3 cases when you will not receive payment under CASCO

Is it possible to get money instead of repairs in case of an accident under CASCO insurance?

The motorist needs to study the contents of his policy, which spells out the options for possible payments in the event of an insured event.

The legislative act “On the organization of insurance business in the Russian Federation,” the latest version of which has been in force since August 2021, states that insurance conditions allow the replacement of damaged property with a similar product. If the item can be repaired, the insurance company must reimburse the costs for the damage repaired. The procedure for obtaining comprehensive insurance is enshrined in Chapter 48 of the Civil Code of the Russian Federation.

When an organization pays money or makes repairs under CASCO, this means that this provision is reflected in the contract. When applying for a policy, indicate how the services will be paid for:

• the insurance company sends the car to a service station;
• The service station is chosen by the client;
• Cash payments are made based on the conclusion of experts, and the insurer sends them for an independent examination.

The price of the policy directly depends on the provided payment of costs. The driver should be careful when purchasing CASCO insurance. The choice of an insurance company (IC) should be made not based on the cost of the issued paper, but by studying ways to satisfy requests for repayment of expenses.

Is it possible to receive compensation under CASCO without an accident and in case of theft?

As a rule, without an accident, damages are compensated due to bad weather conditions that led to damage to the vehicle. This includes all kinds of hurricanes, snowfalls, rainstorms, landslides, floods, hail and the like. To document the occurrence of such a case, you must contact specialized city services for a certificate.

Another option is car theft. In this case, the amount of insurance compensation under CASCO is calculated as follows:

maximum amount under the contract - depreciation - unconditional deductible - the amount of previous payments (with the aggregate method of compensation) - unpaid contributions.

In what cases is monetary compensation possible?

If the car is repaired independently, according to the law (Article 929 clause 1 of the Civil Code of the Russian Federation), the insurer is obliged to reimburse the costs when the driver demands money for it. But first an independent examination of the machine must be carried out. Perform operations in the following order:

• provide the damaged car to the insurance company;
• faults are determined by examination;
• take an expert’s report where the cost of service station services is calculated;
• carry out repair work;
• The insurer inspects the restored car and draws up a report, which records the parameters of the actions taken.

Based on a calculation made by an independent appraiser, money is recovered from the insurance company. To confirm the costs, attach to the experts' report receipts for which payment was made to the car service center or an order drawn up by a car mechanic based on the order.

It happens that the insurer sends a vehicle to a service center, but the owner cannot repair it for reasons beyond his control:

• long lines;
• The car mechanic refused to service the scope of work, did not complete everything or provided poor quality service.

In this case, the insurance client may demand cash, since the organization has violated contractual terms.

Cars under warranty are repaired only at a car service center that is an official dealer of the company. When referred to another structure, the insurance company must pay the amount for the work performed specified in the invoice.

Documents for receiving compensation

To receive compensation for a CASCO insurance event, you need to contact the insurance company with some documents. First of all, you need to write a statement about the occurrence of an insured event, which is submitted to the company. As a rule, you need to bring it no more than 7 days after the accident.

For insurance compensation under CASCO you need to bring:

1. CASCO policy;
2. driver license;
3. inspection certificate;
4. car passport
5. vehicle registration certificate.

The documents will subsequently be copied and left with the company.

Next, you need some documents from the traffic police. In particular, you must have a certificate stating that an accident occurred, indicating its date and location. It should contain information about the damage caused. You also need to take a protocol on the administrative violation. If a criminal case has been initiated, take the appropriate resolution. If the initiation of a criminal case was refused, it is necessary to take a decision on refusal.

When a legal entity applies to an insurance company as a representative, you need to take the appropriate power of attorney with all the signatures and seal. If an individual, but not the owner of the car, applies for insurance payment under CASCO, there is also a need to take a power of attorney or waybill.

All documents for compensation of CASCO insurance payments must be submitted to a special department of the insurance company and received a referral for an independent examination.

