Joint and several liability of insurers for causing harm to the life and health of third parties (the practice of applying clause 9.1 of Article 12 of the Federal Law “On Compulsory Motor Liability Insurance”)

The civil liability protection agreement clearly states that this document is aimed at covering damage to third parties injured as a result of an accident that occurred due to the fault of the policy owner. This includes expenses not only for repairing the damaged car, but also for treating injuries received by the injured party during the accident. The amount of compensation for specific injuries provided for by the RSA regulations will be shown by the unified table of payments under compulsory motor liability insurance for injury to health, which we will read in the article below.

Briefly about OSAGO

OSAGO is a temporary form included in the list of documents required for driving vehicles. Unlike CASCO, its competence covers only one insured event - a traffic accident involving two or more cars. But compensation under the said agreement may be intended exclusively for the affected persons. The owner of the policy himself does not receive any financial compensation for vehicle repairs or restoration of health under the auto insurance policy.

Depending on social

category and actual condition of victims of road accidents who suffered harm to health, the amount of payment under compulsory motor liability insurance will range from 5 to 500 thousand rubles. But for movable property this limit does not exceed 125,000 rubles for one damaged vehicle, and 160,000 rubles for two or more damaged vehicles.

In addition, movement on public roads without a mandatory insurance policy on the territory of the Russian Federation is punishable by law. For the first time, the lack of insurance will entail liability for the driver in the form of a fine of 500 rubles. Well, subsequent disregard of the rules may result in his arrest for a period of 3-6 months.

Compensation for damage to health

In accordance with the RSA regulations, all citizens, without exception, have the right to compensation from the insurance company when injured in an accident, regardless of their status at the time of the accident (driver or passenger). Payments under compulsory motor liability insurance for personal injury in 2021 are calculated based on the following indicators:

• The amount of money spent by the victim on purchasing necessary medications, visiting doctors at the clinic, diagnostic procedures and even a nurse;
• The amount of the wage penalty for the period of rehabilitation of the injured person, if after a traffic accident the loss of ability to work is recorded;
• Costs for the further stay of the accident victim in a sanatorium, if such preventive measures were prescribed by the doctor on the basis of the post-traumatic stress she suffered;
• Costs for purchasing additional equipment (crutches, wheelchair, etc.).

At the same time, the insurance company does not undertake to cover the above-mentioned damage if the injured person was on duty at the time of the accident, since in such situations compensation for damage falls on the shoulders of his employer.

What payments are due?

As we found out earlier, the table of payments under compulsory motor liability insurance can guarantee a maximum limit of half a million rubles, which is provided for the most severe cases. The average damage received by a person in an accident is estimated by insurance companies at approximately 10-20% of the mentioned figure, which in monetary terms reaches 50-100 thousand rubles. But for minor bodily injuries and fractures, a citizen should expect an amount of 250 - 50,000 rubles, depending on the number of injuries and his general health.

How is severity determined?

In accordance with the regulations of the Insurance Company, the following injuries are considered a serious outcome after a traffic accident when compensating for harm to life and health under compulsory motor liability insurance:

• Loss of a limb (jaw, arm, leg, etc.) or any organ (stomach, intestines, part of the lung);
• Burns of III - IV degrees, observed on an area exceeding 4% of the entire skin;
• Spinal fracture (more than 4 links).

Moderate injuries received by a victim as a result of an accident usually include:

• Loss of the front row of teeth (from 7 to 9 pieces);
• Deterioration of hearing or vision;
• Closed and open fractures;
• Loss of one or more fingers;
• Burns of categories I – II, occupying more than 10% of the entire skin.

The table of payments for damage to health under compulsory motor liability insurance includes the following for minor injuries in an accident:

• Cuts and open puncture wounds;
• 1st degree concussion;
• Banal bruises and deep scratches;
• Loss of teeth (up to 3 pieces);
• Minor fractures and burns, the size of which reaches 3-5% of the total area of ​​the skin.

It is worth noting that the last category of injuries occurs most often in practice. But moderate and severe conditions are rare when contacting the Investigative Committee, since the listed degrees of harm are quite difficult to document.

Disability payments for compensation for health damage

As a rule, when a person has suffered serious health damage after being involved in a traffic accident or has received the status of a disabled person, insurance payments are larger.

In such circumstances, the fact of disability is often confirmed after the insurance organization has transferred the premium funds. Then the victim must submit additional documents confirming receipt of the status and the insurance company recalculates payments and transfers them.

