List of insurance and non-insurance cases under MTPL

Since 2003, all car owners are required to have an MTPL policy, which allows them to compensate for moral and material damage in the event of an accident. The maximum amount is 400 thousand rubles. The system works well on paper, but in practice, insurance companies constantly lower payments and sometimes refuse them completely. In this article, we will look at what an insured event is under compulsory motor liability insurance and how to behave in the event of an accident so as not to have problems with paying compensation.

OSAGO according to the law: legal framework

The operating principles of MTPL policies are formulated in Federal Law No. 40 of 2002, Federal Law No. 306 of 2007, Government Decree No. 263 of 2003, and Central Bank Regulation No. 431 of 2014. The law defines an insured event: a citizen with an MTPL policy, while driving a vehicle, caused harm to the health, life or property of others.

The situation is considered an insured event if three conditions are met:

• the culprit of the accident has a compulsory motor liability insurance policy;
• The accident occurred while the culprit’s car was in motion;
• the incident caused damage.

The fact of the incident must be officially recorded, otherwise the insurance company will refuse to pay.

When an event is not considered insured

• The damage was caused while driving a vehicle other than that specified in the MTPL.
• The damage was caused not by the machine, but by the load or trailer.
• The damage was caused during competitions or during training riding in specially designated areas.
• The damage occurred during loading or unloading.
• Only moral damage has been caused, and lost profits cannot be compensated.
• The damage was caused by force majeure circumstances.
• Objects of intangible or very high value (works of art, antiques, etc.) were damaged.

When an accident occurred in a yard or in a parking lot, the incident is considered an insured event under compulsory motor liability insurance if the car of the person responsible for the accident was in motion. When your car is damaged by a door when opening, scratched by a bag or keys, the insurance company will refuse to pay compensation.

Insured events and their exclusions

First, you need to figure out what is an insured event, and for what type of notification to the insurance company about an accident, the car owner will not receive monetary compensation. The list of circumstances that exempt the insurance company from payments includes:

• If the damage was caused by a vehicle other than the one specified in the MTPL policy.
• Caused moral damage.
• If the harm occurred when using vehicles during competitions, tests or training driving in specially designated areas.
• Compensation in the “lost profit” category.
• If the damage was caused as a result of the transportation of dangerous goods, in the absence of a special agreement.
• In case the damage was caused during tests, competitions, or on specially equipped areas for training riding.
• If during an accident damage was caused to architectural, historical, antique values, including buildings, intellectual property, and jewelry.
• There was harm to the life or health of workers during the performance of their labor duties, if this harm is subject to compensation in accordance with the law on the relevant type of compulsory insurance or compulsory social insurance.
• If there is an obligation to compensate the employer for losses caused by harm to the employee.
• If the driver caused damage to the vehicle he was driving and its trailer, the cargo they transported, the equipment installed on them and other property.
• If harm occurred when loading cargo onto a vehicle or unloading it.
• If there was damage to the life, health, or property of passengers during their transportation, if this damage is subject to compensation in accordance with the legislation of the Russian Federation on compulsory insurance of civil liability of the carrier for causing harm to the life, health, or property of passengers.

This is not a complete list of situations that are not covered by insurance. In order to find out whether the case is suitable or not, the culprit of the accident is obliged to inform his insurance company about what happened.

An insured event is the occurrence of civil liability of the owner of a vehicle for causing harm to the life, health or property of victims when using the vehicle, entailing, in accordance with the compulsory insurance contract, the insurer’s obligation to make an insurance payment.

Article 1 Federal Law of April 25, 2002, No. 40-FZ “On compulsory insurance of civil liability of vehicle owners”

If the situation does not fit any of the described ones, and the insurance company refuses to pay compensation, you can go to court.

