclusion from the re-diagnosis of the mutilated vehicle. And if the insurance company paid less than according to an independent examination, then the citizen has every right to recover from the organization the additional payment indicated in the repair estimate.

It is important to know! However, in order not to lose the case, the car should under no circumstances be restored prematurely. After all, then a secondary examination by specialists will not yield any results due to the concealment of the initial damage. The costs of the lawsuit will fall on the plaintiff, creating additional problems for him.

Pre-trial claim

When considering the question of what to do if the insurance company paid little money under compulsory motor liability insurance, we found out that the first step to receiving the remaining funds would be pre-trial proceedings with representatives of the insurance company. This can be done by writing to the organization by filling out an application using a single form.

In this way, the client will warn the other party to the contract about the seriousness of his intentions. But if this does not help, then you will have to act to the end by filing a claim with the local judicial authority. In order not to lose the case, in addition to the claim, it is necessary to prepare an evidence base for the guilt of the insurers (an independent expert opinion and an initial settlement act).

Application to court

Many motorists do not know what to do if the insurance company has paid little under compulsory motor liability insurance, and does not agree to a peaceful resolution of the conflict, threatening to file an insurance claim or subrogation. This situation can be resolved very quickly by contacting the district court with an extract from an independent examination and an initial inspection report of the car. Often this is enough to recover unpaid funds.

It is important to know! But if representatives of the local judicial authority are biased towards the claim put forward, then the citizen reserves the right to file another claim against the magistrate. It is he who will make the final verdict regarding the problem that has arisen between the car owner and the agency providing protection for his civil liability.

Why doesn't the insurance company pay extra?

Since September 2014, during an expert assessment of vehicle damage resulting from an insured event, all calculations must be performed by the insurer using a unified methodology from the Central Bank.

Despite this, situations are possible when the conclusions of different experts of equal qualifications on the same insured event do not coincide. Why is this possible?

The fact is that the Central Bank’s methodology provides for uniform calculation rules, and if the input information is the same, then the calculation results will be the same.

But there is no unified method of expert examination yet, and even if there is one, discrepancies in the assessment are still possible, since much is determined organoleptically, that is, “by eye/touch.” And the volume of required repairs also largely depends on the individual vision of the specialist. Therefore, the data for calculations give different indicators.

The difference in examination results may also be influenced by:

• Professional training of a specialist and his attitude to his duties;
• Difficulty in accessing hidden damage , including instrumentation;
• Inspection conditions : the machine is heavily soiled or there is insufficient lighting.

Insurance companies may reduce benefits for these and some other reasons listed below.

How to prevent underpayments

We have considered what to do if the insurance company has paid little under compulsory motor liability insurance. And in order to avoid such problems in the future, motorists need to prepare documents regarding the accident as soon as possible. And it is advisable to start with the preparation of the Euro protocol. Next, it is recommended to do an independent examination and wait for a statement of the calculated payment from your insurance company.

We learned the correct procedure for reducing the amount of compensation paid by the insurance company. In conclusion, it is worth adding that in case of minor damage to the car, it is better to disperse amicably, without affecting the agency employees. Thus, you will not only get rid of lengthy red tape, but also save your KBM rating.

Useful tips

• Allowed errors with corrections in the expert documentation must be endorsed with the signature “corrected to believe” and a seal.
• The handwriting of important documents written by hand must be uniform.
• Your own independent examination , if possible (accreditation), is best carried out at the service station where further repairs are planned.
• There is no need to resort to deception during your own independent examination - insurers, especially such suspicious ones as RESO or Rosgosstrakh, will easily figure it out and the whole case will fall apart, and you or your expert will be accused of deceiving the court.

What actions are best not to take?

To ensure that the insurance company does not underestimate the payment under the MTPL policy , you must fully follow the established rules of action after the occurrence of a certain insured event.

There are the following actions that may affect the fact that an underpayment of compensation occurs:

1. Elimination of damage before insurance inspection and vehicle diagnostics. Even in cases where the vehicle owner fully carries out photo and video recording of the damage, and also carries out his own independent repairs at a service station, the insurer will have the right not to accept all the data obtained in this way. Theoretically, in such situations, the company should make concessions, since the driver may need a car urgently after an accident. At the same time, in practice, it turns out that insurers do not pay the entire amount, or even refuse to provide assistance , since the other party to the contract has violated the established Rules.
2. Also, under no circumstances should you trust an insurance expert . This is due to the fact that he works for the company with which the MTPL policy was concluded. As a result, this specialist will often work in the interests of his own employer.
3. There is no need to throw away the results of an independent examination , the vehicle inspection report, or payment information even after the car has been repaired. They may in some cases be useful for defending their own interests if, some time after the accident, it turns out that certain malfunctions were not initially detected.

If you are careful not to carry out all of the above cases, it is possible to receive the full objectively determined amount of compensation .

Attention! Repairs are completely prohibited until the vehicle is inspected by an authorized person by the insurance company.

also not be carried out in cases where the parties have not reached an agreement on what the amount of financial assistance should be.

If the driver is considered to have underpaid the company , he can arrange for a re-inspection of the vehicle, after which a new insurance claim report will be drawn up. Such actions will only make sense when the car has not yet been repaired.