Why do insurance companies insist on compensation in the form of car repairs?

It is beneficial for insurance institutions to comply with the terms of the contract developed by them. Although it happens that the agreement does not contain a word about eliminating defects in auto repair shops. But when consumers contact us, insurance company employees begin:

• convince customers about the feasibility of auto repair;
• prove the immutability of the insurance rules adopted by the organization.

The reason is:

1. Correction of technical components is not always carried out after an examination; if the insurer tried to convince the driver that there is no such need, it is possible that the car mechanic will eliminate defects only visible to him and will miss the main damaged units.
2. Auto repair shops are often partners with insurance companies; mechanics install the spare parts they purchase, and in the documents they indicate prices that do not correspond to the actual ones.
3. Space for fraudulent schemes. To avoid participation, you need to scrupulously check the car before and after restoration and payment records.

Repairing minor cosmetic damage to a vehicle and other minor breakdowns is profitable and convenient for drivers. Do not rush to refuse the services of workshops.

If the stated conditions in the CASCO pole contradict legal provisions and infringe on the rights of the consumer, they are not considered valid by law.

If it comes to litigation, you will need to provide correspondence with your opponent. Any position cannot be legally recognized on the basis of unfounded, oral statements. Documents must be attached to each request.

How to get a cash refund under CASCO

The CASCO agreement provides for rules that determine the procedure for issuing funds. The parties can change the conditions recorded by signatures upon mutual agreement of each point. If the policy does not provide for payment of damages in cash without the intervention of a car repair shop, then a similar procedure cannot be used for compensation.

Therefore, you need to re-read the concluded agreement; perhaps it contains a clause on payments or other types of compensation for property losses. If the violations in the car qualify as an insured event, there will be no problems.

To determine the amount, choose one of the options:

• turn to experts for settlements and pay for their services;
• the insurance company carries out the check if the client trusts the employees.

And yet there are ways to compensate for damages with money if this condition is not reflected in the agreement:

• the car is stolen by criminals, for such a case the help of a service station is not needed, but you need to discuss the situation with the insurer in advance;
• after eliminating the deformations, problems in the mechanisms remained, the work was carried out in bad faith or incompletely - there is no difference, but only an independent examination can prove this fact;
• If fraud or violations of the agreement are discovered, only the court can restore justice.

Application form and required documents

The procedure for any application form, the following documents are attached to the application:

• extracts from the traffic police, which reflect information about road accidents or collisions with solid obstacles;
• passports of the car owners who participated in the incident;
• PTS;
• driving license;
• CASCO policy with confirmation of payment;
• inspection card;
• materials on the accident on various media;
• witness statements about the accident.

An application for insurance coverage is filled out with a detailed reflection of all events, where the details are indicated:

• time;
• date of;
• insurance number;
• names of the persons involved;
• license plate numbers of cars.

Within what time frame is the insurer obliged to pay compensation?

After submitting all documents, the money transfer must arrive in the client’s account no later than 30 days. If the insurance company delays payments without explaining the reasons, or does not make contact with the client, you must demand an explanation of the reasons in writing. Typically the insurer refers to:

• for a long process of coordinating all repair issues;
• waiting for the recovery order.

When the Investigative Committee does not provide deadlines for reimbursement of funds in the case under consideration, a claim sent to the legal authority for pre-trial proceedings with a requirement to pay the costs within 7 days will correct the situation. If the terms of the complaint are not satisfied, you need to file a lawsuit and demand payment of penalties for overdue days.

Terms of compensation

Refund periods are also set differently by each company. They must be written down in the comprehensive insurance rules or in the contract.

Typically the period ranges from ten days to a month. Of course, delays are also possible, not only due to the reluctance of the client to pay (usually found in small companies), but also for completely objective reasons, for example, a delay in the receipt of the necessary spare parts or a large queue of people wishing to receive a refund.