Each disability group has its own insurance premium percentage. So, when a person has received the status of a group I disabled person, he is entitled to a payment in the amount of 100% of the maximum established amount. If a person is a Group II disabled person, then the amount of payment should be no more than 70% of the maximum. For persons who have received group III disabled status, the amount of compensation is 50% of the maximum payment.

If, as a result of a road accident, injuries resulted in a child being assigned disabled status, the amount of insurance compensation is 100% of the maximum amount of insurance compensation.

Penalties for late insurance payments under MTPL

Who to sue in case of an accident, the owner or driver, if there is no compulsory motor liability insurance, read here.

Find out how to challenge payments under compulsory motor liability insurance at the link:

How to determine the amount of compensation

Having learned to distinguish between three types of injuries in an accident, a citizen can easily find out approximately how much money the company undertakes to compensate him under the contract. The injured party can more accurately calculate the amount of damage using the MTPL payment table below:

It is important to know! If the insurance company refuses to pay the calculated amount of compensation voluntarily, then the injured party reserves the right to file a written claim for compensation for health damage to the RSA or to a local court.

Refund procedure

If you are involved in a traffic accident that results in injuries to third parties (including pedestrians), the person at fault must immediately contact their insurance company and notify them of the tragedy. Further, so that the Investigative Committee does not refuse compensation to injured citizens, the driver is obliged to prepare a package of required documents describing the details of the accident and confirming the condition of the injured people.

After the collected papers are submitted to the agency for consideration, both parties to the conflict will only have to wait for the verdict from the insurers. On average, it takes the insurance company about 3-5 days to calculate the amount for compulsory motor liability insurance and further transfer money to the account of accident victims. The maximum period for carrying out this procedure, in accordance with Art. 12 Federal Law, cannot exceed two weeks. Otherwise, the policy holder has the right to file a complaint against the company’s employees with the RSA or the local judicial authority.

Required documents

In order to receive compensation for damage caused to health in a traffic accident, the client of the insurance company must provide the following package of documents for verification:

• A valid contract for the protection of civil liability;
• Internal passport;
• Written application (filled out in free form);
• Protocol of the State Traffic Inspectorate from the scene of an accident;
• An extract from the clinic about the condition of the victims.

This list of papers and certificates is considered minimal. But depending on the chosen one, “RGS”, “Tinkoff”, etc.), it may be supplemented with other documents:

• A general power of attorney from the policy owner, issued in the name of the victim (required if the accident victim decides to seek compensation independently);
• Bank account number for transferring funds for treatment;
• The decision of the judicial authority, which indicates the guilty party;
• Parents' consent to receive financial assistance from the insurance company (for persons under the age of majority).

It is important to know! The RSA regulations do not provide for a broader list of documents for such procedures. This means that the requirement for additional papers on the part of the Investigative Committee employees can be perceived as illegal.

What to do if compensation does not cover treatment costs

Sometimes it happens that the compensation paid by the insurance company does not fully cover the expenses of the injured party for treatment and further rehabilitation. After all, the table of compensation for health damage under compulsory motor liability insurance is not capable of calculating the associated costs of clients. In such a situation, you need to act according to the following algorithm:

1. The injured person submits a written claim to the person responsible for the accident, demanding additional payment from him in a specific amount;
2. The policy owner, in turn, transfers the received paper to the insurance company, along with a certificate from the hospital, which indicates specific numbers and expenses;
3. If the company refuses to make an additional payment, despite the legality of the client’s demand, then the case with all related materials is transferred to the Russian Union of Auto Insurers or to a local court.

It must be remembered that the insurance company has the right to a negative answer in a number of circumstances prescribed in the unified regulations of the RSA. Therefore, the policyholder should review this list before filing a complaint.

What to do if compensation for injury to health under compulsory motor liability insurance does not cover expenses

So, previously a list of cases was indicated when the injured person has the right to receive compensation payment from the insurance organization. Currently, such payments can be transferred at the time of drawing up a preliminary medical report.

In turn, it is necessary to note the fact that such a document does not take into account the procedure for the course of treatment, and accordingly, it does not take into account possible complications that may appear in the future. This means that even after such a document is issued, in cases where a person incurs additional expenses, the insurance organization must pay additional funds in the amount of the person’s additional expenses.

These payments are usually associated with the following types of expenses:

• Purchase of additional medications;
• The need for special nutrition;
• The need to obtain services from third parties (for example, a nurse, if a person is unable to care for himself);
• Implementation of a list of rehabilitation measures;
• Implementation of prosthetics.

