Why is an accident not an insured event? Compensation for damage caused if an insurance case occurs due to compulsory motor insurance during an accident

The MTPL policy must insure its owners against significant expenses in front of another motorist due to accidents on the roads, so its registration is mandatory. All insured events are specified in Federal Law No. 40, and each company is obliged to comply with it.

However, cunning insurers try to avoid payments and interpret each situation in their own way. Study insurance cases under compulsory motor liability insurance to understand when payment is due and when not.

How to determine an insured event

To understand whether a company is obligated to pay compensation, you need to know the signs of insured events. No matter what the insurance company tells you, always double-check the information they give, since most often the insurer is not interested in paying out. An incident is considered an insured event when:

1. Damage was caused to a vehicle insured under the contract.
2. In an accident there are both the culprit and the victim. This is a must. The at-fault party will be subject to civil liability and the victim will receive compensation from the at-fault party's insurance company.

An example would be a situation where a driver was driving fast, but there was a traffic light ahead. He did not have time to brake and crashed into the car in front. The insurance company of the culprit is obliged to pay compensation to the victim. Another example: the driver of a large truck drove past a passenger car and carelessly hit it, causing damage. His insurance company will pay the cost of repairs to the owner of the car.

In case of an accidentOSAGO exclusively insures liabilityin front of another driver. The culprit is obliged to restore his own car at his own expense.

Uninsured cases under compulsory motor liability insurance

The legislation establishes rules when the insurance company is not obliged to pay compensation, that is, non-insurance cases. Here is their list:

That's not all. There are situations in which the insurance company is also not obliged to pay anything:

• natural disasters, accidents;
• damage resulting from a nuclear attack;
• if any type of war begins: civil, world and others;
• damage was caused by popular unrest: rallies, uprisings, etc.

There will be no payment in the listed situations, regardless of the location of the incident, factors, and so on.

What if the accident happened in a parking lot?

Legislation will help you understand this issue, or rather Article 1 of Law No. 40-FZ “On Compulsory Motor Liability Insurance”. It states that an insured event can be considered damage to the car or the lives of victims due to the use of the car. Now you need to pay attention to the last two words. The use of a car means its operation on roads and areas adjacent to them. Parking is classified as such in accordance with paragraph 1.2 of Article 1 of the Traffic Regulations. This means that even if an accident happened in a parking lot or parking lot, it should be considered an insured event.

EIf a car is damaged in a parking lot, for example, by an icicle falling from the roof, then this is not an insured event.

Procedure in case of an accident

To be guaranteed to receive compensation from the insurance company after an accident, you need to follow the following algorithm:

1. Carefully inspect the scene of the accident and determine whether there are victims. If yes, call an ambulance.
2. Call the traffic police and contact the insurance institution.
3. Don't touch anything, leave it as is. It is advisable to record the scene of the incident on camera. If the car interferes with the traffic flow, after filming you need to drive the car to the side of the road.
4. Find witnesses and take their contacts.
5. You should look at the person who caused the accident's insurance, his documents, and get his phone number.
6. Traffic police officers or an emergency commissioner will arrive and take the necessary actions. Study the protocol before signing it, make sure everything is written down correctly.
7. Within 5 days after the incident, you should contact the insurance company with a certificate confirming the fact of the accident, as well as a list of other documents, which can be clarified by the insurance company.
8. At the appointed time, an examination will be carried out to assess the damage. After this, the company will provide a referral for repairs.

Here is what is best for the victim and the culprit of the accident if an accident occurs.

Now you know what is an insured event and what is not. Remember, the insurer will try to evade compensation for damage, so you need to study in detail all the articles of the Federal Law “On Compulsory Motor Liability Insurance” relating to payments, or enlist the support of an auto lawyer.

Insurance companies often deny owners of compulsory motor third party liability insurance policies compensation for damage caused.

