Recently, we had a chance to face cases of refusal to compensate for the loss of commodity value (hereinafter referred to as TCB), which our clients “caught” by writing an application for compensation to the well-known company Rosgosstrakh, the largest OSAGO insurer in Russia, by the way. So, let's take a look. what a respected insurer writes to us:

This type of payment is not provided for by the Rules. compulsory insurance civil liability of owners of vehicles approved by the Regulation of the Bank of Russia No. 431-P dated September 19, 2014. and is not included in the insurance premium. In addition, in accordance with the Rules for the organization and conduct of independent technical expertise vehicle when deciding whether to pay insurance compensation under the OSAGO agreement, the assessment of the loss of commodity value is not provided.

Eh, now, referring to the instructions of 2014, in 2018, to refuse payments .... The position of the Bank of Russia does not really provide for compensation for TCB, besides, it does not provide for many things yet, for example, the priority of in-kind compensation, but insurance companies prefer to forget about this.

Until 2014, the issue of TCB compensation was repeatedly raised and the position Supreme Court The Russian Federation has always been unambiguous: - TCB compensate! But fortunately for us, the PPVS of the Russian Federation No. 59 has recently been released, which agrees with the position of the 2014 regulation in the part “not included in the insurance payment” and says the following:

Clause 20. In the application for insurance compensation, the victim must also report other damage known to him at the time of filing the application, except for the costs of restoring damaged property that is subject to compensation (for example, the loss of commodity value, the costs of evacuating the vehicle from the road -transport accident, etc.).

Clause 37. Along with the cost of repairs and spare parts, the real damage resulting from a traffic accident also includes the loss of commodity value, which is a decrease in the value of the vehicle caused by premature deterioration of the commercial (external) appearance of the vehicle and its operational qualities as a result of a decrease in the strength and durability of individual parts, components and assemblies, joints and protective coatings due to a traffic accident and subsequent repairs.

The loss of commodity value is also subject to compensation if the insurance compensation is carried out under a compulsory insurance contract in the form of organizing and (or) paying for the restoration repair of a damaged vehicle at a service station with which the insurer has concluded a contract for the repair of a vehicle, in the manner prescribed by law limit of the sum insured.

Clause 50. When indemnifying for damage in the form of organizing and paying for the restoration repair of a damaged vehicle at a service station with which the insurer has concluded a contract for the repair of a vehicle, the insurer is not exempt from reimbursement of other expenses due to the occurrence insured event and necessary for the realization by the injured of the right to receive insurance compensation (for example, loss of commodity value, evacuation of the vehicle from the scene of a traffic accident, storage of a damaged vehicle, delivery of the victim to a medical institution, the cost of restoring a road sign, fencing, delivery costs repair materials to the scene of a traffic accident, etc.). The victim must submit an appropriate application to the insurer for reimbursement of other expenses.

It seems like nowhere is clearer, right? It is stipulated not only that the TCB is subject to compensation, but also the order in which this compensation occurs. Accordingly, if you receive any replies to your application for TCB compensation, feel free to order an independent assessment and demand compensation in a claim procedure, and in case of refusal, go to court. With a probability close to 100%, the court will take your side and oblige the insurer to compensate not only the TCB, but also legal costs. The main thing is that your car falls under the requirements for TCB compensation.

Well, now let's talk about the fact that the Unified Methodology (EM) does not provide for the calculation of TCF, this is true, but insurers forget that the EM does not describe the methodology for assessing damage to health, damage to buildings and does not describe anything at all except for refurbishment, maybe this means that nothing but repairs and compensation is not necessary? - No!

Let us all refer to the same PPVS RF No. 58, it says:

Clause 37. Under the compulsory insurance contract, the amount of insurance compensation payable to the victim in connection with damage to the vehicle, for insured events that occurred starting from October 17, 2014, is determined only in accordance with the Unified Methodology for Determining the Amount of Expenses for Restoration Repairs in Respect of the Damaged vehicle approved by the Regulation Central Bank Russian Federation dated September 19, 2014 No. 432-P (hereinafter referred to as the Methodology).

Expenses necessary for restoration repairs and payment for works related to such repairs, not provided for by the Methodology, are not included in the amount of insurance compensation (for example, the costs of applying (restoring) airbrush and other drawings to a damaged vehicle).

