Sample statement of claim for recovery of insurance payment under a CASCO agreement (download for free)

The conditions under which compensation is provided are clearly stated in the insurance contract.

To receive a refund, it is important not to miss the expiration date of the document. Upon the occurrence of an insured event, the client is obliged to prove that he really is such.

To do this, the insurer is provided with the relevant documents and the expert’s assessment report. Also, the policyholder must strictly follow the rules specified in the contract.

CASCO insurance compensation is not available to just anyone. The right to receive compensation has the policyholder himself, the beneficiary or a citizen who has provided the company with a power of attorney certified by an authorized person.

In what cases will compensation be denied?

There are situations that are not covered by the CASCO policy. They do not provide for compensation of losses at the expense of the insurer. Such cases are always indicated in the rules of insurance companies and are specified in the contract.

It is impossible to receive compensation under CASCO in a number of cases:

1. failure to fulfill the obligations specified in the contract, failure to submit the required documentation;
2. the policyholder himself caused damage to the vehicle in order to obtain a benefit;
3. gross violation of traffic rules (driving without a driver's license or while intoxicated;
4. operation of the vehicle by a person not included in the insurance;
5. The vehicle has been damaged by a nuclear explosion or radiation;
6. the car was used for training or competitions;
7. harm resulting from hostilities or civil unrest;
8. confiscation or disposal of vehicles by decision of authorized bodies.

Also, the client will not receive payment if false information was provided when drawing up the insurance contract.

What is the essence of CASCO

CASCO refers to a type of property insurance that is designed to protect a car. If civil liability is insured within the framework of compulsory motor liability insurance, then it is the property that is protected under the specified product. This is voluntary insurance, so everyone has the right to independently decide whether to buy such a policy or not.

A feature of CASCO is its high cost, which is nevertheless compensated by the fact that the car will be insured against any troubles.

This is protection against the risk of theft or theft of vehicles, damage caused by natural disasters, fire, illegal actions of third parties, as well as complete loss of the car.

Another question is how to obtain insurance if one of the cases provided for in the agreement occurs. Before considering the algorithm of actions after an incident, you need to understand the conditions under which compensation is calculated.

Maximum compensation

The largest amount of damage is always limited to the insured amount specified in the CASCO agreement. These figures do not always correspond to the price of the car at the time of signing the contract, and it cannot be higher than this value.

The amount of compensation under CASCO is always limited. For example, the total amount of compensation provided during the validity of the contract does not exceed the established value - the liability limit of the insurance company.

Its size and scope of application are determined by the agreement. If the owner of the car was damaged as a result of an accident, which was issued under the Europrotocol, insurance payment is provided in accordance with the law on compulsory motor liability insurance for the Europrotocol.

"Theft, theft"

If there has been a theft of a vehicle, its individual parts, components, assemblies, assemblies or additional equipment (qualified in accordance with the legislation of the Russian Federation)

What to do?

• If individual parts are stolen, try to ensure the continued safety of the car, do not leave it unattended, and do not destroy possible evidence of malicious actions.
• Call the police: 020 – for Megafon, Tele2, Rostelecom subscribers; 102 – MTS; 002 - Beeline. The single emergency number is 112 (for all operators). The call is possible with a zero balance.
• Write a statement to the police department at the place of the theft.
• Call the 24-hour SOGAZ contact center at 8 (800) 333-0-888 to register the event and coordinate further actions. If it is more convenient for you to use the Internet, fill out the insurance event notification form on the website.
• If the insured event occurred far from the place where the insurance contract was concluded, record the damaged property in photographs, contact authorized expert organizations for an inspection and calculation of damage.

The notification period for theft (theft) is 2 business days from the moment of discovery (unless otherwise provided by the insurance contract).

Documents required to receive insurance payment:

• An identification document of the insured, or a notarized power of attorney for his representative;
• A set of documents issued upon concluding a comprehensive insurance agreement: application for insurance;
• insurance policy or insurance contract;
• additional agreement to the policy or insurance contract (if drawn up);
• receipt for payment of insurance premium;
• certificate of inspection of the vehicle when it was accepted for insurance (if an inspection was carried out).

