home Deposits Legal advice: sample claim against RSA in case of refusal to pay compensation under compulsory motor insurance. How to receive compensation payment from RSA under compulsory motor insurance? Application request for compensation payment sample filling

Legal advice: sample claim against RSA in case of refusal to pay compensation under compulsory motor insurance. How to receive compensation payment from RSA under compulsory motor insurance? Application request for compensation payment sample filling

Compensation payment is a payment that is made in accordance with Art. Art. 18, 19, 20 Federal Law No. 40-FZ "On compulsory insurance civil liability owners Vehicle"in cases where insurance payment under compulsory insurance cannot be made. Compensation payments are made by the professional association of insurers - the Russian Union of Auto Insurers (hereinafter referred to as RSA). RSA has adopted its own local act - the rules for the implementation by the Russian Union of Auto Insurers of compensation payments to victims, including the priority satisfaction of these requirements in the event of insufficient funds of the Russian Union of Auto Insurers, and the procedure for distributing responsibility among its members for the obligations of the Russian Union of Auto Insurers related to the implementation of compensation payments, approved by the Presidium of the Russian Union of Insurers on June 8, 2004 (as amended on June 26, 2008).

Procedure for receiving compensation payment:

In order to receive compensation payment, you must:

contact the RSA or one of the authorized insurance companies that is a full member of the RSA and collects documents for the RSA on compensation payments;
fill out an application in the prescribed form and attach the following necessary documents.

Documents required to receive compensation payment:

1. Application for compensation payment (Application form for compensation payment).

2. Documents allowing to identify a traffic accident as an insured event (originals or copies of documents certified by the State Traffic Safety Inspectorate):

2.1 Certificate of a traffic accident issued by the State Traffic Safety Inspectorate - form No. 154 (or No. 748, issued before 02/01/2012).

2.2 Copies of the protocol on an administrative offense, a resolution on a case on an administrative offense or a ruling on the refusal to initiate a case on an administrative offense must be presented to the victim in cases where the preparation of such documents is provided for by the legislation of the Russian Federation.

3. Notification of a road accident (if the application is under the European Protocol, the notification of an accident must be filled out COMPLETELY by both participants in the accident).

4. A copy of the policy of the person responsible for the accident (if available).

5. Conclusion of an independent technical examination (drawn up in accordance with the current legislation: vehicle inspection report, damage calculation, photo tables, expert documents), confirming the amount of compensation required by the victim (original or copy, certified by a notary or the expert organization that conducted the examination).

5.1. To reimburse payment for the services of an independent expert, services for evacuation and storage of damaged property, original documents (bank payment, cash receipt or numbered receipt) confirming payment for these services are provided.

6.Other documents (copies):

6.1 For individuals:

1. Passport of the injured person (the owner of the vehicle, or the person receiving compensation payment under a notarized power of attorney from the owner of the vehicle) (first page and registration).

In the event that the applicant is not the owner of the vehicle - the representative’s passport and power of attorney for the right to represent the owner’s interests in the RSA / for the right to submit documents / with the right to receive compensation payment.

2. Driver's license of the person driving the victim's vehicle.

3. Passport technical means(copies of both sides).

4. Certificate of registration of the damaged vehicle (copies of both sides).

5. Documents of ownership of the damaged property (in case of damage NOT to a vehicle). Depending on the situation and the damaged item, additional documents may be requested.

6. Recipient’s current account and bank details for transferring funds (compensation payment);

The grounds for receiving compensation payments are:

1. Application of bankruptcy proceedings to the insurance company.

2. Revocation of the insurance company’s license to carry out insurance activities.

3. Unknown person responsible for the harm caused to the victim (only in case of harm to the life or health of the victim/victims).

4. Absence of a compulsory motor liability insurance agreement with the harm-cauter due to failure to fulfill the obligation to insure the civil liability of vehicle owners (only in case of harm to the life or health of the victim/victims).

The basis for receiving a compensation payment is, among other things, the conclusion of an independent examination to determine the costs required to repair the car.