The insurance owner cannot analyze the situation on his own, and this only plays into the hands of a dishonest insurer. Insurance cases under MTPL include a wide range of situations on the road and parking areas. It is frivolous to think that this is solely an accident. Let's talk about this further.

To describe in detail which situations must necessarily be recognized as insured events under compulsory motor liability insurance, let us touch upon the interpretation of the term itself. If you have basic information on motor third party liability insurance, it will be much easier to understand the essence of the issue.

The “price” of the health of a victim in an accident under compulsory motor liability insurance.

• vehicle registration certificate;
• driver's passport;
• driving license;
• registration certificate

In the event of a collision with another car, if harm is caused to the health of passengers or the driver of another car, it is worth filing a statement.

It is important that the following conditions are met:

• there were more than one car involved in the accident;
• all cars involved in the accident had a valid MTPL contract;
• Only the vehicle suffered damage.

The application is submitted to the insurance company, which executed the contract of compulsory motor third party liability insurance for the driver.

But there are also a number of situations in which the completed application must be submitted to the Russian Union of Auto Insurers, and not to the insurance company:

• SK is bankrupt and has lost its license;
• It was not possible to identify the culprit of the accident on the road; he did not sign the MTPL agreement, but only if the damage was caused to human life or health.

In other situations, you will need to file a claim with the insurance company of the person at fault for the accident.

Results

Practice shows that not all road accidents are considered grounds for compensation of expenses incurred by the insurance company.

It is important to understand what is really considered a reason for compensation for damage, and what expenses cannot be reimbursed at the expense of the insurance company. Then you can avoid paperwork, wasting your own time, nerves, and effort.

First of all, an insured event is not the most pleasant event in the life of a motorist. And for insurers this event cannot be called pleasant.

The victim naturally considers the losses and damages that were caused to his property, life or health, but at the same time, the insurance company also bears losses, because in this case it is the insurance company that has the responsibility to pay the victim for his damages (you can find out how much the insurance company pays under compulsory motor liability insurance in case of an accident). Naturally, the insurer also incurs costs in this case. Very often, insurance companies try in every possible way to avoid paying victims.

Due to the legal illiteracy of many vehicle owners, insurance organizations quite often manage to avoid payments for insured events.

In order to avoid deception by unscrupulous employees of the insurance company and receive compensation for the damage caused to you after the occurrence of an insured event, you must be competent in the matter of insurance. The policyholder needs to know which cases are considered insured and which are not. what are required and how to properly document this incident (you can find out the detailed procedure for applying to the insurance company for compensation under compulsory motor liability insurance after an accident).

In case of an incident

An insured event under compulsory motor liability insurance can occur both during an accident and without it. First, let's look at what a traffic accident is. The concept of an accident is defined in clause 1.2 of the traffic rules: an accident is an event that occurs during the movement of a car on the road and with its direct participation, in which the vehicle, cargo, structures, etc. were damaged. or harm to the health and life of people is caused.

This concept includes the following features:

1. occurs only as a result of the car moving on the road. For example, if a car hits a pedestrian while moving. But the other side of the situation is when a pedestrian falls on a car is no longer considered an accident.
2. Only a situation in which a car is involved is considered an accident. For example, if a bottle thrown from a car window hits a pedestrian, then this situation does not fall under the classification of an accident. But if a bicycle falls from a car and falls on a pedestrian, then such a case will already be considered an accident, since the bicycle belongs to the category of vehicles and is in motion when it falls.
3. An event is classified as an accident if it caused harm to the health and life of people, a vehicle, a building, etc.

Without him

However, there is another category of cases that relate to insurance under MTPL. The reason for such insurance cases is not an accident during the driver’s operation of his vehicle (we have already described in more detail what types of insurance cases exist under compulsory motor liability insurance in). This kind of incident is also considered by the Investigative Committee as damage caused to the property of the car owner, since not in all cases the vehicle can be found and restored.