In case of damage to property that is not related to vehicles (in particular, real estate, gas station equipment, etc.), the amount of insurance compensation is determined on the basis of an assessment, estimate, etc.

Wow, it turns out that the EM does not provide for everything and what needs to be compensated, but what it does not provide is simply not included in the insurance compensation? Those. if these expenses are not included in the insurance compensation (it is said in the Rosgosstrakh's reply), it does not mean at all that they should not be reimbursed (and Rosgosstrakh forgot about this). Actually, all this was clear even from the 20th paragraph, which we cited above.

So, dear insurers, you should not try to make fools out of people with your clumsy replies and try to highlight only the parts of the text you need. And as always, we advise drivers to fight for their rights and not give up.

Thank you for your attention and as always ready to answer your questions by phone!

The list of grounds for refusing to pay is established in the Rules for Compulsory Insurance of Civil Liability of Vehicle Owners, approved. Decree of the Government of May 7, 2003 No. 263.

8. In accordance with these Rules, damage caused as a result of:
A) force majeure or intention of the victim;
b) the impact of a nuclear explosion, radiation or radioactive contamination;
c) military operations, as well as maneuvers or other military measures;
d) civil war, civil unrest or strikes.
8.1. Damage caused to property belonging to the person responsible for the damage caused shall not be compensated.
9. The onset of civil liability of vehicle owners due to:
a) causing harm when using a vehicle other than the one specified in the compulsory insurance contract;
b) causing moral damage or an obligation to compensate for lost profits arises;
c) causing harm when using vehicles during competitions, tests or training driving in specially designated areas;
d) environmental pollution;
e) causing harm as a result of the impact of the transported cargo, if the risk of such liability is subject to compulsory insurance in accordance with the law on the relevant type of compulsory insurance;
f) infliction of harm to the life or health of employees in the performance of their labor duties, if this harm is subject to compensation in accordance with the law on the relevant type of compulsory insurance or compulsory social insurance;
g) the emergence of an obligation to compensate the employer for losses caused by causing harm to the employee;
h) causing damage by the driver to the vehicle he drives and the trailer to it, the cargo carried in them, the equipment installed on them and other property;
i) causing damage when loading cargo onto a vehicle or unloading it;
j) expired.
k) damage or destruction of antique and other unique items, buildings and structures of historical and cultural significance, products made of precious metals and precious and semi-precious stones, cash, valuable papers, objects of religious worship, as well as works of science, literature and art, other objects of intellectual property;
l) the occurrence of the obligation of the vehicle owner to compensate for damage in excess of the amount of liability provided for by the Federal "Law" "On Compulsory Insurance of Civil Liability of Vehicle Owners" and "Chapter 59" of the Civil Code of the Russian Federation (if a higher amount of liability is established federal law or contract)
m) causing harm to the life, health and property of passengers during their transportation, if this harm is subject to compensation in accordance with the legislation of the Russian Federation on compulsory insurance of the carrier's civil liability for causing harm to the life, health and property of passengers.

You can file a lawsuit, but ... they hurried with the repair of the car.

SOLUTION

In the name of the Russian Federation

<данные изъяты>2010 Lyubertsy

Lyubertsy City Court of the Moscow Region composed of: the presiding judge Sorokina T.V., under the secretary Potylitsina V.M., having considered the case on the claim in open court<данные изъяты>to LLC "Rosgosstrakh" on the recovery of insurance compensation, the recovery of interest for the use of other people's funds, the recovery court costs,

INST A N O V&L:

The plaintiff filed a lawsuit for the recovery of insurance compensation, the recovery of interest for the use of other people's funds, the recovery of court costs against Rosgosstrakh LLC, motivating her claims by the fact that on DD.MM.YY between her and the defendant an insurance contract was concluded land transport. The subject of the insurance contract was a car belonging to her brand<данные изъяты>.
Indicated that the car was insured against the risk of theft (theft) + damage.
Sum insured has been sized<данные изъяты>.
The plaintiff pointed out that for the conclusion of the insurance contract she had to pay in installments an insurance premium in the amount of<данные изъяты>first payment of<данные изъяты>rub. was paid no later than DD.MM.YY DD.MM.YY, in the period from 00 o'clock to 11 o'clock, an unidentified person, having the intent to secretly steal someone else's property, stole a car of the brand through free access<данные изъяты>., cost<данные изъяты>., parked near the house<адрес>on st.<адрес>, which belongs to her. After that, she fled from the scene of the crime, causing her large material damage in the amount of the specified cost of the car.
She indicated that she had filed a corresponding application with law enforcement agencies on the fact of stealing a car, and on the basis of this application a criminal case was initiated.
Upon the occurrence of an insured event, she filed an application for the payment of insurance compensation to the insurance company Rosgosstrakh LLC, for which she was refused payment.
Rosgosstrakh LLC motivated its refusal to pay by the fact that the policyholder violated the conditions voluntary insurance"A" of vehicles developed in accordance with the rules No. 102 of voluntary insurance of vehicles dated 25.03.2003.
She indicated that the car was stolen along with the registration document left in it - a certificate of registration of the vehicle.
He considers that the condition of the insurance rules that the secret theft of a vehicle along with its registration documents and (or) a set of original keys is not an insured event is void as contrary to Art. 963, 964 of the Civil Code of the Russian Federation, which provide for cases of exemption of the insurer from the payment of the sum insured.
She asked to recover from Rosgosstrakh LLC in her favor the amount of insurance compensation in the amount<данные изъяты>.; collect the cost of paying the state duty in the amount of<данные изъяты>.; recover the costs of providing legal services in the amount of<данные изъяты>.; collect interest for the use of other people's funds in the amount<данные изъяты>.
The plaintiff did not appear at the hearing. Properly notified of the hearing.
The representative of the plaintiff Druzhinin C.G. at the hearing claims supported in full, asked them to satisfy.
The representative of LLC "Rosgosstrakh" did not recognize the claims at the court session and asked to dismiss the claim.
Having studied the materials of the case, having listened to the explanations of the parties, the court concludes that the claims are subject to partial satisfaction.
From the case file, it is seen that DD.MM.YY between the plaintiff and the defendant was concluded an insurance contract for land transport.
The subject of the insurance contract was a car belonging to her brand<данные изъяты>The car was insured against the risk of theft (theft) + damage. The sum insured was set at<данные изъяты>.
The court found that DD.MM.YY in the period from 00 o'clock to 11 o'clock, an unidentified person, having the intent to secretly steal someone else's property, stole a car of the brand through free access<данные изъяты>., cost<данные изъяты>parked near the house<адрес>on st.<адрес>, owned by the plaintiff, after which he fled from the scene of the crime, causing the plaintiff large material damage in the amount of the indicated value of the car. On this fact, a criminal case was initiated.
The car was stolen along with the registration document left in it - a vehicle registration certificate.
Rosgosstrakh LLC refused to pay insurance compensation to the plaintiff, motivating its refusal by the fact that the policyholder violated the conditions of voluntary insurance "A" of vehicles developed in accordance with rules No. 102 of voluntary insurance of vehicles dated 03/25/2003.
The parties do not deny the occurrence of the insured event DD.MM.YY, namely the fact that the plaintiff's car was stolen during the term of the voluntary insurance agreement concluded by the parties for a period from DD.MM.YY to DD.MM.YY for a total amount<данные изъяты>.
The first insurance premium in the amount<данные изъяты>was paid by the plaintiff before DD.MM.YY
The defendant's representative did not further deny that the plaintiff had submitted to the insurance company all Required documents, except for a vehicle registration certificate, a driver's license and a genuine insurance policy, a technical service coupon (ld No.).
In accordance with paragraph 1 of Article 963 of the Civil Code of the Russian Federation, the insurer is exempt from paying insurance compensation or the sum insured if the insured event occurred due to the intent of the insured, beneficiary or insured person, except for the cases provided for in paragraphs 2 and 3 of this article. The law may provide for cases of exemption of the insurer from the payment of insurance compensation under contracts property insurance in the event of an insured event due to gross negligence of the insured or the beneficiary.
By virtue of Art. 964 of the Civil Code of the Russian Federation, unless otherwise provided by law or an insurance contract, the insurer is exempt from paying insurance compensation and the sum insured when the insured event occurred as a result of the impact of a nuclear explosion, radiation or radioactive contamination; military operations, as well as maneuvers or other military measures; civil war, civil unrest of any kind, or strikes. Unless otherwise provided by the property insurance contract, the insurer shall be exempt from paying insurance compensation for losses incurred as a result of seizure, confiscation, requisition, arrest or destruction of the insured property by order of state bodies.
Thus, from the above norms of the Civil Code of the Russian Federation it follows that the possibility of exempting the insurer from the payment of insurance compensation upon the occurrence of an insured event can be provided exclusively by law, including when there has been gross negligence on the part of the insured or the beneficiary.
Taking into account the judicial practice of the Supreme Court of the Russian Federation on this issue, set out in particular in the ruling of the Supreme Court of the Russian Federation of July 29, 2008 No. for No. 51-В08-7, which states that since such a basis for exemption from payment of insurance compensation as a result of theft of a car as leaving registration documents in it (certificate of registration of a vehicle and / or vehicle passport) and / or ignition keys (which, in essence, is the gross negligence of the insured) is not provided for by the norms of the Civil Code of the Russian Federation or any other law, then the inclusion of such a condition in the insurance contract is void, contrary to Civil Code Russian Federation and, accordingly, should not be applied (ld No.), the court concluded that the insurer had no legal grounds for refusing to pay insurance compensation to the insured.
According to paragraph 67 of the Rules for the risk "Theft", the amount of insurance compensation is determined based on the sum insured specified in insurance policy, minus (in this order):
a) depreciation of the vehicle for the period of validity of the insurance contract. The insurer applies the following depreciation rates as a percentage of the sum insured: 1st year of operation - 20% (1.67% per month for each month). In this case, an incomplete month of the validity of the insurance contract is considered as a full month.
b) unconditional deductible established by the insurance contract;
c) previously made payments against the risk "Damage" (in case of aggregate insurance).
Thus, the amount of insurance compensation for this insured event will be<данные изъяты>(20% at the time of the insured event, the contract was valid for 12 months)<данные изъяты>.
Interest under Art. 395 of the Civil Code of the Russian Federation will be for the period from DD.MM.YY to DD.MM.YY for<данные изъяты>days will be:<данные изъяты>however, the plaintiff asked for interest in the amount<данные изъяты>. and this claim is subject to satisfaction in this volume.
The costs of providing legal assistance are subject to partial satisfaction in accordance with Art. 100 Code of Civil Procedure of the Russian Federation in the amount of 20,000 rubles, state duty expenses in the amount<данные изъяты>.
In the rest claims on the recovery of costs for the provision of legal assistance should be provided.

