The insurance company demands compensation for the difference under comprehensive insurance. What if after an accident the insurance company demands compensation for damage? Case from practice

When we sign the contract for our liability insurance, we immediately breathe a sigh of relief because we have an inner conviction that now it is not you, but your insurer, who will pay for everything that happens. But it was not there. Often, insurance companies simply refuse to carry out their legal actions and resort to sophisticated tricks and influence their client in an illegal legal way. How to avoid falling for the tricks of unscrupulous employees - read on.

There are regulated situations, as a result of which, after payment, the insurance company begins to demand compensation for its expenses. Moreover, this situation may arise despite the fact that you have a CASCO or MTPL policy. Insurers have two procedures for exercising their rights to reimbursement of funds: recourse and subrogation. You should immediately understand how they differ.

Requirements for reimbursement of expenses on behalf of the victim from the insurer arise in the cases set out in the law on compulsory insurance, this list is exhaustive, and such a requirement itself is called recourse.

This castling occurs in cases specified in the law, namely:

the life or health of the victim was harmed if there was intent on the part of the perpetrator;
the perpetrator caused harm while drunk;
The culprit had no rights to drive a vehicle at all;
the person at fault left the scene of the accident;
the person at fault is not named in the compulsory motor insurance policy for the vehicle that turned out to be the cause of the accident;
the insured event occurred when the insurance ceased or had not yet taken effect;
the insurance company did not provide the document that was drawn up at the scene of the accident;
if within 15 working days the damaged vehicle is not provided to the expert organization at the request of the insurer;
When concluding a contract electronically, the guilty party provided incomplete information, which significantly reduced the amount of the insurance premium.

Subrogation is also a change of parties in which the insurer delegates the rights of the insured to claim losses.

What to do if the insurance company demands compensation for damage

An unpleasant practice has developed, which is based on the dishonesty of insurance companies. They do not rush to immediately submit claims for compensation, but calmly wait for the expiration of the statute of limitations, within which they must file a claim in court. This period is 3 years from the date of the incident. This leisurely behavior minimizes the risk of challenging their claims, despite the fact that they may be illegal. The court does not believe unfounded statements, so you should keep all documents from accidents that happened to you for at least three years, which are laid down for the possibility of recovering funds from you through the court.

As soon as you get your hands on a document from the insurance company, the main topic of which is the requirement to compensate them for losses, you should not panic; it will not help you here. Follow the given points carefully.

Your actions should be as follows:

familiarize yourself with the document that came to you. You need to understand the claim or statement of claim in your hands. If there is a claim, you can conduct a dialogue with the insurance company. If there is a lawsuit, then the court will await you.

Start by starting from the date of the document; perhaps this war was won before it even began, thanks to the omission of the statute of limitations.

one should dive into the origins of memory and restore that ill-fated day and, accordingly, all the details that accompanied it. Here your documentary meticulousness and scrupulousness will play into your hands, thanks to which it is possible to refute the documents referred to by the insurer.

These actions will allow you to collect your thoughts and prepare a line of defense.

How is pre-trial proceedings conducted?

Pre-trial proceedings imply a claim procedure, which is mandatory before the case is sent to court. Submitting a claim to the guilty party starts the pre-trial process.

The deadline for responding to a claim may be specified in the insurance contract. If there are no such conditions, then the response period is 30 days from the date of receipt of the complaint. Accordingly, if the letter is registered, then from the moment you put your signature on the notification, if not registered, then the date on the stamp of your post office. Please note that if you do not receive a claim deliberately without going to the post office, then upon returning this letter back to the addressee, the insurer’s obligation to comply with the claim procedure will be fulfilled.

How to file a claim

The claim must meet the stated requirements for such a document. The content of the claim itself must convey the essence of the situation, contain facts and regulatory justifications for presenting the stated requirements. It is also necessary to prepare and provide documents as an appendix to the claim; these must be documents supporting the stated position. Such documents may be:

expert opinions;
inspection report;
document confirming payment, etc.

