Insurance contracts will not have anyvalues if the company does not fulfill its duties and does not pay when an insured event occurs. Insurance payment is one of the main guidelines when choosing an insurer, and its size and speed of transfer are of primary importance for the affected persons.
Consider what is the insurance payment, how it is provided, and how this indicator can be used to judge the work of the insurance company.
In insurance textbooks, insurance paymentsis defined as material or financial means aimed at compensating for harm caused to the health or property of the victim. The list of factors that make possible the payment of funds is called an insurance event. Types of insured events are described in detail in the contract, which is concluded between the insurer and the insured person.
The insurance contract may provide for full and partial coverage of the damage. As a result, the insurance payment can be the equivalent of protection, presented in cash.
In most cases, the insurance payment isthe amount agreed between the insurer and the policyholder. This rule is known as the principle of supplier limitations. The maximum amount of insurance payment is indicated in the policy or established by law. The insurer has the right not to pay more than this amount. The limitation of the maximum payment was confirmed in the Civil Code of the Russian Federation, in particular, this is stated in Art. 929, 942,934,947.
Consideration of the issue of calculating the amount of insurancepayments are made on the basis of an insurance certificate or an emergency certificate. This document is made by the representative of the insurance company on the basis of the examination, which confirms the occurrence of the accident. If necessary, the insurer has the right to request information about the insured event from various state and commercial enterprises, law enforcement agencies, banks, medical institutions.
Organizations and enterprises of any formproperty must provide the insurer with the necessary data, including those that are commercial secrets. The insurer is obliged to observe confidentiality at reception of the information, differently it can be brought to court for disclosure of the private commercial information.
First of all, the victim should writeapplication for insurance payment and attach to it documents confirming the occurrence of the insured event. Draw with the filing of documents should not be - the victim is given for this only a month. The package of securities is different for different types of insurance. Among other necessary documents may require:
List of documents that must be followedprovide on the occurrence of the circumstances described in the policy, is available on the website of each insurance company. It is not out of place to clarify this list when buying a policy from an insurance agent.
Based on documents submitted to the victimsthe insurance company decides on the payment. To this the insurer is given the law from five to fifteen days. Based on the relevant documents, the insurer makes a decision on payment or refusal of monetary compensation. The last decision must necessarily be confirmed by objective reasons (an accident that does not fall under the points of the insurance contract, and so on).
Sometimes this period may be prolonged due tothe need for a more thorough verification of the circumstances that provoked the occurrence of the insured event. But it is necessary to notify interested persons about this. In some cases, an application for payment can not be considered due to circumstances - the current criminal or civil process. Then the insurer has every right to suspend the payment right up to the issuance of a court verdict.
If the insurance takes a positive decision,wait for the transfer of money to your account within ten to fifteen banking days. Payment can be one-off or consist of several parts. If you are refused, the insurer must justify this decision. There is always the opportunity to appeal the refusal in court.
All insurance companies are required at the end of the yearpublicly provide the results of their commercial activities. Such financial statements should be freely available on the websites of all insurers. They have indicators of collecting insurance premiums, indicated the number of applications accepted and reviewed, as well as the percentage of compensatory insurance payments. This value is essential for a potential policy holder.
According to various experts, the mostan acceptable rate of payment is about 30-50% of all collected funds. If the indicator is less - there is a high probability that legal insurance compensation will have to be knocked out in court.
Not very good for the holder of insurance and reverseoption - if more than half of the applications for insurance payment are submitted. This, most likely, indicates the irrational use of insurance reserves. Any insurance company must support itself, and its sources of income are the contributions of ordinary insurers. If payment of claims is excessive, it is possible that the insurer will soon announce its bankruptcy and will not be able to guarantee the insurance payment.
