When must the insurer be notified of the occurrence of an insured event?

Every car owner is required to have a valid MTPL policy. A unique feature of this type of insurance is the nuance that, on its basis, the insurance company of the culprit of the accident helps to compensate for the damage to the injured party during the accident. But in practice, it is much more difficult to guarantee payment after an emergency on the road.

Drivers who have signed such an agreement face a number of difficulties caused by incorrect application procedures and the list of documents required for this. Therefore, it is worth carefully studying all the features of the procedure and considering frequently occurring situations.

Procedure in case of an accident

Without accurate information about exactly when and where to go in case of an accident, the driver risks violating the rules of the insurance contract, which will complicate the claim for compensation.

Therefore, citizens should clearly know when the culprit of an accident must notify his company, and when it is better not to do this in order to avoid filing a recourse claim under OSAGO. Thus, the owners of the car involved in an accident immediately after the incident must:

1. Immediately stop the vehicle, turn on the emergency lights and put up a warning triangle. At the same time, it is prohibited to move objects that are in any way involved in the incident - it is prohibited.
2. If there are injured persons, it is necessary to call an ambulance and provide emergency assistance until they arrive. In case of emergency, send accident victims to the nearest medical facility by passing or personal transport.
3. When an accident impedes traffic, clear the roadway as quickly as possible. But before swapping objects that could later affect the course of the investigation, the position of the cars and related objects should be recorded in the presence of witnesses.
4. Then you need to report the incident to the traffic police, write down the main contacts of witnesses and wait for the arrival of State Traffic Inspectorate officers. All documents, which will then be issued by representatives of the Ministry of Internal Affairs, may be required by drivers when receiving payments.

The ideal case is an accident where both participants in the accident have a compulsory motor liability insurance policy. Then each victim has the right to apply for payments to his own organization or a similar company of another culprit. But if both citizens do not have a compulsory insurance policy, all responsibilities for making payments fall entirely on him. If there is a related CASCO agreement, part of the funds can actually be compensated from this insurance.

The need to notify the insurance company about an accident

There are two parties to an accident - the guilty party and the victim. It is understood that both parties have compulsory motor third party liability insurance (MTPL). The absence of such insurance is a violation of the law (Federal Law of the Russian Federation No. 40-FZ of April 25, 2002 “On OSAGO”). Recognition of the occurrence of insured liability and compensation for damage caused is the responsibility of the insurance company of the guilty party. Therefore, notifying the insurance company about an accident is the responsibility of the insured person. The victim, according to Art. 14.1 Federal Law No. 40-FZ, you should notify your insurance company in the following cases:

• If the accident involved no more than two cars;
• If no people were injured in the accident;
• If all participants in the car accident have a compulsory motor liability insurance policy.

Other situations require that the injured party must notify the insurance company of the person responsible for the accident. Does someone at fault in a car accident need to notify their insurance company? This question is answered by clause 3.3 of Chapter No. 3 of the Regulations of the Central Bank of the Russian Federation No. 431-P dated September 19, 2014, as amended on January 1, 2018: “Participants in a road traffic accident must notify the insurers who insured their civil liability of the occurrence of an insurance claim.” cases in the cases and terms established by these Rules.”

Therefore, both parties must notify their insurance companies about the accident. The notification period is stipulated by the same document (clause 3.8), which states that notification must take place no later than 5 working days from the moment of the accident. An exception is the situation when damage caused to health during an accident occurred later than the designated five days (clause 3.7). In this case, the victim, along with other documents, must submit a medical report to the Investigative Committee.

What are the deadlines for submitting documents to the Investigative Committee?

A fixed deadline for contacting the insurance company after an accident is an extremely important stage in receiving payments under compulsory motor liability insurance. It is worth remembering that in case of delay, the entire procedure can become significantly more complicated and prolonged. But if you strictly follow the standards disclosed in clause 42 of the policy rules, then the driver is obliged to notify his organization as quickly as possible. The maximum period for filing an accident report should not exceed 5 days from the date of the accident. But these 5 days are only the period for submitting an official application when registering an accident under the European Protocol. While a similar registration of an accident by traffic police officers allows you to count on payments even after 3 years.

