After a traffic accident, insured citizens apply to Insurance companies to receive a refund. The allocated funds will be used to restore health or repair the affected car.
But the compulsory insurance policy has rules regarding which the terms of payment, or rather, the one to whom you need to apply for them, are strictly established. Therefore, in order to receive funds for repairs, the victim must know which insurer he should contact to receive compensation for the car. civil liability. After all, the circumstances of the accident can be different, and contacting the wrong company will take time to file an application.
In this article, we will try to understand what direct compensation for OSAGO losses is, the procedure and conditions for paying compensation in the event of an accident, and also when the victim needs to contact the insurer for money or a referral for repairs.
Everyone is accustomed to the fact that compensation for damage to drivers under the “auto-citizenship” is carried out by the insurer who insured the civil liability of the person who caused the damage. That is, mandatory compensation in case of an accident is due to the victim from the side of the culprit of the accident. 
But having got into an accident under OSAGO, not only the insurer of the guilty party, but also already familiar to the victim, can compensate for the damage after the accident. insurance organization where he defended his responsibility. Consequently, it is not the perpetrator of the incident and the company protecting his interests that will pay for the harm caused, but the company of the injured insured.
Direct refund damage under OSAGO - this is the very case when, after an accident, “its own” organization pays compensation. But the procedure for paying insurance compensation is such that it is allowed to apply for it to your protecting company only under certain circumstances.
Reimbursement procedure
The concept of PVU in insurance appeared only in 2014, and until that moment, after a car accident, having waited for a decision on the recognition of the driver’s guilt, the victim had the right to determine the company that would compensate for the damage under OSAGO. Now, the parties defending the perpetrators of the accident do not accept claims for direct compensation, since only the insurer of the victim has the authority to pay such compensation.
The necessary conditions for direct direct settlement of OSAGO losses in 2020 are as follows:
- When registering a traffic accident, the protocol indicated that only property was damaged in a car accident, namely two cars (the initiator and the victim);
- The victim has no injuries to be treated, which means that his health has not been affected;
- Both participants in the car accident defended themselves earlier on the “auto-citizenship” and their policies are valid;
- Only one driver has been proven guilty, and mutual guilt is out of the question.
If this procedure for compensation for damage in case of an accident under OSAGO is observed, then the insured should go to his insurer. First, you need to notify the organization about what happened, and then, within 5-10 days, apply there with a written application for the payment of PES.
After accepting your application, the insurer is obliged to notify you in writing about decision. If the refusal to pay does not follow, then the car will be sent for examination, where the amount of insurance compensation will be established.
Application for direct compensation for losses under OSAGO
So, in the event of a traffic accident, you must submit a request for payment of a PES to your insurance company, which is why it is called direct. The current rules say that it is impossible to apply to the insurer who made direct compensation if such an application had previously been submitted to the company of the guilty driver.
This means that the return procedure is strictly regulated on legislative level and the insured himself must comply with it. First of all, to indemnify for auto insurance losses, you should send an application to the insurer.
The company that compensates for the damage in an accident must accept the following documents from the insured:
Conclusion of an agreement
The agreement on direct compensation for losses under OSAGO is initially concluded between the insurance company RSA. According to this agreement, the conditions for the payment of insurance compensation are observed, disputes are regulated, insurance payments are calculated, and the like.
The Auto Insurers Trade Union allows the injured party in an accident to receive a payment when direct compensation is not made due to bankruptcy or revocation of the organization's license. This means that the Russian Union of Motor Insurers will assume the obligations of an insurer that has insured the civil liability of the victim and, in the event of its liquidation (bankruptcy), is not able to pay compensation.
Faced with such a situation, the insured should send an application for compensation payment to the PCA, attaching the list of documents listed above for the PSP.
What does the amount depend on?
It does not matter who will make compensation payments to the PCA or the insurer, because the amount of compensation is determined solely by an expert assessment of the affected car.
Naturally, for the most part, the amount of compensation will depend on the nature of the damage to the car, but, in addition to this, other factors also affect the amount:
- Territorial affiliation of the car. Here, the cost of spare parts and repairs relative to a certain region is taken into account;
- duration of protection.
What to do if the payment is not enough
To determine the amount of compensation payments, insurers use the services of expertise. But often, the calculated amounts do not suit the victims, since they are not able to cover all the damage received.
Of course, the policyholder is free to determine the amount compensation payment using special calculators for calculating compensation in case of an accident. But insurers will not take such a calculation into account, since it is an expert assessment that is needed.
But in this case, the injured driver has the right to apply to an independent examination and, on the basis of the drawn up damage assessment act, demand from the company appropriate compensation, including covering the costs of the appraiser's services.
When should the perpetrator pay?
According to the law on compensation for damage under OSAGO, policyholders are entitled to receive no more than 400,000 rubles for damage caused to property. A driver protection company cannot provide compensation in excess of the prescribed amount. So, if the damage still exceeds the limit, the rest must be demanded from the culprit. It happens in judicial order.