How to dispute your guilt

The main criterion for submitting a claim for damages to you is whether you were at fault in the insured event. That is, in order not to pay compensation, you must prove the absence of guilt - by challenging it.

You should build a line of proving your innocence based on the arguments presented by the insurance company; most often in their position you can already find a loophole to create your defense. In particular, if the parties were equally at fault, then damages will be distributed equally.

How to reduce damage

If your guilt is confirmed, all that remains is to dispute the amount of compensation. To do this, be sure to read the list of requirements. Be careful, because insurance companies do not hesitate to make incompetent calculations, for example, duplicating positions, highlight these positions and draw the court’s attention to this.

Also, the insurance company does not have the right to calculate current prices for parts and work; expert appraisers will come to your aid to dispute this point.

I want to forget about car accidents as quickly as possible, because this is far from the most pleasant event in the life of every driver. The very communication with the traffic police authorities, combined with the preparation of papers, can often turn out to be even more unpleasant than the fact of the accident itself. But is it worth completely relaxing when everything has supposedly been resolved? In many situations, the issue could be resolved on the spot, but even here there may be unpleasant surprises.

Suppose a little or even a decent amount of time has passed and then suddenly, like a bolt from the blue, a demand, usually for a fairly large sum, comes from an insurance company. The number of zeros in this requirement can make even the most persistent car enthusiasts feel sick. In this article, we will look at why this can happen, how to fight back against the insurance company, what other demands the insurer may make, and much more.

The insurance company tries to reimburse the funds that were paid to the victim in the accident, collecting them from the person responsible for the accident. If you have compulsory motor liability insurance at the time of the accident, your insurance company must cover the amount within the limit of another insurance company. If this limit is not enough, then they demand from you the remaining difference. In this case, you will already need to defend your position in court, so ignoring such questions is categorically not recommended and worth it.

There are two options when the insurance company can demand funds for damage caused to other participants in an accident, where you are the culprit:

Subrogation. When the victim has CASCO and the insurance company has already fully covered his repair costs.
Regression. When recovery from the culprit is carried out under compulsory motor liability insurance.

What is subrogation and what to do in this situation?

Subrogation is the right of the insurance company to claim the lost amount from the person at fault for the accident. If translated literally from Latin, the word itself means “replacement”, in fact this is exactly what happens. The right to demand compensation for damage passes to the insurer from the victim after he receives payments.

However, this is precisely the right of claim for the purpose of reimbursement to the insurance company, but not the obligation to pay the entire amount. In their claim, insurers often ask not just for large sums, but can also double some items in the acts in order to further increase the final figure.

Check the filing date of the claim. There is a chance that you can win the case even without the help of lawyers, and all thanks to the statute of limitations. The statute of limitations is three years from the date of the incident. And also thoroughly study all the documents attached to the application. In most cases, a list of work and spare parts will be attached there.
Try to remember all the details of the incident. Insurers often take advantage of the fact that, due to the long deadline, the culprit simply will not be able to get his bearings. Find the documents that were drawn up then, compare them with those that the insurance company provided for review. There are situations where it is possible to challenge who is at fault for the accident.
Be sure to review all the stated items from which the amount is formed. Check everything for which they may demand compensation from you, because insurance companies can easily count some spare parts twice or enter certain pennies into the payment request due to the statute of limitations. They have no right to demand any late fees.

In the list of spare parts, insurance companies indicate the cost of exclusively new spare parts. Moreover, at official dealer prices. By law, they must attach an assessment report taking into account the wear and tear of the spare parts. This data will help to significantly reduce the required amount.

Regression under compulsory motor liability insurance and for what reasons it may occur

Recourse is nothing more than the recovery from the culprit of the accident of the amount that was paid to other participants in the accident. This is usually because the culprit is:

Was under the influence of alcohol or drugs;
Did not have a driving license with him;
Fled from the scene of an accident;
Did not have a power of attorney with him to manage the fund;
Had an expired inspection ticket in hand if he is a truck driver;
It is not included in the MTPL policy that he has;
Deliberately provoked an emergency situation, by his own design leading to an accident and causing damage to the victims.