What documents do I need to provide?

Since the payment of required insurance payments is rather of a declarative nature, it is impossible to do without collecting the necessary papers and information about the accident. According to standard requirements, the following documents are most often needed:

• car owner's passport;
• application for payment;
• certificate of accident with a list of damages;
• driver's license;
• TIN and registration certificate for the car;
• copy of the insurance policy.

Much less often, an additional list may be required, including:

1. Power of attorney for a vehicle (instead of a certificate).
2. Protocol on the offense.
3. Resolution on the case of an offense.
4. The fact of evacuation and storage of a car after an accident.

If you have decided to conduct an independent assessment of the damage, you will need to draw up an expert report with the assessment results and obtain confirmation that this inspection has been carried out. It is advisable to make copies of all mentioned papers.

What are the deadlines?

Everything here is quite twofold.

• If an accident was registered with traffic police officers, then the culprit needs to notify the insurance company as soon as possible (without specifics in the law).
• The victim also needs to do this as soon as possible. Clause 3 of Article 11 of the Federal Law refers to the Insurance Rules, clause 3.9.
• If a European protocol was filled out, then all participants in the accident must send their copy of the notice within 5 working days. In this case, the victim must submit it along with an application for insurance compensation.

What happens if you don't apply on time?

If the application deadline is missed (for example, later than 5 days), the insurer has the right to legally refuse payment. The fact of withdrawal of compensation after an accident will be provided in writing. But there are situations when the standard period can be extended on a general basis. Only for this purpose it is worth providing certain documentation that confirms the circumstances due to which there was an unexpected delay in reporting an accident:

• certificates from the hospital (if the citizen was seriously injured);
• travel document;
• tickets or copy of hotel reservation on vacation;
• confirmation of the investigation into the incident.

It is possible to submit the application and duplicate papers in a timely manner by mail or courier delivery. Based on the explanations provided to the company, it is possible to increase the initial period of treatment after an accident under compulsory motor liability insurance (from 5 days to several months).
In the absence of the listed documents, the issue with the deadline can only be resolved in court.

In what order are insurance payments made?

According to current legislation, the insurance company, having recognized the incident as an insured event, fully or partially compensates for the costs of repairing the car:

• up to 400 thousand rubles - harm to health;
• up to 500 thousand rubles - damage to a car and other property.

The insurer is given 20 days to check the entire package of documents, excluding holidays and weekends. As a result, the amount of compensation and a special document for repairing the car at a service station are transferred to the victim’s account.

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If this deadline is not met, the applicant has the right to also receive a penalty at the rate of 1% of the payment amount. To do this, you need to submit a corresponding application to the insurance company.

After completing all the steps described above, the owner of the damaged car must notify the insurance company about the accident within 5 days. After this, the specified package of documents is submitted to the insurance company.

Within 5 days from the moment the documents are received, the insurance company conducts an inspection of the damage to the car. Within 20 days, the organization makes a verdict: either refuses compensation, or gives a referral for free restoration of the car, or pays compensation in cash.

Who can claim insurance benefits?

In order for the culprit of an accident to be able to figure out whether he is entitled to standard payments under compulsory motor liability insurance or not, it is necessary to assess the type of accident.

Sometimes financial support is allowed only if the incident was recognized as mutual (when both drivers are equally to blame, then the party whose fault is less will receive more funds).

In other cases, when there was no refusal to consider the application, then in case of an accident, insurance is paid to the following persons who were physically injured:

1. The owner of the car (even if another person was driving).
2. The owner of the power of attorney for compensation from the owner of the car.
3. Relatives or relatives of the deceased driver.

When both participants in an accident have only a compulsory motor liability insurance policy correctly issued, only the injured party can claim payment of insurance funds , but the culprit of the accident cannot. But the second citizen has the right to count on partial compensation if, in addition to compulsory motor liability insurance, he purchased a CASCO policy (the contract must contain a clause covering such a case from the legal side).