Based on the aforesaid and guided by Article. Art. 927-929, 963, 395 of the Civil Code of the Russian Federation, Art. Art. 194 - 198, 12, 56 Code of Civil Procedure of the Russian Federation, court

Claim<данные изъяты>partially satisfy.
Collect from Rosgosstrakh LLC in favor of<данные изъяты>total insurance benefit<данные изъяты>, interest for the use of other people's funds in the amount<данные изъяты>. for the period from DD.MM.YY to DD.MM.YY, the cost of paying the state duty in the amount<данные изъяты>and expenses for the provision of legal services in part in the amount<данные изъяты>, Total<данные изъяты>. <данные изъяты>
The rest of the claims for the recovery of expenses for the provision of legal assistance shall be denied.

The decision can be appealed to the Moscow Regional Court through the Lyubertsy City Court within 10 days.

Referee: Sorokina T.The.

If you have any questions or need professional help ininsurance disputes , disputes over damages orother , You can always call us or write your question to

Every vehicle owner must purchase OSAGO. Each driver should know not only how to correctly record an insured event, but what to do if, after an accident, a refusal to pay for OSAGO is received. We will consider in the article what are the legitimate reasons for refusing to pay insurance compensation and what to do if the insurance company refused to pay out under OSAGO in steps.

Legal reasons for refusal

There are various legal grounds for refusing to pay under OSAGO. Each victim should study them carefully. As a rule, all the nuances listed below are spelled out in the rules that are issued to each client when applying for insurance.