Amount of compensation payments:

Damage caused to the life or health of the victim - no more than 160 thousand rubles.
Damage caused to the property of one victim - No more than 120 thousand rubles.
Damage caused to the property of several victims - No more than 160 thousand rubles.

The company "Volan M" LLC cooperates with insurance companies that collect documents for the Russian Union of Auto Insurers (RUA) on compensation payments.

You can come to one of our offices located on the territory of the insurance company, collecting documents for the RCA, where we will help you in conducting an independent examination and collecting a full set of documents to receive compensation payment, including preparing an independent examination report on the day of your application (subject to presentation of the damaged property to the expert).

All details can be found by phone.

Despite the guaranteed procedure for payments to victims under compulsory motor liability insurance, in some cases not every victim of an accident has the right to count on receiving compensation from the insurance company. For such cases, the legislation provides for an additional source of payments - compensation payments from the RSA.

In this article, we will look at what RSA compensation payments are under compulsory motor liability insurance, in what cases and to whom they may be due, what is the procedure for the insured to apply and what documents need to be collected for this, within what time frame compensation payments are made and in what cases RSA may refuse them.

Grounds for receiving RSA payments

The initially effective version of Federal Law No. 40 “On Compulsory Motor Liability Liability Liability Insurance” regulated the obligation of each vehicle owner to insure their motor third party liability under a motor third party liability insurance contract, which allowed victims of road accidents to count on receiving payments from the insurance company. However, in practice, situations arose when citizens, for objective reasons, could not count on the standard procedure for compensation for damage - for example, when an insurance company’s license was revoked, or when it was impossible to identify the culprit of an accident.

For such non-standard situations, changes were made to Federal Law No. 40 that made it possible to receive compensation payments not from the insurance company, but from the Russian Union of Auto Insurers (RUA). These types of payments are designed to receive compensation in the following cases:

compensation for harm caused to the life and health of citizens;
compensation for property damage.

The main basis for receiving RCA compensation is not the insurance company’s refusal to pay, but the objective impossibility of paying insurance compensation in the following cases:

termination of the insurance company's activities as a result of bankruptcy or revocation of a permit (license);
inability to identify the culprit of the accident;
the person at fault for the accident does not have a valid MTPL policy.

The listed grounds fully apply to cases where harm to life or health is caused as a result of an accident. For situations where the culprit suffered property damage in a traffic accident, the basis for payments will only be the termination of the insurance company's activities.

The procedure for assigning compensation payments

The RSA Compensation Fund provides priority compensation for harm caused to the life and health of citizens. The following payments fall into this category:

payment of expenses for medical treatment and rehabilitation after treatment;
payment of expenses associated with the onset of disability;
payment of income lost as a result of harm caused to life and health.

Note! Insured events for receiving compensation payments are considered to be standard circumstances of an accident that resulted in damage to the property and health (life) of the victim. However, an additional factor influencing the order of compensation will be one of the three grounds indicated above.

The following are currently in effect maximum dimensions compensation:

for compensation for harm to health - no more than 500,000 rubles;
for compensation of property damage – no more than 400,000 rubles.

The actual amount of payments is influenced by many factors: actual expenses incurred by the victims, treatment costs, etc. Therefore, the payment limit established by law is not always paid in full.

Procedure for completing documents to receive compensation

The procedure for processing the payment differs from the standard rules for receiving payments under compulsory motor liability insurance. The first step in order for RSA to have grounds to pay compensation is to record the fact of an accident and collect documents according to the rules provided for by the Law “On Compulsory Motor Liability Insurance”.

After collecting road accident documents and contacting your insurance company, it is established that there is one of the grounds that does not allow you to receive insurance compensation in the usual manner. Only if it is impossible to receive payment from the insurance company, the victim has the right to file an appeal to receive compensation from the RSA.

You can contact RSA in one of the following ways:

directly by contacting the territorial representative office of the RSA;
by contacting any insurance company that is a member of the Union of Auto Insurers;
by calling the RSA phone number listed on its official website.