Cases falling under the category of insurance under MTPL without an accident are considered:

• Car theft.
• Spontaneous combustion or deliberate arson of a car.
• Disaster.
• Damage caused by third parties.

In order to receive compensation for damages in all of the above cases, the victim should promptly collect all the documents necessary for payment and contact the traffic police to have an investigation into the case.

What situations are they not?

Now about non-insurance cases. To understand which cases are not insured under MTPL, let’s turn to the “Law on MTPL” and consider the concept of an insured event, which is given in this law. In order for the insurance company to recognize a case as insured, the following conditions must be met:

1. The driver of the vehicle must be subject to civil liability.
2. In the event that you are the only participant in an accident (for example, you drove into a pole), then accordingly this case will not be considered by the insurance company as an insured event under a compulsory insurance contract.

   According to the rules of compulsory motor liability insurance, there must be at least two participants in an accident. Civil liability should arise from one participant, while the other participant in an accident in such a situation is recognized as a victim and has the right to receive compensation for the harm caused to him (with the exception of cases of car owners).

The insurance company may refuse to pay under compulsory motor liability insurance if the car was damaged while it was parked and the causes and circumstances of the damage are unknown. For example, if it turns out that someone accidentally touched a car with a bag and scratched it, then this case of IC will not be classified as an accident, since the person at fault in this case, if identified, then this citizen did not cause harm to his vehicle, and therefore The SK is not responsible for it.

But if your car was damaged by another vehicle, and the culprit is known, then such a case will be covered under compulsory motor liability insurance.

It turns out that in order for the insurance company to recognize the case as insured, the damage to the car must be caused by another vehicle, the owner of which was found guilty of causing damage to the victim. So, if a billboard falls on your car, then you will not receive a payment under compulsory motor liability insurance; for this, there is another type of insurance such as CASCO. The damage to the victim's vehicle must be caused by the culprit when using his vehicle.

The use of motor transport is its operation directly related to traffic. In the event that your car was damaged in a parking lot by the culprit’s parked car, for example, the driver scratched your car when opening the door of his vehicle, then this situation will not be an insured event.

IMPORTANT: A mandatory condition for recognizing a case as insured is the movement of the vehicle.

However, there are cases that correspond to the conditions that we listed above, but such situations are excluded from the cases subject to compensation under the MTPL policy.

Cases that are not insured under MTPL:

Car collision in the yard

Is a collision between two cars in the yard an insured event? In the event that the person driving the car did not notice another car while reversing, or if an emergency situation in the yard occurred for another reason, the driver should carry out all those actions that need to be taken in the event of an accident.

An accident in the yard is a standard situation. This accident is subject to the same regulations as an accident that occurs on a regular road. It is necessary to understand that if the driver leaves the scene of an accident, no matter where it happened (in the yard of a house or on the highway), then this will be considered a serious violation of traffic rules. Such an act may result in serious punishment.

Therefore, if you are involved in an accident in the courtyard of your house, you will have to stop and leave your car in the position in which it was at the time of the accident. Further you should wait for the traffic police officers and file this case properly(read about what procedure is necessary to receive compensation under compulsory motor liability insurance if you are involved in an accident).

After you receive documents from the traffic police, you should come to the Investigative Committee with a complete list of necessary documentation and write an application for compensation for the damage caused to you.

Many policyholders are faced with a situation where, when applying for insurance compensation, the company protecting the interests of the guilty party refuses to pay compensation. Such situations are not uncommon, even when the fact of a traffic accident has been officially registered.

Of course, it is not profitable for insurers to cover the damage and they try to come up with excuses not to make payments. In order not to fall for the illegal tricks of the insurance company, it is important for car owners to know what can be considered an insured event under MTPL, and what really is not.

These cases are regulated by the provisions of traffic rules and Federal Law, therefore, in the event of controversial situations, it is necessary to resort to these documents.

Car owners who purchase a compulsory car insurance policy hope that, thanks to it, the victim will be able to receive compensation for the restoration of a vehicle damaged in a car accident without any delays.

