Procedure for obtaining insurance compensation after an accident under compulsory motor liability insurance

Your own or someone else's insurance

Before deciding which insurance company to contact in the event of an accident, you need to assess the damage caused and the circumstances under which the accident occurred.

To assess the situation, you need to pay attention to the following points:

1. How many cars were damaged in the accident?
2. How serious is the damage?
3. Do other drivers have insurance?
4. Did anyone die in the accident?

It is also worth remembering that with the onset of 2014, the so-called PPV became available to drivers - this is direct compensation for damage. And in order to receive it, the victim of an accident is obliged to contact exclusively his insurance company.

If the damage to the accident does not exceed 50 thousand rubles, then the participants in the accident can draw up a European protocol. According to the European protocol, an accident can only be registered if certain rules are observed.

In 2021, two participants in an accident have the right to draw up a European protocol if:

• No more than 2 cars are involved in the accident;
• Each driver has compulsory motor liability insurance;
• There was no damage to health or life;
• Insurance may cover all damage.

If all of the above conditions are met, then the victim must visit his insurance company and receive the due compensation. If, as a result of an accident, people were injured, or the damage caused exceeds the limit under compulsory motor liability insurance, or there are three cars in the accident, then it will not be possible to register the incident as under the European protocol. The insurance company of the person at fault must handle the registration of the accident.

What regulates the mandatory notification?

After an accident registered without the participation of traffic police officers according to the European protocol, the victim has the right to apply for damages to his insurance company. And the culprit has 2 important responsibilities:

1. notify the insurance company about the accident by sending a notification form within 5 working days after the accident - this is prescribed by part 2 of article 11.1 of the Federal Law No. 40 On OSAGO,
2. do not start repairing your car for 15 calendar days or until the insurance company requires you to provide the car for inspection or examination - part 3 of the same article of the Federal Law.

These terms are uniform, prescribed by law and do not depend on a specific insurance company - be it Rosgosstrakh, Ingosstrakh or others.

Please note that the period for notifying the insurance company is considered working days, and the period for prohibiting repairs is considered calendar days.

Situation one—two drivers are at fault

An accident in which both drivers are at fault is usually recorded by traffic police and the insurance company. This happens if both the first and second drivers violated traffic rules, and a protocol on the violation was issued for each.

In such a situation, the court will decide which driver is most to blame for the incident. Drivers can demand compensation from the insurance company only if the court has not determined who is to blame for the accident, or one of the drivers did not have an insurance policy or it was invalid.

Situation two—more than two machines are involved

If more than 2 participants are involved in an accident, then a completely unclear situation arises. Who is to blame?

In this case, you should contact your insurance company only if the following rules have not been violated:

• The policy is valid;
• No harm done;
• Inspectors were called to the scene of the accident.

The insurance company immediately pays damages to its clients, and only then begins to establish the details of the accident with other injured persons and their companies.

But such a solution to the problem is only permissible if no one was injured in the accident. If the accident caused damage to the health of any of the people, then it is necessary to contact the insurance company of the participant whose actions led to the accident.

Is it possible not to notify if the victim does not apply for payment?

No. But there will be no consequences for this either - in this case, the insurance company will not pay a penny to the victim, which means that it will have no grounds for recourse against the culprit of the accident.

Another thing is that if an innocent participant in an accident tells you that he will not apply, then you cannot be sure that he will not change his mind, so it is much better to notify and do it correctly.

But in this case, the BMF will increase!

By law you shouldn't. The discount for accident-free driving does not depend at all on the fact of the insured event - an accident, as many motorists believe. It is applied specifically for the fact of compensation. This is directly evidenced by the description of the bonus-malus coefficient itself. Instructions of the Bank of Russia on the maximum base rates of insurance tariffs.

Thus, if you simply notify your insurance company about the accident by sending a European protocol form, thereby complying with the requirements of the 2021 law, then your CBM will not increase in the next insurance period. It will only increase if the victim applies for payment or repairs as compensation.

Situation three - there was a trailer

In practice, very often insurance companies are unwilling to pay compensation in situations where a trailer was involved in the accident.

It is worth noting that such “unwillingness” is illegal, and the insurance client must demand compensation for damage, but only in the following cases:

• The insurance document states that the car can transport a trailer;
• No one was injured in the accident;
• The accident occurred only between two vehicles.

If the listed rules are not followed, then the issue will have to be resolved with the company of the second participant in the accident.

When is the right time to submit documents to the insurance company?

In order not to receive a refusal to pay compensation from your insurance company, you need to remember that you must submit the necessary documents to the insurance company on time. Application deadlines are established by law. The maximum time to submit an application to the insurance company is only 5 days, but it is better to do this as early as possible. If the documents were not provided to the insurance company within 5 days, then it is likely that its client will be refused compensation.

It is worth noting that there are certain situations that allow you to increase the period for contacting the insurance company.

