home Loans What is an insured event in case of an accident? Insurance case. Insurance "Rosgosstrakh": features of compulsory motor insurance

What is an insured event in case of an accident? Insurance case. Insurance "Rosgosstrakh": features of compulsory motor insurance

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

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

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

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

In case of an incident

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

This concept includes the following features:

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

Without him

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

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

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

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

What situations are they not?

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

The driver of the vehicle must be subject to civil liability.
In the event that you are the only participant in an accident (for example, you drove into a pole), then accordingly this case will not be considered by the insurance company as an insured event under a compulsory insurance contract.
According to the rules of compulsory motor liability insurance, there must be at least two participants in an accident. Civil liability should arise from one participant, while the other participant in the accident in such a situation is recognized as a victim and has the right to receive compensation for the harm caused to him (with the exception of cases of car owners).

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

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

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

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

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

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

Cases that are not insured under MTPL:

Car collision in the yard

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

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

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

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

The settlement of insurance cases under compulsory motor liability insurance often raises many questions, especially when controversial situations arise with insurance companies that refuse to recognize certain cases as insured. In this article we will try to analyze in detail in what situations the driver has the right to count on compensation for damage under the MTPL policy, which cases are insurable and which are not, and what legislative norms govern this.

What law governs compulsory motor liability insurance?

Due to the fact that compulsory MTPL insurance is regulated by the relevant Federal Law No. 40 of April 25, 2002, all basic principles and concepts are recorded and documented in it. This also applies to information about the conditions for the occurrence of an insured event and its recognition as such. Therefore, if any controversial situations arise, you should refer to this document.

Summarizing the main provisions of this law, we can draw the following conclusion:

Insured events are all events in which a citizen, having a valid MTPL policy in hand, while driving a vehicle, caused harm to the life or health of other persons or the property of these persons. If such an event occurs, the company is obliged to compensate for the damage caused.

At the same time, the law also specifies an extensive list of events that are not insured events and the occurrence of which is not covered by the policy.

The version of the law dated July 3, 2016 provides for a maximum amount of compensation of 400 thousand rubles for compensation for damage to property, and 500 thousand rubles for damage to life and health.

Criteria for recognizing an event as insured

According to the above-mentioned law, an insured event under compulsory motor liability insurance occurs when two main conditions are met:

The presence of the culprit of the accident, in respect of whom such a concept as civil liability will apply. Accordingly, there must be at least two participants in the accident: the culprit and the victim (who will be compensated for the damage by paying him compensation from the insurance company). Here are examples of relevant insurance and non-insurance events for this situation:
Insured event: The driver was distracted and did not have time to brake in front of a pedestrian crossing, which is why he crashed into a car in front.

Non-insurance event: A citizen, leaving a shopping center, discovered a dent in the trunk of his car. There were no witnesses to the incident, as a result of which the culprit of the incident was not identified.
The damage must have occurred when the culprit used an insured vehicle (VV). According to the law, such use is recognized as driving a vehicle associated with its movement on roads and adjacent territories on which the vehicle is intended to move. Here are examples of relevant insurance and non-insurance events for this situation:
Insured event: A dump truck drove past a car parked in a parking lot and accidentally crashed into it.

Non-insurance event: Poorly secured construction material fell out of a parked truck and damaged a neighboring car. The fact that the truck was moving was not recorded, and, therefore, it is pointless to expect that the insurance company will cover the damage.

What cases are not covered by insurance?

According to Article 6 of the above Law “On Compulsory Motor Liability Insurance”, the following events are not recognized as insurance:

causing damage while driving a vehicle other than that specified in the MTPL policy. Insurance is issued exclusively for the vehicle, and not for its owner;
causing harm by cargo, the transportation of which is associated with risk. Such cargo must be insured separately by the owner;
moral damages and lost profits incurred by the victim in an accident (estimated income that could have been received if the accident had not occurred);
causing harm by a vehicle at competitions, during training driving and in other circumstances of this kind, occurring in places specially designed for these actions;
causing damage to the life or health of citizens who are in the performance of their work duties in the case where such damage is compensated by a separate type of insurance (social, individual);
the occurrence of other situations in which damage to the vehicle or property of the victim was caused directly by the driver of the vehicle;
damage caused during loading and unloading operations;
causing losses to the employing organization if an employee of this organization was injured on a vehicle (for which the policy was issued);
Damage caused to historical and cultural values (architecture, antiques, etc.), cash, jewelry is compensated not by the insurance company, but directly by the culprit of the accident, usually in court.