But insurance organizations do not always recognize insured events (CA), even if the insured car has damage of various types.

That is, it is important for the insurance company that, when accepting an application from the insured of a victim of an accident, it confirms the presence of a guilty and injured party, the location of the incident that is suitable for the CC and other circumstances. Otherwise, such an event will not be recognized as insurable under compulsory motor liability insurance.

A compulsory car insurance policy protects the car owner from financial penalties that may be imposed on him if he is found guilty of a car accident. In this case, car insurance covers damage to the injured person as if on behalf of the culprit.

Consequently, it is not the initiator of the accident who pays for the damage, but his insurance company. But in order for insurers to pay compensation, you need to know what is included in an insured event under compulsory motor liability insurance, so as not to waste time filing an application and know in advance in what case a refusal will follow.

In 2018, according to the current Federal Law “On Compulsory Motor Liability Insurance”, there are only a few situations that are included in the list of insured events, namely:

• An event that occurred on roads and adjacent areas, resulting in damage to people and their lives. A sign of SS in this situation is the harm to health and life suffered by innocent car owners, their passengers or pedestrians.
• An event that occurred as a result of the movement of a vehicle on the road, in which the property of an innocent car owner was damaged. Here, only the victim’s vehicle falls under SS.

It is these two situations that constitute an insured event under compulsory motor liability insurance, but each of them has certain subtleties in its definition. To understand in more detail, let's look at examples.

Insured event under compulsory motor liability insurance in case of an accident

So, we know that insurers are in no hurry to recognize all accidents on roads as an insured event for which they are obliged to pay compensation.

Consequently, the occurrence of an insured event under compulsory motor liability insurance is recognized only if the following conditions are met::

1. Damage to property (vehicle) as a result of an accident was recorded.
2. Damage to the health of other persons was caused as a result of the movement of the vehicle.
3. The at-fault party was insured at the time of the accident.
4. When drawing up the European Protocol, traffic police officers or participants independently identified both the guilty and the injured parties.
5. A car accident or minor accident occurred on the territory of a qualifying road and adjacent objects (parking lots, parking lots, alleys, roadsides).

That is, if an accident occurs, but there is no victim in it, a statement was not sent to the insurance company, then there will be no insurance policy as such, since there will be no one to pay compensation. If the incident occurs on the territory of a special racing track, then this will also not qualify as an insured event in case of an accident, even if the culprits are identified.

The law and the insurer decide in what cases under compulsory motor liability insurance in case of an accident compensation is paid. The presence of damage does not guarantee that the company will recognize this CC and pay compensation to the injured party.

No accidents

When we talk about in what cases it is paid, we need to remember what exactly this type of car insurance protects. Thus, this insurance is paid by the company representing the interests of the car owner who initiated the car accident.

That is, the MTPL policy implies payment of compensation to the party injured in a car accident instead of its initiator. Consequently, the “motor citizen” protects the car owner’s liability to third parties. The protection applies to incidents that occur on the road involving only two or more vehicles.

This means that if the vehicle was damaged not by another car, but by a fallen tree or an intruder, then such insurance cases under MTPL without an accident are not recognized. To receive compensation in such incidents, those that did not occur on the road, you will have to buy additional Casco insurance that covers damage in such situations.

When insurance cases are not recognized

As you already understand, only the injured party has the right to receive compensation from the insurance company under a compulsory auto insurance policy. Consequently, if the initiator of the incident wants to receive compensation, then he needs to have a voluntary auto insurance policy, since the “automobile insurance” protects his liability and does not cover the damage to the culprit.