The client has the right not to contact the insurance company within 5 days for the following valid reasons:

1. Lives in another city.
2. He was in the hospital as an inpatient.

ATTENTION !!! Of course, the presence of valid reasons must be documented. For example, provide the insurer with sick leave, an epicrisis, or confirmation of a business trip to another city.

The insurance company must make a payment in the form of compensation to its client no later than 20 days after filing the application. If no money was received within this period, then it is worth finding a good car lawyer to solve the problem that has arisen.

How to properly notify the insurance company about the European protocol and an accident?

So, as of 2021, both participants in an accident are still required to send a European protocol notification form to the insurance company within 5 business days. If the consequences have been removed, then the obligation itself still exists.

If for the injured party everything is simple - since he or she will apply for payment or repairs to his insurance company, then during this period he will provide his form, then for the culprit, separate actions are needed for this.

The completed European protocol form is submitted by the culprit to his insurance company. At the same time, it is not enough to simply call the organization or deliver a notice within this period. It is necessary to send the completed OSAGO form - hand it over to the insurer and be sure to obtain evidence of delivery of the European Protocol.

And here there are 2 options for such delivery:

• sending the European protocol by mail (in this case, the date of notification will be considered the date of sending the letter),
• handing it over in person at the insurer's office.

In the first case, you need to put the notice in an envelope and send a letter with a list of investments, declared value and preferably with a return receipt. The receipt, notification of delivery (including those received after such delivery) and the list of investments must not be lost under any circumstances and stored for 3 years - this is the general limitation period.

If you decide to get to the insurer’s office on your own, then this is not the best decision. Perhaps there will be no problems with this, but perhaps there will be if the insurance workers refuse to record the very fact of delivery and give you any confirmation of acceptance of the European protocol form. You need to receive an incoming notification number or document acceptance certificate. This is also very important, because if you do not have evidence of the transmission of the notice, then you will lose the court, and if the insurer understands that it did not give you anything in return for the accepted European protocol, then it may well take advantage of your omission.

Do I need to submit any documents other than the European protocol?

No. For both the culprit of the accident and the injured party, the only mandatory document is notification by sending a European protocol notice.

The insurance company does not have the right to demand other documents not provided for by law, and does not do this in practice in 2021.

What documents need to be prepared?

The package of documents required by the insurance company in order to receive compensation may vary depending on the specific situation.

But, as a rule, you should have the following papers on hand:

1. Statement. You can obtain a sample from your insurance company.
2. Original OSAGO.
3. Passport.
4. Driver's license.
5. All documents for the vehicle.
6. Notification of an accident.
7. Accident protocol.
8. If available, a check for payment of expenses that were necessary, for example, to call tow trucks.
9. Details of the account to which the compensation will be credited.

As already mentioned, in one situation or another, additional paperwork may be required. For example, a sick leave certificate or a death certificate (if relatives of the deceased apply for compensation).

Insured event "OSAGO"

BRIEF NOTE:

If harm is caused to the victim's health in connection with an insured event, the victim's lost earnings (income) that he had or definitely could have had on the day the harm was caused, as well as additional expenses incurred caused by damage to health, including expenses for treatment, additional food, purchase of medicines, prosthetics, outside care, sanatorium treatment, purchase of special vehicles, preparation for another profession, if it is established that the victim needs these types of help and care and is not entitled to receive them free of charge.

IMPORTANT!

If harm is caused to the life or health of passengers in vehicles, the notification of a road traffic accident shall indicate the presence of injured passengers. If participants in a traffic accident have information about the injured passengers (last names, first names, patronymics), this information must be provided to the insurer. Information about injured passengers is provided to the insurer by the police based on his written request.

To receive an insurance payment in case of harm to the life and health of the victim, in addition to the documents provided above, the victim attaches documents to the application for insurance payment depending on the requirements presented:

When submitting a claim for compensation of lost earnings (income), the victim must submit:

Attention! The size of attached files should not exceed 50 MB.

• a conclusion from the relevant medical institution indicating the nature of the injuries and injuries received by the victim, the diagnosis, the period of incapacity for work; a medical examination report issued in accordance with the procedure established by the legislation of the Russian Federation on the degree of loss of professional ability to work, and in the absence of professional ability to work - on the degree of loss of general ability to work; a certificate or other document about the average monthly earnings (income), scholarships, pensions, benefits that the victim had on the day of harm to his health;
• other documents confirming the income of the victim, which are taken into account when determining the amount of lost earnings (income);

IMPORTANT!

The amount of earnings (income) lost by the victim to be compensated is determined as a percentage of his average monthly earnings (income) before injury or other damage to health or until he lost his ability to work, corresponding to the degree of loss of professional ability by the victim, in accordance with the legislation of the Russian Federation.

Persons who have suffered damage as a result of the death of the breadwinner, when filing a claim for compensation for damage, represent:

Attention! The size of attached files should not exceed 50 MB.