From the point of view of insurance law, recourse looks more like a punishment. That is, to give an example: after repairing the car and receiving payment for the parts, the owner finds out that the culprit intentionally caused an emergency. After this, he has the right to demand from the person at fault for the accident not only the cost of the parts, but also compensation for the funds spent on replacing or repairing them.

The basis for recourse is precisely the intentional illegal actions committed by the culprit of the accident. Random events and unintentional actions cannot be the cause. If you did not intentionally commit the listed points, then seek help from a lawyer, because you will need to prove the opposite and that there is no recourse.

How to behave in court?

First of all, you must defend your interests, you absolutely cannot let things take their course. It is also necessary that you be present at every court hearing; this must be done in person. Failure to appear may result in a default judgment, which means that the claims made by the insurance company will be fully satisfied. Even if they are unsubstantiated or contain false information. Be sure to take this factor into account.

Secondly, you need to collect information from the legal framework that applies to your situation. In this matter, you may need consultation or direct assistance. Considering that the participation of a good lawyer in the process can significantly reduce the final amount or even challenge it completely, his presence will only bring you good.

As an example, damage to the front left headlight may be indicated, although you drove the victim into the rear right one. Your task is to identify all the data provided by the insurance company in court that does not correspond to reality.

If the case:

Considered in your favor, then the costs of a lawyer (according to the Code of Civil Procedure of the Russian Federation) and his services will be reimbursed to you. This will be done proportionally or within reasonable limits.
Reviewed and the decision was not made in your favor, then this is not a reason to give up. On the contrary, it is worth appealing an illegally made decision in a higher court. This should be done if the decision was made due to circumstances beyond your control.

Do not hesitate to seek the help of qualified specialists, because in almost every case of this nature there are many pitfalls. Insurance companies will try to confuse you, mislead you and collect funds that you should not pay them. A good lawyer in this matter is already half the success.

Some car owners get lost. In their understanding, registration of a motor vehicle license excludes any liability, but this is a mistake. In certain cases, you have to return the money. It is worth familiarizing yourself with such situations in order to know what to do and comply with all established legal requirements.

The actions of insurers are legal, but this does not mean that you need to immediately agree to incredible amounts. It is much easier to use the services of an experienced lawyer. His phone number can be found above to get the help you need in difficult cases. Knowledge and practical skills will allow you to quickly study the documents and then make the best decision to reduce or refuse the payment.

In what cases does the insurance company require compensation for damage?

When the insurance company sends a claim, the driver should understand the reasons for this. They are significant enough to ensure that the documents are completed correctly. You shouldn’t be surprised that someone wants to get money from me; there are reasons when the other party, in accordance with the terms of the contract, has the right to do this.

Large payout amount;
Someone else's insurance company.

The insurance company is demanding my money back. The reasons for this should be considered in detail; the claim may be unlawful. Because of this, it is better to contact a lawyer who will clarify the details and tell you what to do and not break the law.

Large payout amount

Most often, the insurance company demands compensation for damages for an accident when the maximum payment limit is exceeded. In accordance with the legislation of the Russian Federation, it can reach 120 thousand rubles, and if the number of participants in the accident is more than 2, it is 160 thousand rubles. When, after calculations, the final amount turns out to be huge, the other party has the right to demand the difference.

The insurance company has sent a claim, so you will have to contact the company to clarify the reasons for the claim. This is usually due to the excess cost of repairing the victims’ cars, so the transfer will still have to be made. Such an action remains legal, and one cannot simply forget about it.

Someone else's insurance company

It is not necessary that your own insurance company demands compensation for the damage. The driver may receive a claim from a third-party company, which is also stipulated in the legislation of the Russian Federation. The submitted document must indicate the reasons for this. Usually they are CASCO, which guarantees transfers regardless of the details of the incident.

After an accident, the insurance company demands compensation for damages from funds transferred to a third party. Usually, organizations resolve such incidents among themselves, but this is not always possible. As a result, the car owner has to attend the trial, becoming a mandatory participant. Otherwise, you will definitely have to compensate for the damage caused to the other car.