If the payment period is not specified anywhere, you will have to be guided by the Civil Code, which establishes the obligation of a reasonable payment period. If a month has passed and there are still no payments, the reasonable period has clearly expired, and you can demand from the insurance company not only compensation, but also a penalty for the delay in payment.

Unless otherwise specified in the contract, the period during which damage must be compensated begins to count from the day all required documents are provided.

How many times can you receive a cash refund?

Receipt of cash is not limited by the number of requests; payments are made in the amounts stipulated by the agreement. For example, a policy is concluded for 600,000 rubles, the client is entitled to:

• financing as many times as there are requests until obligations are fully fulfilled;
• payment of all money if the car is stolen or completely destroyed beyond repair.

The insurance agreement specifies a maximum amount that should not exceed the actual price of the car. It is difficult for a car owner to receive full compensation:

• if theft is confirmed, the insurance company will deduct the depreciation of the vehicle;
• after the insurance claims are satisfied, the price of the policy is reduced by the payment made.

Additional Information. When the insurer paid the client 200,000 rubles. from 600,000 rub. for damage from an accident, then after the theft 400,000 rubles will not be transferred to him, from here the wear of all components will be deducted. The UK's approach to the complete destruction of a car is interesting. The mechanism is recognized as such if the expert determines at least 80% of the damage. The maximum amount will be reduced by 20%. This part is considered suitable for implementation. You can sell the iron for scrap and remove spare parts.

The insurance company refuses to pay (does not pay) under the CASCO policy. What to do?

Insurance companies have already developed standard responses to policyholders’ applications for payment of insurance compensation, which they use to refuse payment under a CASCO policy.

Let's look at some of them:

• The insurance company refuses to pay insurance compensation after an accident for which you were found guilty;
• The insurance company does not pay money under CASCO due to the fact that the accident occurred as a result of a gross violation of traffic rules;
• The insurance company refused to pay money under CASCO, citing the fact that the accident or damage to the car occurred as a result of the direct intent of the policyholder or beneficiary;
• The insurance company does not pay money under CASCO insurance, since the accident occurred due to a technical malfunction of the car;
• The insurance company does not pay money under CASCO insurance if the policyholder (vehicle owner) provided false information about the accident;
• The insurance company refused to pay money under CASCO if the car was stolen and the policyholder or beneficiary did not have 2 sets of keys;
• The insurance company will not pay CASCO insurance if the owner or beneficiary was under the influence of alcohol or drugs at the time of the accident.

These are the most common excuses from insurance companies for paying insurance compensation under a CASCO insurance policy.
If you are faced with one of these problems, call our insurance dispute lawyers and get guidance 8 (812) 992-39-98

What to do if the insurance company refuses to provide monetary compensation

The insurer may give various reasons for its refusal to compensate financial costs. Basically, the insurance company refers to a violation of insurance rules:

• deliberate destruction of a car to claim funds in an illegal way;
• refusal to restore minimal transportation violations to victims;
• there are no claims against the culprit of the incident, which is confirmed in writing by law enforcement agencies;
• the traffic police were not called to the scene of the accident, the owner of the car did not contact the Investigative Committee for a long time;
• the unreliability of the specified facts about the accident was discovered;
• the driver carried out the repair work himself without an expert assessment.

Only in court, by providing real evidence, can justice be achieved. To do this, you need to require a written official refusal from the insurance company.

Additional Information. According to reviews from car owners who have been through an accident, many are satisfied with repairs instead of monetary compensation. There was no need to search for spare parts and a workshop. But the quality of restoration and long terms did not satisfy everyone.

The insurance company refused compensation for damages under CASCO

Many have experienced first-hand the refusal to pay compensation for damage under a CASCO agreement. In what cases do insurers have the right to refuse compensation to a company and what do they refer to?

In this case, it is always extremely important to understand the hidden depth of all clauses of the insurance contract. Therefore, before signing it, it makes sense to take a sample for review and, possibly, consultation with a lawyer.