Is an insured event possible without an accident?

From the content of the Law “On Compulsory Motor Liability Insurance” it follows that if the fact of an accident has not been documented, then you should not expect that the insurance company will pay anything. As noted above, the case must be traffic related. If there is a need to insure a vehicle against all kinds of risks not related to accidents on the road (natural disasters, theft, fire, spontaneous combustion and other troubles), you must also take out a CASCO policy.

However, there is one exception to this situation. Many companies like to impose additional services on the client, one of which is damage insurance and theft insurance programs. Therefore, if the client decides to additionally include one of these programs in the policy, then, of course, upon the occurrence of the stipulated insured event, he will be paid monetary compensation.

Does OSAGO apply in courtyards and parking lots?

Many car owners are interested in the question: will the policy be valid if an accident occurs not while driving on the road, but in the parking lot or yard where the car was left? According to the content of the law, courtyards and parking lots are areas adjacent to the road, which means that exactly the same rules apply regarding incidents that occur there.

It should be remembered that for these territories there are standard requirements for documents submitted to the insurance company to receive payment. Getting into a serious accident in a parking lot is difficult and is mostly limited to minor accidents with minor damage. Given this fact, drivers often do not want to spend too much time on paperwork, make many mistakes in the documents, and ultimately the injured party is left without monetary payment.

In addition, accidents often occur in parking lots due to inattention, even when the cars of both the victim and the culprit are not in motion at all. A typical situation of this kind is careless opening of car doors, leading to damage to a nearby car. This incident is not an accident, which means the Law “On Compulsory Motor Liability Insurance” will not apply to it.

Is it possible to repair a bumper under OSAGO or replace it?

After an accident has occurred and the victim has contacted the insurer with documents for damage compensation, the company must assess the condition of the car after the accident. Based on the examination, a conclusion is made on the recommended course of action - in this context, repairing the bumper or replacing it. Of course, the amount of payment will depend entirely on the expert’s conclusion. Repairing the bumper will obviously cost insurers less, so there are often cases when the assessment of the car’s condition is biased. In such a situation, you need to apply for an examination to another organization, and transfer the resulting conclusion with the cost of repairs to the insurance company. If the organization does not want to pay the specified amount, then there is only one way out - to go to court.

It should be remembered that the modernization and tuning of the car must be officially registered, otherwise there is a possibility that compulsory motor liability insurance will not cover losses. For example, if a car crashes into the back of another car and causes an accident. At first glance, the case is clearly an insurance case. But when registering an accident, it turns out that the stylish bumper on the car is not original, and this modernization has not been registered in any way. As a result, driving such a car may be considered illegal, and the incident may be considered uninsurable. Accordingly, no compensation can be expected in such a situation. And this regulation applies to all parts and components of the machine that are not included in the basic configuration.

Conclusion

Insurance and non-insurance cases under compulsory motor liability insurance are enshrined in law and compensation for damage is carried out only in accordance with the norms of legal acts. Under compulsory motor liability insurance, the insurance company provides compensation only in the event of an accident, while minor accidents in parking lots or in the courtyards of houses also qualify as insured events.

Reading time: 6 minutes

Compulsory motor third party liability insurance (MTPL) often turns out to be vital. Automobile insurance is mandatory, as follows from the very name of this type of insurance, and for the absence of a policy you are fined. On the other hand, insurance cases under compulsory motor liability insurance arouse keen interest among motorists. Indeed, it is not always clear to us what incident falls under the definition of an accident and whether we can count on an adequate response from the insurer in a particular situation. Let's try to figure it out.

What is an OSAGO policy?

From the MTPL decoding it follows that the policy covers the personal liability of the car owner to third parties.

Insurance does not cover either the vehicle (vehicle) or the life or health of its owner, but exclusively protects the rights of victims of an accident.