Important! Typically, a claim from someone else's insurer occurs due to the closure of the organization that once insured the car.

When the insurance company demands compensation for damage under CASCO, the amounts will become significant. Drivers won't want to face these costs, so they'll need a lawyer to advise them on how to reassess the damages. Otherwise, the compensation for damage will have to be paid.

What to do in such a situation?

Order an independent examination;
Request recalculation of costs;
Check the insurance policies of the victims.

If the insurance company demands a refund from the culprit, it is not necessary to check the statute of limitations. It is 3 years, so this condition is probably not violated. Although it would be useful to order an examination and then demand a recalculation of the amounts. This action is provided for by law, so the lawyer will quickly prepare the necessary documents.

Victims' policies will be interesting. In major accidents, CASCO insurers often resort to deception when they demand money from the culprit in the absence of compelling reasons for this. Because of this, lawyers usually start from this stage in order to avoid mistakes.

The legality of the payment is checked immediately after receiving the claim. The insurance company demands compensation for damages for the accident; subrogation remains permitted, but this also occurs in cases of fraud.

How to refuse a funds transfer?

Statute of limitations;
Trial;
Making a claim.

A long statute of limitations usually makes it difficult to refute, but during a trial a person has the right to present his own evidence. Based on them, the driver has the opportunity to indicate the illegality of the claim, and with it the plaintiff’s demands. Such cases are rare, so one should not hope for a miracle.

Making a claim

Filing a claim must be discussed separately. After an accident, the insurance company demands compensation for damage, but this does not mean that it has fully prepared the package of documents correctly. Lying is a common practice, so experienced lawyers are sure to check.

What should it include?

Independent examination report;
Confirmation of guilt in an accident;
Confirmation of the pattern of subrogation.

Rosgosstrakh makes payments for road accidents quickly, but after them litigation often begins. You should carefully check the package of documents, since without it you can’t try to refute them in court. In practice, this is not easy to do, so it is better to trust a lawyer.

Disputing guilt

The drivers say the insurance company is demanding money from me, but I was the victim. There is obvious illegality in the organization’s actions, so you will have to use the services of a lawyer to prove your own innocence. There is no need to talk about forgery of documents or a special change in the scene of the incident. Usually the cause is incorrect interpretation of the recorded data.

How to achieve justice?

Conduct an examination of the scene of the incident;
Find witnesses to the accident.

Being innocent, you will not have to pay any money, but this fact will have to be confirmed in several different ways. During the trial, the accident is thoroughly analyzed, so any error is identified without much difficulty. It is better to protect your interests with mandatory participation, otherwise there is a chance of losing your money and being guilty of an accident.

Conduct an examination of the scene of the incident

If an ambiguous situation arises, you will have to turn to experts to re-evaluate the role of each driver. No matter how many years have passed, experts will quickly draw conclusions based on this. They will be completely true, so no one will challenge them.

An independent examination after an accident is mandatory, but the car owner can also order it without a court decision. In some cases, only it confirms a person’s innocence, because an error can creep into any protocol. It can influence the decision and subsequent money transfers. It is no coincidence that lawyers prefer additional checks when taking on a complex case.

Important! In Moscow, different agencies offer similar services, but their availability needs to be clarified separately.

Find witnesses to an accident

Finding witnesses to a traffic accident is usually difficult. People do not like to attend court proceedings, so it is almost impossible to attract them to the courtroom. It is impossible to do without witnesses, because their words are the best confirmation of the rightness of the victim, especially when the review takes place several years later.

Long term becomes the main problem. People have to remember events that happen in which they did not participate. After receiving official testimony, you can be confident in a positive decision. The person will confirm his innocence and will not have to hand over the money.

If the insurance company demands a refund of money under compulsory motor liability insurance from the culprit, the statute of limitations turns out to be significant for forwarding the claim. After receiving the documents, you should refer to a clear procedure that will save you from unnecessary troubles.

What is the best way to proceed?