Legitimate reasons:

Expired policy	Very often, motorists remember the extension of the OSAGO contract only when they are stopped by the traffic police, or an accident occurs. If the contract has expired, the insurance company may refuse to transfer money to the victim on a legal basis. In this case, the injured party can receive money for repair work only from the culprit.
The driver is not insured	Since the liability of the driver is insured under the contract, then financial institution will not send money to the victim if the accident was caused by an uninsured driver. Unfortunately, some drivers trust their car to third parties in the hope that nothing will happen.
Wrongly recorded case	Some drivers have heard about the European Protocol, but they do not know at all how to properly record an insured event. Very often, drivers are refused because they do not call the traffic police and apply after 5 days to the office of the insurer.

At the same time, it is important to understand that insurance organization must submit the waiver in writing. It must indicate:

• full name of the company;
• the name of the leader;
• case number;
• vehicle characteristics;
• reason.

Wrong grounds for refusal

Unfortunately, many drivers are faced with a situation where the insurance organization has refused to pay out OSAGO illegally. In this case, you should not give up and pay for repairs at the expense of your own savings. You should always get the insurer to pay the money. Our consultants on the site can help you get a payment, who will tell you what needs to be done.

In practice, an unlawful denial of an insurance payment for OSAGO is received if:

The driver is drunk	Very often, insurance companies do not want to transfer funds due to the fact that the driver was under the influence of alcohol or drugs. In fact, according to the rules, the insurance company is obliged to transfer funds to the injured party.
The guilty party escaped	If the guilty party was recorded, but fled the scene of an accident, the insurer is also obliged to pay funds to the victim. In practice, organizations often do not transfer funds voluntarily.
The company's license for OSAGO insurance has been revoked	It is important to know that an organization whose license for OSAGO insurance has been revoked is obliged to make payments under all concluded contracts and be liable for several years. Of course, there are exceptions when the insurer leaves the market completely. financial services. In this case, an assignee is appointed, to whom all contracts under which she will be liable, as a result of the occurrence of an insured event, are transferred.

These are the most common unlawful reasons for refusing to pay out OSAGO to injured motorists.

What to do step by step if the insurance company refused to pay

If the insurance company does not want to make a payment under OSAGO, then each victim should know what needs to be done. We offer step by step procedure for those who illegally received a negative decision in the payment of compensation.

Walkthrough:

Getting rejected	The insurance company must provide a written refusal, in which the reason will be clearly stated. It is good if the insurer not only indicates the reason in writing, but also writes down a clause of the rules, according to which it will not transfer money for refurbishment.
Learning the rules	You need to make sure that the insurance company really refused illegally. To do this, you should carefully study the rules and the law. If necessary, you can get advice from an experienced expert on our website, which works around the clock.
Drafting a pre-trial claim	If, after studying the rights, it is clear that the financial institution is refusing to pay under OSAGO illegally, then a pre-trial claim should be drawn up. The document must specify the amount of damage received, a paragraph of the rules according to which it is necessary to make a transfer of money and details of a personal account. It is also necessary to indicate the terms during which the insurer is obliged to either pay out the funds or provide a second refusal.
Going to court	Only upon receipt of a second refusal can a claim be made and go to court. You can go to court either yourself or entrust it to an experienced lawyer. In case of victory, the services of a lawyer will be paid by the insurance company. In practice, the court always takes the side of the victim if the refusal is granted illegally.
Getting compensation	After the issuance judgment you will receive a writ of execution in your hands, with which you must contact the bank where the insurer has an account and write an application for funds to repair the car. Also with writ of execution you can turn to bailiffs, but this is used extremely rarely.

The entire procedure for obtaining compensation, as a rule, lasts no more than 14 working days. If necessary, you can always get advice from a specialist on our website, who will tell you your rights and how to properly file a claim in court. Sign up for a free consultation in a special form.

The insurer was not notified in time

The rules clearly state that the guilty party must notify the insurer of the occurrence of an insured event within 5 working days (according to the European protocol). If the accident was recorded by the traffic police, then you can apply on any day convenient for you, since the deadline limitation period in this case is 3 years.

The company is not always obliged to refuse the victim if he applied after 5 days for payment, and there is no official confirmation from the traffic police. In such a situation, the insurer must:

• request a form of OSAGO agreement;
• europrotocol;
• a statement stating the reason according to which the guilty party could not apply in a timely manner.

Only after accepting the application, the insurance company should announce the decision. If the case is recognized as insurance, send the victim to an independent expert to assess the damage. In case of refusal, prepare official document and send it to the client by registered mail or hand it over personally against signature.

