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The rules of compulsory liability insurance provide only one reason for refusing insurance payment - the absence of an insured event. Let me remind you that any traffic accident in which one of the participants in the accident is guilty is an insured event.
How is material damage compensated? In accordance with the insurance rules, the victim can contact any appraisal company. The specialist who inspects the motorcycle, determines what damage has occurred as a result of an accident, and draws up an act. Based on the act and the cost of repair is calculated. The victim provides these documents to the insurance company.
Having received the documents, the insurance company has the right to take one of three decisions: to pay the entire amount, refuse to pay, reduce its size. In the second and third cases, the decision must be reasoned. Theoretically, the insurance company may doubt the disinterestedness of the appraiser invited by the victims and invite an expert on his part. In this case, the motorcycle owner must provide the motorcycle for inspection. The insurance company is obliged to conduct an assessment of the cost of repairing damages within five days from the date of the victim’s appeal. If she did not do this, the victim has the right to start repairs, and then provide the insurer with repair documents for payment.
By agreement with the victim, the insurance company may send the motorcycle for repair. In this case, the organization of technical service will be responsible for the quality of the repair. I must say that not many people remember their right to independently assess the damage caused to them, and therefore rely on the conclusions of appraisers of insurance companies. But, as it turns out, the amount of damage by “specialists” is often underestimated by two or more times.
And the last one. The maximum amount of damages “for iron” is 120 thousand rubles (160 thousand - if there are several victims). In addition, damage compensation shall take into account the degree of depreciation of the vehicle. Both the depreciation and the difference between the maximum possible payment under compulsory motor third-party liability insurance and the amount of real damage, the victim has the right to recover directly from the person who caused the harm.
It is obvious that the issue of compensation for health damage for motorcyclists is almost the main one in negotiations with insurance companies. Let me remind you that in the framework of compulsory insurance, the lost earnings of the victim, as well as the additional expenses incurred due to poor health, are reimbursed, namely (I quote the "Insurance Rules …"): "The cost of treatment, additional food, the purchase of medicines, prosthetics, outside care, sanatorium “resort treatment, the acquisition of special vehicles, preparation for another profession, if it is established that the victim needs these types of help and care and does not have the right to receive them for free.”
Naturally, all expenses must be documented. Lost earnings - certificates from the place of work; treatment costs - by checks, contracts with medical institutions; the grounds for care, sanatorium treatment, the purchase of special vehicles - the relevant conclusions of medical, expert institutions and the like. Naturally, in the same way as in the case of property damage, if these expenses are exceeded (the maximum amount of 240, 000 rubles - if there are several victims and 160, 000 rubles - for one victim), the rest can be recovered directly from the person responsible for the harm health.
I repeat: any refusal of the insurance company to pay compensation or a decrease in the size of insurance compensation should be motivated and reasoned.