The cost and procedure for registration are determined by the state. In particular, with the help of Federal Law No. 40-FZ of April 25, 2002. And the rules of work of insurers are regulated by the Regulation of the Central Bank No. 431-P dated September 19, 2014.

The standard contract period is one year. The policyholder can choose the insurance period depending on the seasonality of the vehicle’s use, as well as the number of persons allowed to drive it. The damage to the victim is compensated by the insurer of the culprit. In some cases, direct reimbursement (by your insurer) is possible.

It is possible to receive compensation from several insurance companies (IC) if the damage was caused by more than one participant in the incident. The payment may be maximum, and the number of such “maximums” in one insurance period is not limited. The mechanism is not entirely simple, but only at first glance.

What is considered an insured event under compulsory motor liability insurance?

The above-mentioned Law No. 40, dedicated to this type of insurance, gives a precise definition.

An insured event in an accident under compulsory motor liability insurance is the onset of liability of the car owner for damage caused to the life, health or property of victims while using the vehicle, followed by mandatory compensation for damage.

Any cases (regardless of the number of participants) when payments or restoration repairs are legally possible are considered insurance.

Recognition of an event as insured: criteria

It is important for a car owner to know which cases are covered by insurance. After all, the further development of events after a traffic accident (RTA) depends on this. Therefore, you should understand the definition of an accident and its varieties, since the criteria for recognizing an insured event are closely related to it.

According to clause 1.2 of the Road Traffic Rules (TRAF), a road traffic accident is an event involving a vehicle that occurred during its movement on the road, resulting in dead or injured people, damaged vehicles, structures, cargo or other material damage. You could say the first criterion is movement, and the second is damage.

The culprit of the accident. That is, there must be at least two participants.
Insurance from the culprit.

Here it is necessary to clarify what is considered a road and adjacent areas on which traffic is permitted.

List of insured events

Legislators do not provide a specific list of insurance cases under compulsory motor liability insurance; they limited themselves to listing the conditions that do not allow the situation to be recognized as such.

So, insurance is any case in which the insured person while driving a vehicle causes harm to someone else’s life, health or property.

But damage can occur not only as a result of direct contact between two vehicles. For example, if a tree fell on a car. However, such a case does not fall under the MTPL law.

What cases are not recognized as insurance?

Clause 2 of Article 6 of Law No. 40-FZ and Central Bank Regulation No. 431-P states in which cases compulsory motor liability insurance is not paid:

The accident was not caused by the same vehicle that appears in the contract.
For moral damage and lost profits.
For damage during tests, training rides or competitions, even in places designated for these purposes.
The damage was caused by the cargo being transported.
Damage to the life or health of employees caused during the performance of their duties, if it is compensated under other laws.
If the employer has an obligation to compensate the employee for losses.
For damage caused by the driver himself to the vehicle, trailer, transported cargo, equipment or any other property.
Damage caused during loading or unloading of a vehicle.
Antique valuables, historical buildings, products made of precious metals, objects of art, intellectual property and spiritual heritage were damaged/destroyed.
Damage was caused to passengers (property, life or health), if by law it must be compensated.

A non-insurance event is declared for any violation of the contract. These are:

violation of deadlines for applications, provision of an incomplete package of documents;
fake policy;
finding the victim guilty;
intentional accident;
bankruptcy of the insurer and other force majeure events noted in the contract.

Can an insured event occur without an accident?

It has already been noted what the MTPL policy covers. This is liability to third parties in the event of direct contact or collision with vehicles, pedestrians and other road users. You can also receive payments in case of a non-contact accident, if the presence of the culprit of the accident is proven. But hitting an obstacle is not considered an insured event.

Insurers often try to impose additional services, and this sometimes turns out to be useful. Here is what is included in the insurance case without an accident when drawing up such an additional agreement:

theft or theft of a car;
harm caused intentionally by third parties.
fire, arson;
disaster.

If the contract contains such a clause, the case will be considered insured and you can count on payment.

OSAGO in parking lots and courtyards

Internal territories, which include parking lots and courtyards, have recently been covered by the MTPL policy, since they are equated to public roads. In this case, the following conditions must be met:

At least two vehicles are involved, one of which must be moving at the time of the event.
Availability of insurance policies for all participants in the incident.
Both the culprit and the victim have been identified.