In order not to waste time collecting documents, it is advisable to know in what cases insurance is not paid in an accident:

1. If a vehicle not listed in the vehicle license was damaged in a car accident. That is, the at-fault party does not have a valid auto insurance policy.
2. The victim wants to receive compensation citing lost profits. What is not an insured event cannot be obtained from compulsory motor liability insurance, because with such an appeal you can go to court and recover compensation from the culprit directly.
3. The injured party became such because of the load carried in the culprit's car. If a vehicle is transporting dangerous cargo, it must be insured separately.
4. The accident occurred on a training track, competition or other types of training driving.
5. Moral compensation is in non-insurance cases of compulsory motor liability insurance, but it can be demanded through the court.
6. Damage to green spaces, architectural monuments or buildings are also cases when insurance is not paid.

Registration of an insured event under compulsory motor liability insurance

We have already said earlier that in order to receive compensation and recognition of the incident by the SS, there must be an injured party. That is, the settlement of insurance cases under compulsory motor liability insurance occurs only if there is a culprit and a victim.

The latter must submit an application to the company within the prescribed period so that it will consider it, inspect the damage and make a payment. The main thing that needs to be done after an accident is to report the insured event to the insurance company.

Notifying the insurer about an incident involves filing an application with a request for payment of compensation, as well as providing the necessary documents and certificates. If the victim is not insured, then he contacts the company of the insured culprit, but if the innocent party also has an auto insurance policy, then he can contact his insurance company.

What documents are needed

If the compulsory motor liability insurance contract for the person responsible for the accident is concluded in the same company where the innocent car owner is insured, then the procedure for registering an insurance policy usually follows a simplified scheme. But even if an application is submitted to other insurance companies, the procedure for registering an insured event will be the same.

To accept an application from the injured policyholder, he will need the following documents:

1. An application written in free form (or on a special form) with a request for payment of compensation.
2. Civil passport or other identification document.
3. A certificate issued by a traffic police inspector.
4. Notification (protocol) of an incident on the road.
5. Information about an accident.

Deadlines for application and consideration

In order not to be denied payment, the party injured in a car accident must submit a statement to the insurance company within a certain time. The period of notification to the insurance company about the incident is also limited for the initiators of the accident.

It is advisable to contact the insurer as soon as the fact of an accident has been recorded, but both parties have several days. Thus, the “motor citizen” will be able to compensate for damage only if the policyholder contacts the company regarding the accident no later than 5 days from the date of the incident.

After submitting the application, you must obtain a certificate from the insurer, which will indicate the date of acceptance of the application. It is from this moment that the time allotted for the insurer to consider the application, inspect the car, and pay compensation will begin. The IC is given 15 days for this.

Payments

OSAGO is paid by providing repair work at specialized service stations. Previously, policyholders had the opportunity to choose between receiving monetary compensation or being referred for repairs. Now, all cases, with the exception of total loss of the car, are subject to repair work, which is paid by the insurance company.

A similar situation occurs with respect to compensation for personal injury. That is, the insurance company will pay for treatment, medications and other expenses necessary to restore the health of the injured car owner.

In the case of compulsory car insurance, the amount of payments is strictly limited. If the amount of damage exceeds the established limit, then the culprit must pay the remaining amount.

Thus, under the “automobile insurance” policyholders can count on compensation in the following amount::

• For damage caused to a vehicle - a maximum of 400,000 rubles.
• In case of harm to life or health - 500,000 rubles.

If the insurance company refuses to pay

We have already said earlier in what cases insurance is not paid in case of an accident, but the refusal of the insurance company is not always justified. Thus, unscrupulous insurers may refuse to pay the insured car owner due to the fact that the person at fault does not have a compulsory insurance policy.

Of course, if the initiator of the accident is not insured anywhere, then from whom should we demand compensation? But in this situation, this issue should be dealt with by the victim’s insurance company. Consequently, if a car owner injured in an accident contacts the company with a request for payment of compensation, then the insurer is obliged to collect compensation from the culprit in court, and not refuse its client.

If the opposite situation occurred, i.e. the victim is not insured, then the refusal is also illegal. In any case, the injured party was paid insurance in case of an accident, covering the costs of restoring the car or health.