• a statement listing the family members of the deceased and indicating the persons who were dependent on him and who had the right to receive maintenance from him;
• a copy of the death certificate;
• a certificate of earnings (income), pension received, lifelong maintenance, scholarships, other payments (rent, alimony, etc.) of the deceased for the period provided for by civil law;
• birth certificate of the child (children), if at the time of the insured event the deceased had minor children as their dependents;
• a certificate confirming the establishment of disability, if on the date of the insured event the deceased was dependent on disabled people;
• a certificate from an educational institution stating that a family member of the deceased who has the right to receive compensation for harm is studying at this educational institution, if at the time of the insured event the dependents of the deceased were persons studying at the educational institution;
• conclusion (certificate of a medical institution, social security authority) on the need for outside care, if at the time of the insured event the deceased was dependent on persons who needed outside care;
• a certificate from a social security authority (medical institution, local government, employment service) stating that one of the parents, spouse or other family member of the deceased does not work and is caring for his relatives, if at the time of the insured event the deceased had non-working members dependent on them families involved in caring for his relatives;

IMPORTANT!

Damage caused to persons as a result of the death of the breadwinner, as a rule, is compensated through regular payments (annuity), however, by agreement with these persons, insurance payments can be made at a time for the entire period of fulfillment of the insurer's obligations to these persons. Persons entitled to compensation for damage in connection with the death of a breadwinner are compensated for damage in the amount of that part of the earnings (income) of the deceased that they received or had the right to receive for their maintenance during his life and which is determined in accordance with the legislation of the Russian Federation.

Persons who have incurred the necessary expenses for the burial of the deceased, when submitting a claim for compensation for damage, represent:

Attention! The size of attached files should not exceed 50 MB.

• a copy of the death certificate;
• documents confirming the necessary funeral expenses incurred;

The victim, when submitting a claim for compensation for additional expenses incurred by him caused by damage to health as a result of the occurrence of an insured event, as well as expenses for treatment and the purchase of medicines, to which the victim is not entitled to receive free of charge (including in excess of the basic compulsory health insurance program), represents :

Attention! The size of attached files should not exceed 50 MB.

• an extract from the medical history issued by the medical institution;
• documents confirming payment for the services of the medical institution;
• documents confirming payment for purchased medications;

The victim, when submitting a claim for compensation for additional expenses incurred by him caused by damage to health as a result of the occurrence of an insured event (except for expenses for treatment and the purchase of medicines), represents

Attention! The size of attached files should not exceed 50 MB.

• a medical report issued in accordance with the procedure established by the legislation of the Russian Federation;
• conclusion of a medical, social or forensic medical examination on the need for additional nutrition, prosthetics, outside care, sanatorium treatment, special vehicles;

When submitting a claim for reimbursement of expenses for additional food:

Attention! The size of attached files should not exceed 50 MB.

• a certificate from local governments or other authorized bodies about the prevailing prices in a given region for products included in the daily food package of additional food;
• a certificate from a medical institution about the composition of the daily food package of additional food required for the victim;
• documents confirming payment for purchased products from the supplementary nutrition food package. Expenses for additional food are included in the insurance payment in an amount not exceeding 3 percent of the insured amount;

When submitting a claim for reimbursement of expenses for prosthetics:

Attention! The size of attached files should not exceed 50 MB.

• documents confirming payment for prosthetic services;

When submitting a claim for reimbursement of expenses for outside care:

Attention! The size of attached files should not exceed 50 MB.

• documents confirming payment for care services;

IMPORTANT!

Expenses for outside care are included in the amount of insurance payment in the amount of no more than 10 percent of the insured amount.

When submitting a claim for reimbursement of expenses for spa treatment:

Attention! The size of attached files should not exceed 50 MB.

• an extract from the medical history issued by the institution where the spa treatment was carried out;
• a copy of the sanatorium-resort voucher or other document confirming receipt of sanatorium-resort treatment, certified in the prescribed manner;
• documents confirming payment for a voucher for sanatorium treatment;

When submitting a claim for reimbursement of expenses for the purchase of special vehicles:

Attention! The size of attached files should not exceed 50 MB.

• a copy of the vehicle’s passport or its registration certificate;
• documents confirming payment for the purchased special vehicle;
• the agreement under which a special vehicle was purchased;

When victims present a claim for reimbursement of expenses associated with training for another profession:

Attention! The size of attached files should not exceed 50 MB.

• invoice for payment of vocational training (retraining);
• a copy of the agreement with the organization providing vocational training (retraining);
• document confirming payment for vocational training (retraining);

So that our specialist can promptly advise you on further actions, please leave your contact details:

What are the limits for compulsory motor liability insurance in 2021?

The amount of compensation that an insurance company client can count on has its own limits.

As of 2021, the following limits apply:

1. 400 thousand rubles. If damage was caused to the vehicle or other property. This amount is the maximum that the owner of a car who was injured in an accident can expect.
2. 500 thousand rubles. If damage was caused to people. This is the maximum amount that can be received for each person injured during a traffic accident.