For example, in the contract you can find the following clause : serious violations of traffic rules by the owner of the insured car. Many violations fall under this formulation, including crossing a double line, speeding, drunk driving, and so on.

There have been cases when compensation for damage was refused due to an overdue technical inspection, which is also a violation of traffic rules.

By signing a statement indicating that the policyholder has no claims against the participants in the accident, he thereby legally releases the charges against them .

Since the insurer has the right to demand compensation for damage from the at-fault party, such a claim may result in non-reimbursement.

Before the examination is carried out, you should not intervene and carry out any repairs to the vehicle, as this may lead to the fact that the insurer, upon refusal, will refer to the fact that he is not able to correctly determine the amount of damage.

When you first discover damage to your car, you must immediately call the traffic police or the police, depending on the situation, without leaving your location. Otherwise, you may not only be left without compensation, but also become suspected of fraud.

Which companies compensate for damages under CASCO in cash?

Every organization that deals with auto insurance offers to conclude a CASCO agreement. Their actions are regulated by the Federal Law and established local rules, the provisions of which are developed on the basis of legislative norms.

As an example of which companies issue CASCO insurance with cash payment, you can consider Ingosstrakh. Where the organization operates according to 3 payment schemes:

1. A constant amount is reimbursed in each insured event. In addition to thefts and complete destruction of the car, when it can no longer be restored after an accident, where all payments fixed in the contract are made, and the policy is canceled.
2. When concluding an agreement for the first insured event within a year, when the maximum possible amount is paid, after which the insurance becomes invalid.
3. The contract provides for a single sum insured. After each request from the policyholder, the finances will be reduced by the amount of payments made.

Rosgosstrakh acts according to a plan to implement specific actions, where the insured person:

• reports to law enforcement agencies about an accident; 3 days after the accident, the information must be received by the Investigative Committee;
• collects a documentary package that confirms the damage;
• transfers the vehicle for inspection.

The insurer determines the existence of an insured event based on the circumstances in order to find out how much to pay. The insured is given money if he agrees to replace this form of compensation with repairs, the transfers go to the service station.

Article 947 of the Civil Code of the Russian Federation states that the insured amount is an important condition of the contract, where the amount depends on the type of insurance. But each organization has its own rules, so before deciding to purchase CASCO, you need to consider all the conditions that different insurance companies offer.

Insurance payment under CASCO after an accident

If the driver has two insurance policies at once - both MTPL and CASCO, then he can, even if he is at fault in an accident, receive compensation from the insurance company. The main thing is that such a condition is specified in the policy.

In addition, the situation with the presence of a double policy allows, in the event of a shortage of compulsory motor liability insurance, to compensate for losses incurred with a CASCO policy. For example, if the losses amounted to 500,000 rubles, then MTPL will cover 400,000, and CASCO will cover the difference of 100,000.

Algorithm of actions in case of an accident:

1. Be sure to call an inspector;
2. Call the IC number and report the accident;
3. Receive a document confirming the accident from the inspector. At the moment this is a protocol (a certificate is not issued);
4. Contact the insurance company within the time limits specified in the insurance policy.

And if with compulsory motor liability insurance a period of 5 days is regulated, then with regard to CASCO there are no such terms. Each company sets its own time frame: in some places it is 3 days, in others it is 14 days (more details on “Time limits for applying for CASCO after an accident” here). Therefore, read the contract carefully so as not to be left without money. If the insured person misses the deadline for informing the insurance company, he may be left without payment.

You need to contact the insurance company with an application for payment. The application form must be on the official website of the Insurance Company. But it is allowed to write it in any form.

The subject must attach the following documents to the application:

• passport;
• PTS;
• protocol;
• CASCO and OSAGO;
• documents confirming the amount of damage caused (if any).

The insurer can inspect the car on site or pick it up to conduct an examination and determine the damage. The vehicle owner must be familiar with the result. If he disagrees, he has the right to an independent assessment.