Check the submitted papers.
Check the accuracy of the calculations with the help of an independent expert.
Check the submitted receipts to ensure the insurer's expenses.
Contact a professional lawyer.

Drivers do not consider the last point mandatory and are very mistaken. You cannot cope with the problem without the help of specialists. Only they have the knowledge to carry out a step-by-step verification, excluding fraud and incorrect data. Independent actions lead to numerous omissions, which result in mandatory payments.

Subrogation for an insurance company

Subrogation first appeared in 2011. Then it was adopted as a support for insurance companies, which in some cases suffer financial losses. The reasons may be different, but in any case they manage to restore their equity at the expense of car owners.

Subrogation is a legal form of claiming funds to compensate for one’s own losses. This may occur as a replenishment of money spent on conducting examinations, or on payments to victims. This may seem strange, but the legislative decision made is based on compelling circumstances.

At one time, subrogation was created solely because of frequent cases of fraud on the part of drivers. They prescribed “extra” damage and tried to pass off lies as reality. Now the situation has changed, but direct waste still remains. Everywhere, companies are closing due to bankruptcy, so additional audits and legal proceedings are carried out regularly.

Do you always have to agree to subrogation?

Subrogation can be waived, but this must be done solely on the basis of the legislation of the Russian Federation. You should not agree to illegal actions, as some small companies try to deceive their clients.

What lies have become widespread?

Erroneous calculations;
False examination results;
Data falsification;
Intimidation of clients.

Misconduct remains a common problem. Some companies try to restore financial balance at the expense of their clients through not the most pleasant actions. Moreover, random errors in calculations are rare, so we often have to talk about intended deception.

False examination results and simple falsification of the information provided are rude actions aimed at intimidated car owners. They don't try to figure it out, preferring to simply transfer a reasonable amount according to the claim. As a result, people give away their own money, agreeing with lies.

Intimidation of clients– a rough step used by beginners. There are proven actions based on judicial proceedings, so transfers should be made after receiving an official decision. If this does not happen, you should not pay even for an expired MTPL policy.

Important! Subrogation for an insurance company is provided for by the legislation of the Russian Federation, but it can be challenged in court.

Protection for the culprit of an accident is possible

Defending the person responsible for the accident seems pointless. The insurance company demands compensation for damages for the accident, so you have to strictly agree to pay. Such actions remain a common mistake, because each participant in an accident has their own rights. They should be used to achieve justice.

The defense of the culprit is always based on the results of independent examinations and testimony. It is focused on agreeing on all amounts with the other party, which allows you to significantly reduce the size of transfers. You just need to contact a lawyer; without his support you will not be able to cope with a difficult situation.

Within 3 years after a traffic accident, each insurance company has the right to make a claim against the car owner. He may not be her client, but after an accident, unexpected nuances appear every time. Their clarification during the trial allows us to obtain an official decision indicating how lawful the demand has been put forward.

Video: your insurance company sued you for a road accident, what should you do?

It is now very common for situations when, after some time, the insurance company issues an invoice for the nth amount of money to the person responsible for the accident. This is due to the fact that in 2014 amendments to Federal Law No. 223 “On compulsory civil liability insurance of vehicle owners” and certain legislative acts of the Russian Federation were approved.

Many drivers are interested in the question of how this happens, what they owe and what can be done in this situation. This is due to the rights of recourse and subrogation (Articles 1081 and 965 of the Civil Code of the Russian Federation), which will also be discussed in this article.

Is a partial refund possible?

The insurer pays damages according to the amount determined by the vehicle assessment expert.

The most common situations occur when an expert establishes a certain amount of damage, after which the victim states that. In these cases, the victim turns to the culprit of the incident with a demand to pay the resulting difference. The appeal occurs to the culprit, and not to the insurance company, precisely because it will be much easier to receive payment directly from a specific person than from the insurance company.

In what cases is compensation required?