Procedure

The form for notifying the insurance company about an accident is prescribed in the insurance contract. As a rule, this is a telephone call or a message through a special option on the official website of the insurer. You should study the text of the contract when signing it, but this is not enough to process compensation payments. The victim must personally provide the following to the insurance company at his place of residence or at the place of the accident:

• OSAGO policy;
• Application for receiving insurance payments. This document is usually drawn up in the IC office on the company’s letterhead. Basic information that must be reflected in the application: name and address of the insurance company;
• information about the applicant (passport details, MTPL policy details, contact information);
• description of the accident;
• claims for damages;
• details for transferring funds for damages;
• date of writing the application, personal signature with transcript.

An alternative to a personal visit (after verbal or electronic notification to the insurance company about a traffic accident) is sending documents by registered mail with a description of the attachment and the option of notification of delivery of the item to the addressee. Another option is to submit documents with the help of a proxy. In this case, it is necessary to issue a power of attorney certified by the signatures of the parties.

Why may insurance benefits be denied?

The list of serious reasons why an insurance company legally refuses to pay a client insurance under a compulsory motor liability insurance policy includes cases when the driver:

• intentionally damaged his vehicle;
• committed a crime that resulted in an accident;
• did not send the application within 5 days;
• forgot to fulfill obligations to establish the causes of the accident;
• did not provide traffic police officers with access to the car.

In order to avoid further misunderstandings between the car owner and the company, it is worth remembering that under the terms of the deal, the policy holder must keep his car in the condition in which it was after the accident. Some drivers neglect this rule, which results in violations of the standard terms of the contract.

The owner of the car has the right to challenge the presented decision through a lawsuit within 3 years, as well as file a complaint with the RSA. This can be done using a simple algorithm in 2 stages:

1. File a formal claim with the insurer. When the victim is not satisfied with the amount of compensation or the company refuses to carry out the request altogether.
2. Submit the claim to court. If the period for consideration of a pre-trial claim (20 days) against the company expires, then the driver can legally go to court.

Without an initial attempt to resolve the conflict with the company on an individual basis, the citizen’s claim will be denied. Based on the latest innovations in the law, the injured party is obliged to first file a claim with the company that issued the MTPL policy, and only then prepare applications to subsequent authorities.

Legal justifications for the timing of contacting the insurance company

The procedure and timing for notifying the insurance company (IC) about an accident are set out in Federal Law No. 40-FZ and the MTPL Rules (approved by Regulations of the Central Bank of the Russian Federation No. 431-P). Here's what regulations and judicial practice say about procedural deadlines when obtaining insurance:

• immediately after an accident on the road you need to notify your insurer (both drivers are required to do this);
• within 5 days after the incident, you must submit to the IC a notification of an accident under the Europrotocol program, or drawn up with the participation of a traffic police inspector;
• if a dispute arises, you need to contact the financial ombudsman and the court within 3 years (this is the standard statute of limitations that applies to compulsory motor liability insurance or motor insurance claims).

The initial notification (message) about an accident can be made by calling the insurer or in another way . This obligation also extends to the culprit of the collision, since recourse claims may be made against him. After the notification is issued, the victim will contact the insurance company.

If payments under compulsory motor liability insurance are delayed

If, having conscientiously fulfilled its obligations under the compulsory motor liability insurance agreement (providing a full set of papers and a car for inspection), the insurance company is not going to pay the required compensation within the legal period, you should send them a claim. Such a document is drawn up in free form, but in the text you should definitely indicate the policy number, the date of the accident and the date of filing the application, as well as put forward a requirement for the speedy implementation of compensation and, in addition, penalties.

The company is given exactly 20 days to review such a package of documents. If this period increases, then for each day of delay the insurer is also obliged to pay a penalty of 1% per day of the total amount of damage (if the delay in payment is not complicated by the results of the inspection). And when complaints arise about the work of the company itself, the client has the right to call RSA with a complaint.

How to write an application to the insurance company

You can submit an application to one or another insurance company in handwritten or printed form.