The above, as well as other types of expenses, can be reimbursed by the insurance organization. The grounds for receiving funds may be submitted additional prescriptions from doctors, as well as documents confirming expenses.

Please note that when the amount of expenses exceeds the maximum amount of insurance compensation, the legislator has given the right to the victim to file a claim against the guilty person and recover monetary expenses from him.

In what case will payment be refused?

Today, citizens can receive a refusal from the insurance company to compensate for damage to health in an accident for only 5 legal reasons:

• The person was not injured in a traffic accident described in the traffic police report;
• The injured party did not prepare the evidence base;
• The accident occurred as a result of natural disasters (flood, fire, hurricane wind, etc.);
• The accident was determined to be intentional;
• The cause of the road tragedy was military action.

It is important to know! Also, a negative response from insurers is allowed if the policy holder fails to comply with the application deadlines, or if the structure of the execution of any of the submitted documents is violated. But in practice, refusal more often arises precisely due to the first 5 circumstances.

We learned what payments are provided under compulsory motor liability insurance for minor, moderate and severe injuries in an accident, and how to calculate their exact amount using a table. In conclusion, it is worth adding that independent calculation of compensation is not mandatory, but it is necessary to carry it out for your own safety. Otherwise, you will have to pay the missing funds for treatment from your own pocket.

What are the deadlines for paying compensation for personal injury after an accident?

Good afternoon? What are the terms of payment for compensation for personal injury after an accident?

Lawyer Antonov A.P.

Good afternoon

According to Part 21 of Art. 21 of the Federal Law “On Compulsory Motor Liability Insurance”, within 20 calendar days, with the exception of non-working holidays, and in the case provided for in paragraph 15.3 of this article, 30 calendar days, with the exception of non-working holidays, from the date the victim’s application for insurance compensation was accepted for consideration or direct compensation for losses and the documents attached to it, provided for by the rules of compulsory insurance, the insurer is obliged to make an insurance payment to the victim or, after inspection and (or) independent technical examination of the damaged vehicle, issue the victim a referral for repair of the vehicle indicating the service station where the his vehicle has been repaired and by which the insurer will pay for the restoration of the damaged vehicle, and the repair period, or send the victim a reasoned refusal of insurance compensation. If the deadline for making an insurance payment or the deadline for issuing a direction to repair a vehicle to the victim is not met, for each day of delay the insurer pays the victim a penalty (penalty) in the amount of one percent of the amount of insurance compensation determined in accordance with this Federal Law by the type of harm caused to each victim. When compensating for damage on the basis of clauses 15.1 - 15.3 of this article in case of violation of the period established by the second paragraph of clause 15.2 of this article for the restoration of the damaged vehicle or the period agreed upon by the insurer and the victim and exceeding the period established by the second paragraph of clause 15.2 of this article for the restoration of the damaged vehicle funds, the insurer, for each day of delay, pays the victim a penalty in the amount of 0.5 percent of the amount of insurance compensation determined in accordance with this Federal Law, but not more than the amount of such compensation. If the deadline for sending a reasoned refusal of insurance compensation to the victim is not met, the insurer, for each day of delay, pays the victim money in the form of a financial sanction in the amount of 0.05 percent of the insurance amount established by this Federal Law for the type of harm caused to each victim. The penalty (fine) or the amount of financial sanction provided for in this paragraph in case of failure to comply with the deadline for making insurance compensation or the deadline for sending a reasoned refusal of insurance compensation to the victim is paid to the victim on the basis of an application submitted by him for the payment of such a penalty (fine) or the amount of such financial sanction, which indicates the form payment (cash or non-cash), as well as bank details for which such a penalty (fine) or the amount of such financial sanction must be paid if the victim chooses a non-cash form of payment, while the insurer does not have the right to require additional documents for their payment. Control over insurers' compliance with the procedure for making insurance compensation is carried out by the Bank of Russia. If the insurer fails to comply with the deadline for making insurance compensation or sends a reasoned refusal, the Bank of Russia issues an order to the insurer on the need to fulfill the obligations established by this article. Until the full determination of the amount of damage subject to compensation under a compulsory insurance contract, the insurer, at the request of the victim, has the right to make a part of the insurance payment corresponding to the actually determined part of the specified damage. Thus, the insurance payment must be made within 20 calendar days.

Sincerely, lawyer Anatoly Antonov, managing partner of the law firm Antonov and Partners.

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