It is necessary to prove the guilt of another participant in an accident in a parking lot, but it is not so easy. The traffic police often recognizes both participants as culprits. Then there will be problems with payment, but the case is covered by insurance. If there is an accident with a cyclist who is at fault, the issue of compensation is resolved voluntarily or through the court.

Questions arise mainly in situations where there is no second participant. He escaped or the damage was caused by the elements. In the first case, the participant in the accident will be searched for, and then the issue of compensation will be resolved. In the second, you will have to prove that the damage was caused while driving. But this will have to be done in court. The same as in the situation if a stone hits the windshield from under the wheel of a car passing by or moving in front.

Actions in case of an insured event

What the victim should do immediately after the accident is set out in Art. 11 of the law on compulsory motor liability insurance:

Act in accordance with traffic rules.
Inform other participants in the incident your policy details and obtain information about their compulsory motor liability insurance (numbers, names and details of the insurance company).
Get a certificate about the accident.
Notify the insurer about the insured event and act according to its instructions.
Collect a package of documents, write an application and send it to the Investigative Committee.
Wait for the decision on reimbursement.

Today you can file an insurance claim without the traffic police - if the damage is small and the participants were able to come to an agreement. A European protocol form (notification of an accident) is issued along with the policy. Filled out by hand on the spot. Together with the necessary documents, it is sent to the insurer within 5 days.

Within 10 days from the moment of the accident, the damaged car must be presented to the insurer for inspection and examination. That is, it cannot be repaired for the first 15 days after the incident.

About payments under compulsory motor liability insurance

Insurance companies are now not obliged to compensate for damages with money. In what case of payment and in what case of repair, the insurer decides - independently or with the insured. Typically, a decision on payments is made if:

The vehicle was completely destroyed.
The cost of restoration exceeds the legal limit, but the owner does not want to pay extra.
The insurer cannot arrange repairs.

Only the owner of the car or his authorized representative can receive payment or a referral for repairs. The victim will be compensated for damage through the Russian Union of Auto Insurers (RUA) if:

The insurance company went bankrupt/lost its license;
the culprit has not been identified, is not insured, or does not have the right to drive the car.

Payment terms should not exceed 20 or 30 days if the victim, upon written request, organizes repairs on his own. The decision on compensation may be delayed indefinitely if the incident is under criminal investigation or the culprit is being sought.

An insurance event report under compulsory motor liability insurance, if necessary, will allow you to prove the fact of the occurrence of an insured situation and the procedure for calculating compensation. At the request of the policyholder, the document is issued within 3 days.

If the insurance company refuses to pay

If the insurance company has no legal grounds to refuse payments, it is first necessary to obtain written confirmation of the refusal. And then - influence the insurer using legal methods in order:

Send a complaint to RSA or the Bank of Russia.
File a lawsuit in the district court at the location of the insurance company.

If the refusal is found to be unfounded, the insurer will be required to pay compensation. Moreover, he will also pay a penalty (1% of the insured amount) and a penalty (0.05% per day of delay).

conclusions

Finally, a few words about compulsory insurance. It is, of course, far from perfect, but still saves in many situations. And besides:

Although a specific list of insured events is not fixed by law, the list of situations when insurance companies can refuse compensation for damage under compulsory motor liability insurance is not so long.
If you have an additional agreement, you can receive payments for an insured event not related to an accident.
The policy is valid in courtyards and parking lots if it is proven that a traffic accident has occurred.
When an insured event occurs, it must be properly documented and promptly notified of the incident to the insurance company.
You can challenge the insurer’s refusal to pay or their amount in the RSA, the Bank of Russia or the court.