The text should reflect in detail the most important points of what happened:

1. At the top right is the name of the company where the applicant is applying.
2. From the passport, personal data of the person is entered, as well as the names of witnesses, eyewitnesses with their contact numbers.
3. The circumstances of the incident and the actions of each party are described in as much detail as possible.
4. The list of damage sustained by the vehicle and the health of the victim is indicated at the time of the accident.
5. The requirement for insurance payment is necessary to cover damage to the car and health.

You don't have to write the text yourself. Thematic sites contain samples with tips or already filled with approximate content. Therefore, in this situation, you just need to concentrate so as not to confuse the numbers in the numbers or not to forget to indicate an important detail.

It is not always possible for participants in a collision to collect and submit a package of documents on their own. But the law is inexorable, and you need to do it within 5 days. In this case, it is possible to apply not in person, but through a representative. However, in this case, you will have to incur additional costs for registering a power of attorney with a notary.

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In the case of insurance under compulsory motor liability insurance, the insurer may prescribe in its rules certain periods within which victims can apply for insurance payments. But many car owners do not comply with these deadlines: they apply a year and a half after the accident. And this is not a basis for refusing insurance payment, because...

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The following terms are regulated under MTPL agreements:

1. The at-fault driver, when registering an accident without police officers, is obliged to send a notice of the accident to his insurer within 5 days from the date of the accident, the victim must send this notice along with an application for insurance compensation within the same time frame.
2. The victim, within 5 days from the date of contacting the insurer, is obliged to provide the vehicle for inspection and an independent examination.

There are no other deadlines for claims related to insured events.

At the same time, there are clarifications: if the victim files a claim with documents substantiating his claims, then the limitation period is suspended for 10 days from the date of receipt of the claim.

An example from judicial practice. The legal entity was denied claims to collect insurance compensation due to missing the statute of limitations. The accident occurred on January 12, 2015. In 2021, the plaintiff filed a lawsuit to collect insurance compensation, but indicated the wrong defendant.

How to make an application for insurance payment?

One of the mandatory stages of obtaining compensation under compulsory motor liability insurance after an accident is writing an application. It can be sent by registered mail to the insurer’s office or visited in person and written on the spot. A standard application form has not yet been established, so it is written in free form. But the following information must be mentioned:

• full name of the director;
• your passport details, full name and contacts;
• the amount of compensation requested;
• details for transferring funds;
• applicant's signature and date.

If you apply in person, you can pick up an application form at the company’s office and clarify all the points of interest . Along with the incoming application, you must also attach a standard package of documents. But if it is not the policy owner himself who contacts the insurer, but his representative, then in addition a power of attorney certified by a notary will be required.

Is it possible to report online on the insurer's website?

Yes. The main thing to remember is that if you fill out a European protocol, this will not constitute proper notification to the insurance organization. As we noted above, in this case you need to send your copy of the notice to the insurer. But you won’t be able to take a photo or scan it and upload it on the official website of the insurance company. Although, again returning to the lack of consequences, in fact in 2021 you can do this, but not by law.

In fact, not all insurance companies can report an accident on the websites. For example, Rosgosstrakh has such forms, but we did not find the opportunity to transmit information about an accident online to AlfaStrakhovanie or VSK.

Something else useful for you:

• Mutual fault under compulsory motor liability insurance - how is payment made?
• What is the maximum payment under compulsory motor liability insurance?
• What payments can you receive under compulsory motor liability insurance after an accident?

How much can I receive a payment?

The MTPL policy has clearly defined limits, which are specified in Art. 7 of Law No. 40 “On compulsory insurance of civil liability of vehicle owners.” Therefore, the driver can count on compensation in:

1. 400 thousand rubles, if only the car was damaged during the accident.
2. 500 thousand rubles if damage is caused to both the car and the owner of the car.

In any case, the final amount of compensation is determined by an assessment of the damage, which will be carried out personally by a representative of the insurance company. If the client considers the compensation under compulsory motor liability insurance to be underestimated, then he has the right to contact independent experts and order a re-check. And when the company refuses to cover the cost of the damage at all, the driver must file a corresponding claim in court.