It is necessary to submit to SOGAZ standard sets of keys and key fobs for the vehicle, as well as keys and key fobs for additionally installed anti-theft devices and search systems in the quantity specified in the insurance contract or application for insurance.

If documents for the car, keys and key fobs are seized for inclusion in the criminal case materials, attach a supporting document from the police department.

Calculation of insurance payments

In the event that the vehicle is not completely lost, compensation for damages under CASCO in case of an accident will depend on the scale of the damage caused, confirmed by documents.

You can confirm the extent of damage received in the following ways:

• calculations by the insurance company for the examination of injuries received;
• official calculations of the independent expert who conducted the inspection;
• checks and other documents from the car service center chosen by the insurer;
• documentation received at the policyholder's car service center, indicating the volume of restoration work (work order) and the amount of costs.

In accordance with the CASCO insurance contract, compensation can be full or partial (depending on the degree of wear and tear of the vehicle). When the contract provides for a deductible, it is subtracted from the cost of repairs (the conditional deductible is deducted only if the damage does not exceed its amount).

If the car is stolen or cannot be repaired, the payment is provided as follows:

1. the maximum possible amount at the time of the incident is limited by the established limit;
2. the franchise is taken away (if it is not conditional and is generally provided for);
3. the cost of usable remains (whole parts suitable for sale) is not taken into account;
4. The balance of the insurance premium is not taken into account.

Among other things, other amounts provided for in the insurance contract will not be taken into account here. These include compensation previously paid under this agreement. All these aspects determine how much compensation a client can receive.

Interesting article: Registration of an electronic Casco policy.

"VSK" - where to submit documents about an insured event?

Applications are submitted within a few days after the incident (the specific period depends on the insurance program) to one of the company’s offices. At the moment, there are more than 600 branches of VSK Insurance House in Russia, which allows you to use the company’s services in most regions of the country.

You can find your nearest office through the official website. You need to do the following:

1. Log in to the company page: vsk.ru.
2. Select the city where the insured person is located (the selection field can be found under the “Buy policy” button).

   

3. Click on the “Offices” link located on the right side of the site.

   

4. Select the method of presenting information (on a map, according to a metro map, using a list).
5. Select the appropriate department, then click on its name to receive detailed information.

   

Using the service, you can find out the address of the branch, its opening hours, and contact information. The brief description of the office also indicates which categories of clients it works with (this must be taken into account during a personal visit).

Thus, on the site, its client can make the statements necessary to receive monetary compensation. A written request is submitted along with additional documents to one of the company's offices. You can find the nearest branch through the VSK website, with step-by-step instructions to help.

How long will it take to compensate for the damage?

Each insurance company independently sets the period of compensation for CASCO insurance. Specific information is always specified in the insurer's rules and contract.

Typically this period ranges from 10 days to one calendar month. Sometimes the refund period may be extended.

This happens not only due to reluctance to provide funds, but also in the event of a delay in the receipt of parts or a queue.

In a situation where the insurer does not indicate the payment period, the client can use the Civil Code of the Russian Federation, which determines the obligation of an adequate period of compensation for damage.

Failure to fulfill obligations to the client within a month threatens the payment of compensation and a penalty for its delay. The period for compensation for damage caused to a vehicle is counted from the day the documents are submitted to the insurance company.

What is a pre-trial claim under CASCO?

Insurers are obliged to comply with all conditions and clauses specified in the contract concluded with the car owner. But not all companies pay compensation in good faith and on time, even if the occurrence of an insured event was confirmed in the prescribed manner. Then a special document is drawn up - a claim. This is a tool for resolving a dispute within civil legal relations without recourse to a government agency. In what cases is a pre-trial claim under CASCO necessary?