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So, what to do in the event of an insured event. Regardless of who is responsible for the incident, the algorithm of actions is always the same:

• Turn on the alarm signals, put up an emergency sign.
• It is necessary to call the traffic police to register the fact of the accident if the damage exceeds 100 thousand rubles.
• If there are victims, call an ambulance.
• If the culprit of the accident is unknown, then it is necessary to collect a source of information - a video recording, testimony of witnesses (if it is a guarded parking lot - a watchman, a public parking lot - security guards of nearby institutions, etc.).
• If the culprit is known, copy down all his data, including the insurance policy number.
• You cannot use a damaged car until traffic police inspectors arrive - they must record all the damage caused.
• Next, documents are collected to submit to the insurance company.

In order to be able to subsequently receive full compensation for the damage caused, it is necessary to draw up documents in detail. Do not indicate “the right wing is dented”, but write down in full, in great detail: “the right wing is crushed with a metal rupture, the glass on the front right headlight is cracked, the protective plastic cover under the wing is broken, possible other hidden damage.”

You cannot repair a vehicle before an examination has been carried out and an inspection report has been drawn up. If there is a suspicion of hidden defects, it is necessary to send the vehicle to a service station for a full inspection.

Car owners who have been involved in an accident for the first time are wondering: “what to do with insurance after an accident if you are not at fault.” The answer is simple: make repairs and eliminate the damage caused.

What should a driver do in the event of an insured event?

If your car has been damaged in an accident, you must take the following actions:

1. Stop the car, turn on the hazard lights, put up an emergency sign, and if it’s dark, you need to put on a vest with reflective elements. Do not move the machine.
2. If someone is injured, you need to call an ambulance.
3. You must notify the traffic police about the accident (by landline - 02, by mobile - 112).
4. If cars are blocking traffic, then you need to fix the position of the vehicles and then drive them away.
5. Before the traffic police arrives, it is advisable to fill out an accident notification form.
6. Record the details of witnesses, if any, and obtain their contacts for further proceedings.
7. Record the accident on video or take detailed photographs.
8. Take a copy of the resolution, protocol and certificate from the traffic police squad that will arrive at the scene of the incident.

This scenario is the only possible one if three or more cars were involved in the accident, the drivers did not agree on the issue of determining the culprit of the accident, one of the drivers refuses to sign the notification of the accident, or the estimated amount of damage is more than 100 thousand rubles.

But besides calling the traffic police, two more options are possible:

• You can report the incident to the traffic police, with their consent, do the paperwork yourself, and only then come to the department.
• You can issue a European protocol, but only if the following conditions are met: two cars were involved in the incident, only the car was damaged and no people were injured, both drivers have MTPL policies and there was no dispute between them regarding the nature of the damage to the cars.

There are a number of actions that should never be taken in the event of an accident. Firstly, flee the scene of the crime (there is only one exception - if it is necessary to take the victim to the hospital). Secondly, do not sign a confession of guilt and do not renounce your claims. All documents must be re-read carefully, and if you do not agree with any points, then report it. If the driver or passengers were seriously injured or the accident resulted in death, it is advisable to immediately call a lawyer to the scene of the accident.

How to fill out the documents yourself

If, with the permission of the traffic police, you have to file an accident yourself, you must fill out the documents. Mistakes cannot be made, otherwise the insurance company will refuse to pay:

1. Notification of an accident. The front side of the document must be filled out jointly by all participants in the accident; if this is not possible, the reason must be indicated. Participation in filling out the document by a third party is not permitted. If drivers have no disagreements, then they can fill out one notice, and the insurer must be informed about this. If the drivers do not agree, each fills out the notice separately, indicating exact information about the accident, its participants, insurance and damage to the cars.
2. Europrotocol. If documents are drawn up according to the European protocol, then both drivers fill out the notice, and all data must be certified by signatures. It must be taken into account that the damage paid under the European protocol does not exceed 100 thousand rubles, but the victim can demand a larger amount from the culprit through the court.

Arguments for refusal

Insurance companies, under any pretext, are trying to refuse direct compensation for losses under compulsory motor liability insurance and send the tortfeasor to the insurer, which is contrary to the law.

However, there are justified arguments for refusal, which include:

• if there are victims who have suffered harm to their health or life (drivers, passengers, pedestrians);
• if there were more than two vehicles involved in the accident;
• if the second participant in the accident did not have a compulsory motor liability insurance policy or its validity period expired;
• if the victim applied for compensation to the company of the culprit;
• if a notification of an accident has not been submitted.