Submission of an application to the RSA must be made in writing - for this, the victim must fill out an application according to a standard sample. This sample can be obtained directly at the place of application to the RSA or downloaded from the link.

The sample application must be accompanied by a package of documents, the composition of which may vary depending on the circumstances of the accident and its consequences. The standard list of documents includes:

a completed sample application for payment of compensation to RSA;
documents confirming the fact of a traffic accident (certificate of road accident);
materials of the administrative case about the offense;
information about the compulsory motor liability insurance policy of the person responsible for the accident;
a report from an independent appraiser on the nature of the damage and the amount of damage;
driver's license, as well as identification documents of the applicant;
documents of vehicles involved in the accident.

Note! In case of termination of the activities of the insurance company and the impossibility of receiving the amount recovered from it, this package of documents includes the original of the judicial act, the original of the writ of execution, as well as the original of the bailiff’s resolution on the termination of enforcement proceedings due to the liquidation of the insurer.

The period for consideration of the application is regulated by Art. 19 FZ-40 and is no more than 20 calendar days from the moment RSA employees receive the full package of documents. After this period of time, the Union of Auto Insurers is obliged to pay the amount of compensation or issue a reasoned refusal of insurance compensation.

Grounds for refusal to pay compensation to RSA

To receive compensation from the RSA compensation fund, similar rules for considering the victim’s application are provided as for ordinary insurance companies. Accordingly, similar grounds apply for RSA to refuse compensation payment.

In practice, the most common grounds for refusal to pay insurance compensation are:

lack of information about the policy of the guilty party in the register of MTPL contracts of the liquidated insurance company;
absence of the culprit of the accident in the list of persons allowed to drive a vehicle in the compulsory motor liability insurance policy;
termination of the MTPL agreement with the insurance company at the time of its liquidation.

As a rule, such grounds for refusal are caused by formal reasons, and during a judicial challenge, the victim can exercise his right to receive compensation. In addition, failure by the Union of Auto Insurers to provide a reasoned refusal to pay may be grounds for subsequent collection of a penalty.

Conclusion

In some cases, compensation payments after an accident are carried out by RSA. To receive compensation for the damage received, the victim must contact the Union of Auto Insurers with an application and package necessary documents. In case of refusal of compensation, the victim has the right to go to court.

Compensation from RSA often becomes a real salvation for drivers injured in an accident.

How to get such compensation and what is needed for this? You will find answers to your questions in this article.

In Russia, many road accidents occur every day. In order to protect drivers as much as possible from losses and allow them to more easily endure accidents, Federal Law No. 40 was adopted in 2002.

According to this law, RSA undertakes to issue compensation to active clients of insurance companies. The client may receive PCA compensation instead of payment under the insurance contract if the latter is not possible.

In what cases can you receive compensation from RSA?
What is required from the victim for this?
what is the size of such payments?
what documents will be needed to obtain

You can receive payments from the union of auto insurers only in a situation where it is impossible to receive them under the insurance contract.

There are only 4 cases for receiving RSA compensation:

Insurance Company, serving the culprit of the accident, became bankrupt
the insurance company has lost its license to operate
the culprit of the accident left the scene of the accident and is therefore unknown
The person at fault for the accident does not have a valid civil liability insurance policy

Warning!

In other cases, you should not even try to get compensation from RSA. This is not provided by law

Compensation payments have little in common with insurance. Compensation can only be obtained for damage to life, health or real property of victims in an accident.

The following are subject to compensation from the union of motor insurers:

income lost by the victim, which he could have received if he had not been involved in the accident
expenses of the victim for treatment, special food, medicines
expenses for special services, services of sanatoriums and resorts
expenses for prosthetics and the purchase of special vehicles due to injury
property claims of the victim
the cost of training for another profession if, due to the nature of the injury, the victim is not able to perform the previous job

Damage must be strictly documented, otherwise PCA compensation will not be possible

Who is eligible to receive compensation?