Proper Insurer Notification Form

Civil legislation does not establish the form of notification. The parties have the right to agree on how the policyholder must notify the insurer in the insurance contract. In addition, the form and method of notification by the policyholder to the insurer may be reflected in the insurance rules.

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Examples of ways to notify the insurer of the occurrence of an insured event

The parties may provide that the policyholder is obliged to notify the insurer within 24 hours (not counting weekends and holidays) by fax, telegraph, telephone or directly. The telephone message must be subsequently (within 72 hours) confirmed in writing. This provision is contained in the Rules for insurance of industrial and commercial enterprises against fire and other hazards, approved by order of the General Director of Renaissance Insurance Group LLC dated June 26, 2008 No. 74 (decision of the Thirteenth Arbitration Court of Appeal dated April 27, 2011 in case No. A56 -43816/2010).

In practice, another option can be found: in accordance with the insurance rules, the policyholder is obliged to notify the insurer of damage, destruction or loss of the insured property in any available way. The obligation to notify the insurer must be fulfilled no later than two business days following the day on which the policyholder became aware of the event. If the information was initially communicated orally, the policyholder must confirm it in writing. Written confirmation must be sent to the insurer or delivered to the insurer's representative no later than five business days following the day on which the policyholder became aware of the event. This version of the notification is contained in the Rules for Insurance of Motor Vehicles, approved by Order of Rossiya Insurance Company dated April 20, 2007 No. 83 (resolution of the Eighth Arbitration Court of Appeal dated September 20, 2010 in case No. A46-4411/2010).

If there is no such condition in the insurance contract or insurance rules, then the policyholder may send a notification to the insurer in any form, including verbally.

Advice: It is better for the policyholder to send the notice to the insurer in writing so that he has confirmation that the insurer was notified within the prescribed period. Because it may happen that he will have to prove the fact of notification if the insurer challenges it.

The policyholder can also provide information about the occurrence of an insured event to the insurer's representative, who is indicated in the insurance policy.

How long can it take to settle without going to court?

There is a misconception among car owners that compulsory MTPL insurance does not allow them to claim the required amount from the person responsible for the accident.

But such suspicions are not justified, because they often arise due to underpayments by insurance companies of the required compensation.

And few drivers also know how to go to court against the second participant in an accident for full compensation. In fact, you can file a claim in court when:

• the amount of insurance under compulsory motor liability insurance does not cover the entire amount for repairing the victim’s car, and the restoration work turned out to be higher than the limit promised under the compulsory insurance legislation;
• the driver who is at fault for the accident does not have an MTPL insurance policy at all, or the validity period of the said agreement has expired, and the agreement has been declared invalid or counterfeit, which is similar to its absence;
• There were more than 2 people involved in the road accident, so the insurance is divided by the company between all drivers, so to cover the resulting damage or harm to health, the final amount may simply not be enough for all the victims;
• there is psychological pressure, insults, discrimination, threats and other manifestations of moral harm, which a priori are not covered by insurance organizations because this is not taken into account under compulsory motor liability insurance as an insurance risk;
• the victim was performing his official duties at the moment when he got into an accident - so he has the right through the court to recover lost profits in the form of part of his earnings, which falls during the period of the accident, proceedings and hospitalization for injury;
• the culprit of the accident has not been identified in a timely manner and there are certain difficulties associated with finding one of the drivers, and this also includes emerging disputes between the parties and the insurer;
• significant damage to the victim’s vehicle was caused not while driving (the policy does not cover these risks by law), but during downtime (for example, when a car parked in a parking lot was hit).

While the insurance company or forensic expert is calculating the total amount of damage, the wear and tear of the car will still be taken into account. It is worth considering that installing additional equipment or improving modifications at the expense of the culprit is considered illegal. When a company does not pay additional compensation, the victim should file a lawsuit not against the culprit, but against the company itself.