We collect documents for the insurance company

The victim must submit documents to the insurance company within the next five days. If the accident occurred in a remote area, the period can be increased to 15 days. It is necessary to collect the following package of documents:

• Statement about the occurrence of an insured event. It can be written in any form, but it must contain the following data: information about the victim and the culprit of the accident; detailed description of the insured event; description of the consequences of the incident; insurance policy data.
• Application for insurance payment.
• A copy of the passport certified by a notary.
• A power of attorney from the victim, if he himself cannot contact the insurer.
• Bank details of the victim.
• Certificate from the traffic police.
• A notification of an accident drawn up by those involved in the accident.

If the victim dies, his immediate relatives apply for insurance.

What is an insured event under compulsory motor liability insurance?

Before drawing up an insurance event report under compulsory motor liability insurance, claiming payment from the insurance company, the citizen must make sure that the event that occurred is actually provided for in the drawn up contract. Indeed, in accordance with the legislation of the Russian Federation, not every road accident belongs to the list of risk situations.

Such an incident can be determined by two main criteria:

• The policy owner is the guilty party;
• More than two vehicles are involved in the accident.

Attention! Material compensation for harm in favor of injured persons under compulsory motor liability insurance also does not occur in the event of damage as a result of other cases that do not relate to the protection of civil liability.

Kinds

We found out that an insured event under compulsory motor liability insurance is a traffic accident that occurs due to the fault of the owner of the insurance policy. But the legislation of the Russian Federation also provides for other circumstances entailing the receipt of compensation payments. These include:

• Theft of movable property;
• Complete destruction of a car as a result of a fire or under the influence of natural disasters (strong wind, flood, landslides, etc.);
• Deliberate arson of a car by third parties.

However, the listed cases are not included in the standard contract for the protection of civil liability, and their execution takes place strictly on an individual basis, for a separate payment.

Signs

Before writing an application to the insurance company for compulsory motor liability insurance, in view of the occurrence of a risky event, the driver should make sure in advance that the agency will not refuse him compensation. A negative response from the insurance company may be facilitated by the absence of the following signs of the event:

• Damage to the movable property of third parties was caused exclusively by the insured vehicle specified in the contract;
• There are two parties to an accident: the victim, for whose benefit the policyholder pays the funds, and the culprit, who bears civil liability.

If the owner of the policy gets into an accident in a vehicle that is not registered under OSAGO, then not a single one, “RESO-Garantiya” and “Soglasie”, will compensate him for the damage caused. Moreover, in the event of such treatment from the client, the insurance company employees reserve the right to file a lawsuit against the driver for attempting to unlawfully obtain compensation.

Actions of the insurance company

The insurance company must review the application, conduct an examination, draw up documents and pay compensation to the victim within 20 days.

Based on the results of the inspection, the insurance company issues a report to the victim, according to which he can verify the correctness of payments. The victim has the right to know all the information, including a description of the damage and its amount, therefore the refusal to issue a report is a violation.

By law, the insurance company must pay:

• compensation for car damage – up to 500 thousand rubles;
• compensation for damage to health – up to 400 thousand rubles;
• in the event of the death of the victim - up to 475 thousand rubles and 25 thousand for burial.

In 2021, it is planned to introduce a number of serious changes regarding compulsory motor liability insurance policies. Firstly, their cost will increase. Now it will be calculated taking into account five coefficients: territorial, age and driving experience of the driver, vehicle power, use of a trailer, and the circle of people allowed to drive. Secondly, in some regions a program for transmitting information about road accidents through the ERA-GLONASS system will be experimentally launched, and in this case the amount of insurance payment under the European protocol will be increased to 400 thousand rubles.

To receive payment under compulsory motor liability insurance, you must strictly comply with legal requirements, pay maximum attention to filling out documents, submit them to the insurer on time and wait for compensation. As a last resort, issues can be resolved through the court: if you entrust the defense to an experienced lawyer, then there is a high probability of a positive outcome of the case.