OSAGO: insured event. Video

Immediately stop the vehicle (hereinafter referred to as the vehicle) and turn on the hazard warning lights.
Place a warning triangle (at least 15 m from the vehicle in a populated area and at least 30 m outside a populated area).
Contact emergency services: 112 - emergency or 102 – Police (free from mobile even in roaming) and act according to the instructions of the traffic police officer.
Record the circumstances of the accident using a mobile application developed by RSA and ensuring the transfer of data to the AIS OSAGO, which is entered through the Unified Identification of Information and Logistics (registration on the State Services portal), for example, “Road accident. Europrotocol", "MTPL Assistant" (in a number of regions), and (or) using technical control means (if they provide data transfer to the AIS MTPL). You can download the application in the Play Market or App Store application stores. Record with the help of photos and videos in relation to each other and road infrastructure objects, traces and objects related to the incident, damage to the vehicle, reg. vehicle numbers and VIN numbers.
To settle an accident under the European Protocol (without calling the traffic police), recording using a mobile application is mandatory only in case of disagreement or the need for settlement in the amount of 100 to 400 thousand rubles.
Clear the roadway if an obstacle is created to the movement of other vehicles (only if there is no harm to life or health, if any, vehicles cannot be moved without the instructions of the traffic police officers).
Fill out the Notification form together with the other participant(s) in the accident - instructions. If a number of conditions are met, it is possible to issue an Electronic Notification of a Road Accident.
Call the Ingosstrakh contact center at:
+7 (495) 956-55-55 (Moscow), 8 (800) 100-77-55 (other regions of the Russian Federation) for advice.

Claiming an insured event

You can file an insurance claim for damage to vehicles and other property as a result of an accident at the offices of independent experts - partners of Ingosstrakh.

inspect the damaged vehicle and conduct an independent examination on the day of application;
significantly speed up the process of considering an insured event and making a decision on making an insurance payment.

You can find a list of independent technical expertise that accepts clients under compulsory motor liability insurance in Moscow and the Moscow region in the section “Settlement Offices”.

Natural form of compensation for harm

Compensation for damage caused to the victim’s vehicle can be carried out by organizing and paying for restoration repairs at a service station (STS), from among those with which Ingosstrakh has concluded relevant agreements, taking into account the criteria for accepting vehicles for repairs for each service station .

You can also familiarize yourself with the functions of the OSAGO Assistant application in the RSA instructional video.

In case of damage to vehicles and other property as a result of an accident.

You can file an insured event at the offices of independent experts - partners of Ingosstrakh:

Submitting an application to the office of independent examination will allow you to:

inspect the damaged vehicle and conduct an independent examination on the day of application;
significantly speed up the process of considering an insured event and making a decision on making an insurance payment.

You can find a list of independent technical expertise that accepts clients under compulsory motor liability insurance in Moscow and the Moscow region in the “Settlement Offices” section.

A natural form of compensation for harm.

Terms of payment of insurance compensation: The victim's application for insurance payment is considered within 20 calendar days (excluding non-working holidays).

IMPORTANT! To receive insurance compensation up to 400 thousand rubles, as well as to receive insurance compensation in the event of disagreements, data on an accident must be recorded by its participants and transferred to the AIS OSAGO through the RSA mobile application “DTP.Europrotocol”. The fact of using the RSA mobile application “DTP.Europrotocol” when registering an accident under the Europrotocol should be indicated in the application for payment of insurance compensation. If there are disagreements, issuing an Electronic Notification of a Road Accident is impossible.

A set of documents to be completed when applying to Ingosstrakh:

A notification of an accident (original) must be submitted within 5 working days from the date of the accident to the following address:
- for Moscow and the Moscow region - Moscow, st. Rochdelskaya, 15, building 35 (direction) ;
- for other regions - addresses of branches in the regional network, see the website see.
Or send a scanned (photo) copy of both sides by email.
Application for payment of insurance compensation.
A duly certified copy of the identity document of the victim (beneficiary).
Documents confirming the victim's ownership of the damaged property: vehicle registration certificate or vehicle passport (PTS). If at the time of the accident the vehicle had transit license plates, the provision of a title is mandatory.
Documents confirming the authority of the person who is the representative of the beneficiary.
Consent of the guardianship and trusteeship authorities, if the payment of insurance compensation will be made to the representative of the victim (beneficiary) under the age of 18 years.
Bank details of the recipient of the insurance compensation (the transfer is made to the account of the owner of the damaged property or to the account of the person entitled to the insurance payment.

When contacting Ingosstrakh, you must provide.

More detailed information on the Europrotocol can be found on the website