1. Deliberate understatement. Some companies try to transfer money in parts, gradually, thereby underestimating the amount of compensation. Most people do not receive up to 40% of their due payment.
2. Refusal of compensation. This is the reason why a CASCO claim is filed with the insurance company in 80% of cases. In this case, reference is made to the provisions of the law or clauses of the rules issued along with the contract upon execution. In some situations, such actions are completely unjustified, and are only an attempt by the organization to avoid its obligations in the event of an insured event.
3. Carrying out work in garages. Conscientious insurance companies or Rossgosstrakh carry out repairs at official service centers, but some operators can issue directions for work to be carried out at small private stations, which reduces the cost of the process. As a result, the car owner receives an unfair restoration of the car.
4. Violation of deadlines. They are looking for a sample of a pre-trial claim to the insurance company for CASCO, also in the event of failure to fulfill the obligations of the insurance company within the period established by law. This is often explained by internal regulations, but if they are also violated, it’s time to take action.
5. Ignoring the client's request. There are situations when the statement of a driver involved in an accident is not accepted by the operator. This is often explained by a violation of the filing order.

A claim is made to the insurance company under CASCO in other situations when the client is confident in the illegality of the actions of the insurers, and can document this. The complaint is filed personally or by a competent specialist: usually car owners turn to lawyers who are professionals in this topic for help.

Sequence of actions when receiving payment

The insurer is contacted immediately after the documents confirming the fact of the accident or damage to the car are completed.

Only after this does the insurance company calculate the amount of compensation. We present step-by-step instructions for receiving a CASCO payment.

Notifying the insurer about the occurrence of an insured event

If damage is discovered or in the event of a traffic accident, you should call the traffic police, because the insurance company will require an official document with the recorded damage.

If the client has an accident, he should not change the location of the car. The arriving employees describe the damage caused, indicating all participants in the incident. It is necessary to ensure that you do not include in the document a column like “I have no complaints against the participants in the incident.”

If you miss this moment, you may be left without insurance payments. In addition, it is better to exchange contacts with the other participants in the accident, take a picture of the area and convey information about the accident to the Investigative Committee by providing the policy number.

It would be acceptable to clarify the deadlines for providing documents when you call, this way you can avoid troubles in the future.

Contacting the insurance company should not take more than 3 days. You should contact your insurance company to report the incident within 1–3 days.

Submitting documents to the Investigative Committee

The insurance organization requires the following package of documentation:

• application for payment (in any form);
• details of the account to which the payment will be sent;
• passport of a citizen of the Russian Federation;
• CASCO insurance policy;
• Receipt of payment;
• documents for the vehicle;
• certificate from the traffic police or the Ministry of Internal Affairs;
• document form No. 3 from the regional police department (damage by strangers);
• a certificate confirming the fact of damage as a result of a natural disaster.

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Inspection by the insurance inspector

The next step is to provide the vehicle to the insurer's expert. At the end of the procedure, the client must request a copy of the report.

Such actions will help you contact an independent specialist in the event that the inspection report and the amount of payment do not suit the policyholder.

If the small amount is confirmed, you will have to go to court.

Interesting material : CASCO against car theft.

Obtaining an estimate for restoration work or self-repair

When the examination is completed and compensation is calculated, the insurance company must provide an estimate for restoration work or indicate the amount of compensation. Receiving a repaired car or cash payment

After the procedures listed above, you need to wait for the long-awaited transfer to a bank account or receipt of a restored car.

Competent lawyers do not recommend letting things take their course, but periodically inquiring about the progress of the case.

Procedure for drawing up a contract

Before applying for material protection of a vehicle, a citizen must decide in advance on the choice of a suitable office (Ingosstrakh, SOGAZ, Soglasie, etc.). Next, the procedure for drawing up a contract follows the following algorithm:

• The client and a representative of the insurance company form an optimal program (a list of insured events is selected, the duration of the policy and the possible amount of the deductible are established);
• The company's expert conducts a thorough inspection of the vehicle for chips, scratches and other defects on the body (existing damage to the car will be entered on a special form and in the event of an accident they will no longer be taken into account);
• The motorist prepares a minimum package of documents and submits it for verification to the Investigative Committee (for individuals and legal entities the list of required papers is slightly different);
• After analyzing the collected certificates and statements from the client, the agents determine the final price of the policy (payment for insurance can be made in any convenient way: through online banking, a terminal or a bank cash desk. But before making a transaction, a person should carefully read the terms of the questionnaire and clarify questions that have arisen);
• The citizen receives the original form for financial protection of movable property, confirming this procedure with a signature.