The following categories of people can receive compensation from RSA:

citizens of Russia
stateless people who permanently live in the Russian Federation
foreigners who permanently live in the Russian Federation
foreigners who temporarily live in the Russian Federation

Regarding foreigners who temporarily reside in Russia, there is special requirements. They can receive a compensation payment if the legislation of their state gives the same opportunity to Russian citizens.

Info

If in the state of which the victim is a citizen, Russians cannot receive compensation, then the victim will not receive it either

To receive compensation payment, you need to contact any of the authorities:

directly RSA
RSA regional offices
RSA information center
any insurance company that is a member of RSA

Procedure for receiving payment:

Contact the authorized body
We fill out the application according to the established form, attaching all the required documents to it
We give the application to RSA employees and wait for them to file a claim for compensation

What documents need to be attached to the application?

The list of required papers depends on the situation.

The following documents are required:

application corresponding to the sample
documents that indicate the occurrence insured event(there may be copies certified by the traffic police)
certificate of form No. 154 about the fact of an accident, issued by traffic police officers
copies of the protocol on an accident (administrative offence), as well as the resolution on the case of an accident or on the refusal to open a case on an accident (if these documents were drawn up at all during a traffic accident)
accident notification
a copy of the MTPL policy of the person at fault for the accident (if he has a policy)
conclusion on an independent examination assessing technical damage to the machine
original receipt or check for payment for the services of an independent expert

Documents regarding the identity of the victim are also needed:

a copy of significant pages of the passport of the car owner or a person who is notarized to receive compensation in his place
a copy of the driver's license of the person driving the car at the time of the accident
notarized power of attorney, if the recipient of compensation is another person
copies of both sides of the registration certificate of the car involved in the accident
copies of both sides of the registration certificate
documents on ownership of damaged property, if something else was damaged in the accident (other than the car)
details to which the payment will be transferred;
original (or a copy certified by court staff) of the court decision on insurance payment in favor of the victim
original writ of execution or resolution to terminate proceedings in the case

The list of documents is very large, so be sure to ask the RSA employees to whom you will give these documents if you forgot to attach anything

If you just give the documents, the RSA will not immediately check their availability, and you will lose several days.

The amount of the RSA payment depends on many factors:

the victim's earnings
presence or absence of additional costs
degree of harm to the life or health of the victim
degree of damage to property (not the car) and other factors

The maximum amount of compensation depends on when exactly the person at fault for the accident entered into the MTPL insurance contract:

the contract was concluded after April 1, 2015, and the victim suffered harm to life or health - 500,000 rubles
the contract was concluded before April 1, 2015, and the victim suffered harm to life or health - 160,000 rubles
the contract was concluded after October 1, 2014, and the victim suffered damage to property - 400,000 rubles
the contract was concluded before October 1, 2014, and the victim suffered damage to property - 120,000 rubles

Attention!

If there are several victims, the amount may be increased. Ask the RSA authorities about this

Terms of compensation payment

The deadlines are established by clause 13 of the RSA rules and are 5 working days from the decision on payment. The date of execution of this payment is fixed on the day the compensation amount is written off from the current account of the union of auto insurers.

In _________________ district court of _____________
Address: _____________________

Plaintiff: Sidorov I.P.
Address: _____________________

Defendant: Russian Union of Auto Insurers
Address: _____________________

The price of the claim is XXXX rubles.

STATEMENT OF CLAIM

“_date_” _month_ 2ХХХ there was a traffic accident in which a car of the brand “Brand Name”, state registration number _______, belonging to me, I.P. Sidorov, and a car of the brand “Brand Name”, state registration number _______ were involved. , driven by driver Petrov S.I.

The accident happened due to the actions of Petrov S.I., which was established by the traffic police inspector, the police captain of the (territorial) Department of Internal Affairs/OVD Surname I.O. (or the judge of the (territorial) court (district, city)).

The civil liability of I. S. Petrova is insured by policy No. XXX dated “_date_” _month_ 2ХХХ in CJSC “Name of the culprit’s insurance company”, whose license was revoked “_date_” _month_ 2ХХХ.