Reasons and terms for notifying the insurer of the occurrence of an insured event

The obligation to immediately notify the insurer of the occurrence of an insured event is provided for by the Civil Code of the Russian Federation (clause 1 of Article 961 of the Civil Code of the Russian Federation). Timely receipt of information about the occurrence of an insured event is important for the insurer for several reasons:

• After receiving information from the policyholder that an insured event has occurred, the insurer can immediately take measures to reduce the amount of losses. For example, he can help the policyholder in searching for missing property or assist in a more profitable sale of property that was damaged as a result of an insured event;

• If the policyholder immediately notifies of the occurrence of an insured event, the insurer will be able to organize a timely inspection of the property. This will enable the insurer to more accurately assess and determine the amount of losses suffered by the insured. After all, if a lot of time has passed since the occurrence of the insured event, then finding out the amount of losses incurred by the insured as a result of damage to his property may be problematic;

• The insurer, immediately after notification of the occurrence of an insured event, may demand payment of insurance compensation from reinsurers with whom it has concluded reinsurance agreements.

Attention! A dispute may arise between the policyholder and the insurer over what the term “immediately” means as used by the Civil Code of the Russian Federation.

The term “immediately” means that the policyholder must notify the insurer of the occurrence of an insured event without delay, immediately after its occurrence. However, the parties may have different understandings of what immediate means. Therefore, if the parties do not provide specific notice periods, this may lead to a legal dispute.

At the same time, the Civil Code of the Russian Federation gives the parties the right to set the deadline for notifying the insurer of the occurrence of an insured event. Thus, if the contract provides for a notice period, then the policyholder must notify the insurer of the occurrence of an insured event within the prescribed period (Clause 1 of Article 961 of the Civil Code of the Russian Federation). This period may be specified in the standard insurance rules or in the insurance policy.

For example, the parties may establish in the contract that the policyholder is obliged to notify the insurer immediately, but no later than 24 hours (or within two or three days) from the moment he learned of the occurrence of an insured event.

Question: the occurrence of an insured event became known not to the policyholder, but to the beneficiary. Should he notify the insurer about the occurrence of an insured event?

Answer: yes, it should. Such an obligation, similar to that of the insured, lies with the beneficiary. That is, on the person in whose favor the insurance contract was concluded.

If the beneficiary knows that the insurance contract has been concluded in his favor and wishes to exercise the right to insurance compensation, then in such cases he is obliged to notify the insurer along with the insured (paragraph 2, clause 1, article 961 of the Civil Code of the Russian Federation).

However, the beneficiary is released from the obligation to inform the insurer about the occurrence of an insured event if, at the time of its occurrence, he was not aware of the conclusion of an insurance contract in his favor.

What changes have been made to the legislation?

In 2021, the Central Bank made significant amendments to the law on compulsory motor liability insurance, which allegedly stipulates an increase in the cost of services by 20% and changes in the procedure for calculating the coefficient. Thanks to a fundamentally new approach to calculating payments, in the future it will be possible to regulate the cost of compensation. The first adjustments to insurance began to appear in 2021, but the final reform is planned only by 2021.

Therefore, in addition to the question about the deadline for submitting documents to the insurance company after an accident under compulsory motor liability insurance, citizens need to take into account the latest changes. The new version of the law allows recourse to the insurer in case of an accident involving 3 or more cars, although the earlier version of the law did not allow this. If the driver acts correctly and remembers his rights, he will receive the required financial assistance in full without any delay.

Useful tips

None of us want to get into an accident. But still, this happens to some drivers. To minimize damage, you need to act clearly and quickly. There are several “golden” rules that any car enthusiast should know.

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The insurance company cannot refuse to accept an application based on the fact that the owner of the car submitted documents not a day later, but only 2-3 days after the accident.

Before submitting all documents, you need to make copies of them, and hand over the originals only for inspection or according to the acceptance certificate against signature.

Payments must be made in full within 20 days from the date of submission of all documents. If the deadline is violated, a penalty is charged for each day of delay.

In case of any disagreement, one must strive to bear responsibility in a pre-trial manner. But you shouldn’t avoid litigation either. With the right approach, this will solve the problem in your favor.