The issued SK certificate should be kept in your car, since all agencies require it (SOGAZ, RESO-Garantiya, VSK, etc.) when drawing up an application for an insurance event under CASCO. Towards the end of the period of validity of the crust, the client is recommended to prolong it.

Basic documents

The list of documents required for an individual to obtain comprehensive insurance includes:

• Passport of the Russian Federation (if additional drivers are included in the contract, their driver’s license and identity cards will also need to be attached);
• PTS of the car (if the car is used, then an independent expert’s opinion on its current technical condition will be required);
• An extract from the traffic police on the timely registration of the vehicle;
• General power of attorney (for people who are not direct owners of the vehicle);
• Certificate of purchase/sale (mandatory form for new cars);
• Bank permission to issue insurance (required only for credit machines);
• Expired policy (this cover is submitted voluntarily, for the purpose of calculating the “bonus malus”).

From legal entities, the Insurance Regulations require the same documents for CASCO, with the exception of two additional certificates: a certificate of registration in the company and a vehicle rental agreement.

Statement

The legislation of the Russian Federation does not provide for a unified application form for financial protection of movable property. But it must be compiled with the obligatory entry of the following data:

• The name of the structure responsible for paying compensation for the insured event (“RESO-Garantiya”, “SOGAZ”, “Tinkoff”, etc.), and the client’s full name (this information is a header, and therefore it must be placed separately, in the upper left corner questionnaires);
• Title of the document (located in the center of the form);
• List of circumstances under which the policy comes into force;
• Additional criteria affecting the cost of CASCO (presence of a franchise or “bonus malus”);
• Contact details of the company and the driver whose name is included in the contract;
• Signatures of both parties and the seal of the Investigative Committee.

It is important to know! The application should be attached to other documents for car insurance. But it’s better to fill it out not on your own, but together with an agent.

How does compensation work?

The procedure for providing insurance payment under CASCO is prescribed in the insurance contract. There are about three ways to restore a vehicle:

1. the car is being repaired at the expense of the insurance company;
2. the amount of damage is paid in cash;
3. The lost car is replaced with the same one.

Most often, insurers resort to repairing damaged cars rather than making cash payments.

This method is convenient for both the driver and the insurer, because drivers are afraid of receiving an amount less than the cost of repairs, and the insurer is not comfortable paying in cash. There are often cases when the possibility of cash payment is not indicated at all in the policy.

Each insurance company actively cooperates with car services that repair cars “due to an insured event.” The company that issued the policy pays for the repair work, and the client receives a restored vehicle. If the contract provides for a deductible, it is paid before the start of repairs.

As you know, you can receive monetary compensation instead of repairs. The desired method of compensation in the form of cash payment is indicated in the application.

A similar procedure is carried out based on the results of an independent examination or receipts for repairs made from a third-party car service center. Next, the client chooses a method of receiving funds, which can be either cash or non-cash.

A complete replacement of property is carried out only in the event of a complete loss of the vehicle or its damage beyond repair.

After transferring the amount of money, it may turn out that cars have become more expensive and the insurance money is not enough to purchase a similar vehicle. This problem is resolved by payment of the missing amount by the insurer.

What is CASCO

Comprehensive insurance is a type of material protection of human health and his movable property from a number of factors provided for by the regulations of the insurance company. This includes:

• Road traffic accidents that occurred due to the fault of the policy owner (the company covers damage to persons affected by the actions of its client);
• Road accidents, natural disasters, acts of vandalism and other circumstances resulting in damage to the insured car (compensation is provided for any scratches, dents, chips and other defects on the car body resulting from the driver’s negligence or exposure to external force);
• Theft of a vehicle or theft of its individual parts (wheels, bumpers, battery, radio, etc.);
• Industrial injury, injury due to personal negligence, the occurrence of pathological conditions, attack by third parties and other factors causing deterioration in the health of the insured citizen;
• Vehicle breakdown in the middle of the road (an additional option from the extended list, which can be activated for an additional fee: it includes not only the visit of a specialist to the scene of the incident, but also the subsequent evacuation of the car to a service station).