There are several cases in which insurance companies require the culprit to pay for damages from an accident:

(Article 965 of the Civil Code of the Russian Federation) The insurance company demands that the culprit reimburse the funds that it paid to its client under CASCO. Thus, initially the insurance company pays money to its client, after which it recovers the same amount from the culprit of the accident;
By way of recourse (Article 1081 of the Civil Code of the Russian Federation) according to OSAGO, in accordance with Federal Law No. 223 Article 14. In other words, the insurer demands compensation for the damage that was paid to the victim under the compulsory insurance policy.

The reasons for applying recourse are special illegal actions of the perpetrator of the incident, which are discussed in detail in Article 14 of the Federal Law.

Namely:

The culprit of the accident specifically caused harm to the life or health of the victim;
The culprit caused harm while driving in a state of alcohol (or other) intoxication;
The culprit did not have the right to use the car (for example, there was no license);
The culprit fled the scene of the accident.

Pre-trial practice

Pre-trial proceedings are carried out, as a rule, with subrogation under CASCO. Initially, the insurance company does not sue the culprit, but sends him a claim, urging him to compensate for the damage of his own free will. It is worth noting that the culprit may receive letter of claim after 2 – 2.5 years after a traffic accident. However, here it is important to understand how justified the requested amount is and whether you need to defend your rights or is it better to agree on an installment plan. As a rule, insurance companies are cooperative when it comes to installment plans.

Procedure for filing a claim

It often happens that the insurance claim is a paper stating the fact of the accident, listing the articles of the law and issuing an invoice. This requirement is unfounded, since a number of documents must be attached to it, namely:

Official papers confirming the amount of damage caused: a report on the inspection of the vehicle by experts with a detailed description of the damage. Original photographs and an estimate of the amount of repairs, or a receipt for payment must also be attached;
Papers that confirm guilt: a certificate of a traffic accident, a conclusion about an administrative violation or a court conclusion;
Papers that confirm the right to subrogation: a copy of the vehicle’s passport, a photocopy of the policy and payment receipt, a copy of the insured person’s statement that an insured event has occurred.

Additional documents:

Only after the insurance company pays compensation to the victim does it have the right to recover funds from the culprit;
Therefore, the amount of the monetary claim against the perpetrator must be within the amount paid to the victim.

Note: the employer must pay for the culprit of a traffic accident who became such while fulfilling his official obligations.

Legal assistance

If after an accident the insurance company demands compensation for damage, you should. He can use several protection methods:

Reduce the amount of damage caused in an accident. If the insurance company reimburses the victim or its client, the at-fault party has the right to dispute the amount of the payment. The insurance company has the right to request compensation for damage only if it was correctly calculated;
Appeal the legality of the payment. In this situation, a general legal examination of the official papers is carried out, which became the basis for the insurance company to pay its client. If it is discovered that there are errors in the documents, or if it is determined that there are not enough documents, the payment is considered illegal. Thus, the insurance company is deprived of the right to demand compensation for damage from the culprit of the road accident;
Appeal the fault of the culprit of the accident. In some cases, during an examination, lawyers reveal that the person at fault in the traffic accident is not guilty, or is partially guilty. And here, even when a claim has been received from the insurance company stating that you are the culprit of the road accident, you have the right to try to prove your innocence in court.

Can insurers cheat?

There are frequent cases when, during subrogation, the insurance company demands compensation for damages in an amount greater than what was reimbursed to the client. For these purposes, they provide dubious calculations that can be easily challenged by a professional either before the trial or in court itself. This means that you should not immediately pay the invoice issued to you in your claim. When there is doubt about whether the repair amount is real, it is recommended to understand all the documents that contain information about the damage assessment, and also check the accuracy of all calculations. You can check your calculations by answering the questions below:

To what extent do car repair work correspond to the damage indicated in the traffic accident certificate? Perhaps you will find damage that is not justified?
Perhaps there are unnecessary parts on the list of parts to be replaced?
Perhaps the same spare parts were counted several times?
How realistic are the cost of parts and standard hours?

It happens when insurers falsify documents in the hope that the person responsible for the accident is incompetent. For example, the injured driver estimated the cost of repairing his car at a much higher amount than the insurance company paid him. And insurers, demanding compensation for losses, present the documents submitted by the victims to the culprit of the accident.