As a result of the accident, my car suffered mechanical damage. The amount of damage is XXXX rubles XX kopecks. In addition, I paid XXXX rubles XX kopecks. for an expert opinion on the cost of repairs.

In accordance with Federal Law No. 40-FZ "On compulsory civil liability insurance of vehicle owners" dated 04/25/2002 and Decree of the Government of the Russian Federation No. 263 dated 05/07/2003 "Rules for compulsory civil liability insurance of vehicle owners", having provided all the documents required by law, I applied to the Russian Union of Auto Insurers for compensation.

The defendant, having violated the requirements of paragraph 1 of Article 18 of Federal Law No. 40-FZ of April 25, 2002 “On compulsory insurance of civil liability of vehicle owners,” refused to pay me compensation, citing the fact that the name of the culprit of the accident was not included in the compulsory motor liability insurance policy ( *** indicate the reason for refusal put forward by RSA).

However, the law “On Compulsory Motor Liability Insurance” does not contain any mention of such a basis for refusing payment. According to clause 5 of Article 14 of the Law “On Compulsory Motor Liability Insurance”, if the person who caused the harm is not included in the compulsory motor liability insurance agreement as authorized to drive a vehicle (when concluding a compulsory motor liability insurance contract with the condition that the vehicle is used only by persons specified in this contract), the insurer contacts the causer harm, the right of recourse arises (link to the corresponding paragraph of the law “On Compulsory Motor Liability Insurance”).

By virtue of Article 19 of the Law “On Compulsory Motor Liability Insurance”, similar rules apply to relations related to compensation payments between the professional association of insurers and the victim, established by law RF for relations between the insurer under a compulsory insurance contract and the beneficiary.

Based on the above, the Russian Union of Auto Insurers, in accordance with clause 70 of the Rules, must pay me a penalty in the amount of one seventy-fifth of the refinancing rate Central Bank of the Russian Federation, in force on the day when the insurer became obligated to pay me compensation, from the established amount of payment according to the type of compensation for harm to each victim.

In this case, the damage was caused only to property, therefore the amount of compensation is XXX thousand rubles, and the amount of the penalty as of the day the claim was filed is XXX rubles. XX kop.

Based on the above, I request:

To compensate for damages, recover from the Defendant in my favor XXXX rubles XX kopecks.
To recover from the Defendant the amount of state duty I paid in the amount of XXX rubles, XX kopecks.
To collect from the Defendant XXX rubles, XXX kopecks. as compensation for legal expenses incurred by me.
To collect from the Defendant in my favor a penalty in the amount of XXXX rubles XX kopecks.

Attached documents:

A copy of the statement of claim.
Receipt for payment of state duty No. ХХХ dated "_date_" _month_ 2ХХХ.
A copy of the traffic police resolution on an administrative offense (a copy of the court decision on the guilt of S.I. Petrov).
A copy of the report of JSC “Independent Expert”;

_p o d p i s b_ /Sidorov I.P./

In 2002, the Federal Law “On compulsory civil liability insurance of vehicle owners” (the so-called “motor citizen”) was adopted. Since then, all persons who own a car are required to insure it in the manner prescribed by law.

You can apply for an MTPL policy at any Russian insurance company. Moreover, as of 2016, 103 insurers, which account for about 90% of all auto insurance transactions carried out in Russia, are members of RSA - the Russian Union of Auto Insurers.

What is the role of RSA?

What is RSA?

To simplify the activities of insurers, as well as ensure the most effective interaction not only with each other, but also with policyholders, the Russian Union of Auto Insurers (RUA) was created on August 8, 2002, a non-profit organization whose activities are regulated by the provisions of the above Federal Law.

RCA solves the problem of bankrupt insurance companies

In the event that for some reason, upon the occurrence of an insured event, the insurance company cannot fulfill its obligations to the policyholder, the resulting debt will be repaid by RSA. Representative offices of the organization operate in six federal districts of Russia.

What are compensation payments?