The standard policy includes only the first two insured events. But for those who want to save money on registration, the insurance company provides several simplified programs:

• 50x50. The citizen gives the agents only half the cost of CASCO, and the second part of the amount is paid additionally only on the condition that during the duration of the contract he applies for compensation;
• Total. One of the cheapest service packages, providing coverage for damage only if the coefficient of insurance coverage is more than 65%;
• Mini. An insurance option that covers the costs of third parties affected by the actions of the policy owner and reimburses part of the cost of the car if it is stolen.

You can also reduce the price of an insurance contract using a franchise. But this is only beneficial for experienced drivers who have a minimal percentage of accidents. For beginners, it is recommended to arrange a full package of services that provides financial protection of movable property in all respects. We will consider below what documents are required for CASCO insurance at RESO-Garantiya, Alfa-Strakhovanie and other companies.

Why can they refuse?

As practice shows, insurers tend to refuse full or partial payment of compensation, and quite often.

It is recommended that you familiarize yourself with the rules for registering an insurance claim in advance and study all possible cases of legal non-provision of insurance payment.

Reasons for refusal are:

• Careless driving and violation of traffic rules.
• The owner of the car did not immediately call the authorized traffic police officers.
• Providing false information about what happened.
• The driver left the scene.
• Informal agreements with other participants in the accident.
• Do-it-yourself car repair.
• Sections of the contract that contradict the receipt of compensation and differ from the incident.
• Refusal for forensic examination.
• Liquidation of an insurance company.
• Taking out a policy after the occurrence of an insured event.

Insurance contracts often have ambiguous provisions for indemnification. This is why you should pay attention to the package of documents after an accident. If any clauses of the contract are unclear, the client has the right to demand that the information be corrected.

Interesting article: Renewing a Casco policy - a step-by-step procedure.

"AlfaStrakhovanie" - Insured event, what to do?

Any insured event must be recorded. This will allow you to quickly receive compensation. How a loss is registered is specified in the insurance rules of the product that the client purchases.

You can download the rules on the official AlfaStrakhovanie website or receive them in the office when concluding a contract. To receive mini-instructions on the official portal you will need:

1. Go to the official website of AlfaStrakhovanie.

2. Next, go to the section “ An insured event has occurred ” using the link: alfastrah.ru/accident .

3. Select client status: individual or legal entity and product case.

4. Read the instructions.

If for some reason it is not possible to study the rules, the client can always call a support specialist
by phone : 8-800-333-09-99 and +7 495 788 0 999.

What to do if an insured event occurs:

• Record the event through the appropriate service. For example, for accident insurance, you should contact a medical institution, while in case of an accident, you should contact the traffic police.
• Receive official confirmation of the occurrence of the insured event. It must indicate the date, personal data of the insured and the nature of the event.
• Prepare the necessary documents to bring to the office.

It is also worth noting that if an insured event occurs, you can always contact a company employee for free through the mobile application, obtain the necessary information and record the incident online.

Samples of claims for insurance compensation according to the legislation for 2021:

Statement of claim for compensation for damage in an accident: recovery of insurance payment under compulsory motor liability insurance in the form of direct compensation for losses

Statement of claim for compensation for damage caused in an accident, collection of insurance payments and penalties (claim for compensation for damage caused to health and property as a result of an accident: collection of insurance payments and penalties for late insurance payments)

Statement of claim for compensation for damage to health caused as a result of an accident by collecting compensation from the Russian Union of Auto Insurers (RUA) as a result of declaring the insurer bankrupt (sample statement of claim)

Statement of claim for compensation by the insurer for damage caused as a result of an accident, penalties in connection with late payment (to the arbitration court)

Sample pre-trial claim: Claim for insurance compensation or direct compensation for damages caused by an accident