Consider an example where the victim was unable to contact the office in a timely manner. For example, Ivan parked his car and went on a business trip for 10 days. At this time, Ilya was parking in the parking lot and hit Ivan's car. Since Ivan is on a business trip, Ilya left all his coordinates to the watchman and additionally photographed the scene of the accident. Upon his return, Ivan received information, contacted Ilya and immediately turned to the office for payment. In such a situation, the company has no right to refuse the client.

The culprit fled the scene of the accident

But what if the party responsible for the accident fled? In this case, the only way out is to look for the culprit. If it is found, then the insurance company will be obliged to pay compensation. Until this happens, the insurer cannot transfer funds to the victim for refurbishment.

The thing is that within the framework of a mandatory contract, the liability of a particular driver is insured. When making a payment, the insurers recover the funds spent from the company where the liability of the perpetrator was insured. It turns out that if there is no guilty person, then there is no one to ask for money back. In this case, the companies do not agree to make payments from their own budget and refuse legally.

The culprit has no insurance

Very often, drivers forget to purchase or renew a compulsory insurance form. In the event of an accident, all costs, in this case, will be assigned to the culprit.

In this case, the guilty party may:

• voluntarily transfer money;
• after the court decision.

In the first case, the victim must be offered to the perpetrator to pay for the assessment of an independent expert and transfer the amount of the loss to a personal account within the agreed period.

In the second case, you should prepare a legal claim, attach an assessment of an independent expert and an official decision from the traffic police. Since the evaluation is done by own funds, then receipts of payment should be attached, since all expenses must be compensated by the person responsible for the accident. All documents are submitted to the court, after which a decision is made, and the terms are discussed during which the guilty party is obliged to transfer money to the injured driver.

In practice, it is through the court that the victims seek money to pay for the restoration of their vehicle.

The culprit has a fake policy

Unfortunately, fake OSAGO policies are not uncommon. In practice, payments under OSAGO in Rosgosstrakh are reduced, since every fifth driver bought a fake policy. This is the most unpleasant situation for the perpetrator, since all damages can be attributed to him.

In this case, the perpetrator must:

• write an application to the insurance company and indicate how the contract form was drawn up;
• duplicate the application to the RAMI or the Central Bank;
• file a claim with the court and wait for the outcome of the investigation.

Not to say that often, but sometimes the court takes the side of the guilty and obliges the insurer to make a payment. As a rule, this happens if the policy was sold through an official partner, broker or agent. However, many drivers refuse to submit an application, because they are sure that they will receive a negative decision on OSAGO in court.

Refusal after trace examination

First of all, it is worth understanding what a trace examination is for OSAGO. Trasological examination is a procedural action, as a result of which an authorized employee conducts a study of material elements in order to identify evidence of an insured event.

An insurance company can order such an examination. In case of refusal, it is necessary to request the results of the examination, write a claim and go to court. Very often in court it turns out that the examination was made with violations. In this case, the injured party receives not only cash for repairs, but also payment for moral compensation.

Refusal to apply for the European Protocol

It is worth noting that in most cases, insurers refuse precisely because the victim applies according to an incorrectly executed European protocol. The company may refuse:

• if there are no photos from the scene of the accident;
• the form of the Europrotocol is filled out incorrectly;
• the form contains inaccurate data (errors);
• on the correction sheet.

The easiest way to fix this is to ask the culprit to redo the document so that the company can make transfers. But what to do if the payment was refused and the perpetrator cannot make changes to the document? In this case, it remains only to defend their rights in court. However, arbitrage practice in this case, it does not always take the side of the victim.

Summing up, it should be noted that any insured event should be recorded correctly. If in doubt, it is always worth calling the traffic police and fixing the accident officially. Also, experienced insurers are advised to carefully study the company in which you plan to issue OSAGO. Before applying, you should carefully study the rating of insurance companies for refusing payments and only after that make a decision.

If you have been denied by an insurance company, we invite you to leave a review and tell other readers about your experience. We will also be grateful to you if you tell us how you sought justice and defended your rights.

And of course, the services of your consultant will always help you, who is ready to help around the clock on any issue related to insurance.

We also offer you to watch a video on the topic, which describes the most popular reasons for refusal under a binding contract.

It is also very important to know in order to achieve justice from the insurance in court.