Compensation payments are cash, transferred by RSA to the policyholder injured as a result of an accident, in the event that the insurance company cannot independently make the specified payments in full.

The payment may be assigned for the purpose of spending funds for the following needs:

payment for treatment, prosthetics, medicines, food;
sanatorium-resort treatment and recovery;
services of nurses and other persons professionally involved in caring for the sick;
professional retraining, the need for which arose due to the inability of the injured person to perform his previous job duties;
compensation for potential income that the victim could have received if he had not lost his ability to work as a result of the accident;
compensation for damage caused to both the car and the property it transports.

Grounds for assigning compensation payments to RSA

In accordance with the provisions of Art. 18 of the law on compulsory motor liability insurance, compensation payments for damages caused to the life and health of the injured party are assigned when the following situations arise:

if bankruptcy proceedings are underway against the insurance company in which the person responsible for the accident purchased the MTPL policy;
if the said company’s license to carry out insurance activities has been revoked;
if it was not possible to identify the person who caused the accident;
if the participant in the accident, as a result of whose actions the damage was caused, did not conclude an insurance contract.

Compensation payments to compensate for damage caused to property belonging to the injured party are awarded only in the first two cases from the above list.

Procedure for receiving compensation payments

In order to exercise their right to receive funds, a person injured in an accident must complete the following sequence of actions:

Submit an application for payment by filling out the prescribed form.
Prepare a package of documents, which includes:

a) certificate of an accident in form No. 154, issued by the traffic police;

b) a copy of the protocol/resolution on the administrative offense;

c) notification of an accident (or a European protocol filled out by both parties to the accident);

d) photocopy insurance policy MTPL received by the person who caused the accident (if any);

e) the conclusion of a technical examination conducted by an independent expert, on the basis of which the requirement for the amount of compensation payment is formulated;

f) if after the accident the injured party incurred additional expenses (payment for the services of an expert, tow truck, etc.), it is necessary to submit all supporting receipts and cash receipts;

g) a copy of the applicant’s passport and driver’s license;

h) copies of the PTS of all participants in the accident;

i) certificate of ownership of the damaged vehicle;

j) details of the current account intended for transferring funds.

After completing all the above steps, you should contact the RSA or its regional representative office to schedule a payment.

Sample application for compensation payment

Application for compensation payment to RSA must contain the following information:

FULL NAME. the applicant and his passport details;
the applicant's address and telephone number;
in the event that the application is submitted by a representative of the injured party - information about the document granting him the right to carry out such legally significant actions;
reference to Article 18 of the Federal Law of April 25, 2002 No. 40 “On compulsory insurance of civil liability of vehicle owners,” according to which RSA is obliged to pay compensation to the injured party;
information about the accident: date, address and consequences (type of damage, as well as full names of the injured persons, make and model of the damaged vehicle);
description of damage;
road accident diagram;
a description of other property that was damaged as a result of the incident;
Full name, MTPL policy number and name of the insurer of the person responsible for the accident;
the make, model and license plate number of the vehicle of the person causing the injury;
the make, model and license plate number of the injured person's vehicle;
information about the organization to which the victim applied before the RSA (insurer company or court), as well as the result of this application;
a list of documents attached to the application;
the amount of material damage determined based on the results of an independent examination;
bank account details for transferring compensation;
date of application and signature of the applicant.

Deadlines for issuing compensation payments

The deadlines given to RSA by the legislator for the payment of compensation correspond to the deadlines established for insurance companies - the victim must receive funds no later than 30 days from the date of filing the application.

However, as practice shows, even the union of auto insurers does not always fulfill its obligations, and citizens injured as a result of an accident have to apply to the courts with statements of claim to restore your rights.

The Russian Union of Auto Insurers is an association that provides citizens with the opportunity to receive compensation payments even if the insurance company in which the MTPL policy was issued went bankrupt or was deprived of its license.

In order to receive funds, the injured party only needs to collect documents confirming the fact of the accident and identifying the culprit, as well as present the results of an independent examination that determines the amount of compensation due.