Situations where the perpetrator, and not the company of the victim, should pay for the damage caused::
- The insurance company did not conclude an agreement with the RSA on the PES (you must contact the company initiating the accident);
- The culprit of the car accident has no insurance policy or it was invalid at the time of the accident;
- The amount of damage exceeds the statutory maximum for the payment of compensation for property damage.
The difference between an alternative PES and a non-alternative one
Until 2014, policyholders who had an accident and wished to receive compensation had the opportunity to choose one of two options for applying. That is, compensation was paid at the discretion of the victim in his insurance company or in the company of the culprit. This method was called alternative PES.
The choice alternative has been abolished, the indemnification has become unalternative, but the insured can still apply to both sides of the protection. But it is worth noting that the non-alternative compensation for losses has rules, the violation of even one of which will contribute to the direction of the injured driver to the defender of the initiator of the disaster for payment of compensation.
What documents need to be provided
When applying for the payment of money within the prescribed period, the victim must bring with him a certain package of documents, since the lack of any certificate may cause a denial of payments.
By filling out the application form for the payment of insurance compensation, the insured must attach the following documents:
- A car accident notification form filled out by both parties to the accident;
- A copy of the certificate of the absence or presence of a protocol on an administrative violation;
- Documents for the car (passport, registration certificate);
- Duplicate insurance form, passport and driver's license;
- Receipts for payment of various services (tow truck, emergency commissioner, impound lot, etc.)
- If necessary, a power of attorney is provided for a person acting on behalf of the victim.
When you don't have to rely on PES
As you know, insurance companies can refuse compensation for many reasons. Sometimes these reasons are quite legitimate, and sometimes vice versa. In such situations, the insured must go to court by providing a certificate of refusal to compensate for the damage. 
But it is worth noting that the denial of a PES for auto insurance does not mean that the victim will not receive anything. Therefore, having received a negative decision on payment, the insured must send the same documents to the organization protecting the perpetrator of the incident.
If a driver is denied a PES by their insurance company, then the circumstances of the accident do not meet one or more of the following requirements:
- Unable to identify the culprit. The circumstances of the accident are such that the traffic police officer is unable to establish the full innocence of the driver who applied for compensation, which means that this will be established by the court;
- There are victims. The health of the driver suffered in a car accident;
- Disagreements. Incorrectly completed documents or disputes of the parties about guilt;
- Reapplying for payment. An application for a PES will not be accepted in “their” insurance if such an application was previously submitted to the company of the initiator of the accident;
- Damage to property other than the car. In case of damage to equipment, antiques, intellectual property and other items not related to the car.
Arbitrage practice
Car accidents are mostly provoked by one of the road users. That is, it is rather difficult to say for sure that both drivers are guilty of the accident. In judicial practice, there are cases when accidents occur without contact, one driver suffered from a violation of the rules of another passenger.
For example, the driver of car A was driving in his lane observing the rules of the road, but car B drove out towards him, due to roughness (pits) on the roadway. To avoid a collision, the driver of car A turned the steering wheel and rolled over into the ditch. In this situation, the driver of car B is clearly at fault, but the insurer determined such a case to be contactless.
To put it simply, the injured driver was denied a PES because the accident occurred without the physical contact of the cars, and the OSAGO law states that a direct settlement is possible in a car accident that occurred as a result of the interaction of cars, with their direct contact.
In this case, the RF Armed Forces decided to apply to the victim in the company of the initiator of the incident, only the PVU will be denied, and not compensation.
Previously, the legislation gave car owners the opportunity to decide on their own where to apply for reimbursement under the “car citizen”. True, such a choice was possible only under certain conditions. At the moment, domestic motorists applying for payment are deprived of such a choice.
If no more than two vehicles were involved in a traffic accident and no harm was caused to the health or life of people, then the victim must apply for payment to the company that sold him the compulsory auto insurance. In other words, direct compensation for damage has ceased to be an alternative. Naturally, the change in the way the PES system operated increased the number of claims reported to insurers by their own clients. The increase in the number of such payment cases resulted in an increase in the interest of policyholders in the basic principles of interaction between insurance companies within the framework of the PES system. It should be noted that today there is practically no official information on this score, but it is still possible to identify the main stages of the settlement of such a loss.
Who pays in the end?
Some domestic motorists mistakenly believe that applying for OSAGO compensation to their insurer will bring him losses. In fact, in any case, the insurance company of the driver who provoked the accident will have to pay for the damage. True, the payment to the victim is still transferred by his auto insurer. To clarify this slightly confusing scheme, it is worth considering the relationship between insurers and the motorist. The sequence of actions of all interested parties when registering a loss on PVU, it looks like this:
- The victim submits an application for payment to the organization that sold the policy to him.
- The insurer sends a request to the company responsible for the accident asking for permission to pay out the indemnity.
- The company of the perpetrator agrees or does not agree to recognize the incident as an insured event, after which it notifies the insurer of the victim of its decision.
- Depending on the decision, the victim is either denied payment or transferred compensation.
It turns out that when registering a loss within the framework of the PES system, the decision to refuse is made by the auto insurer of the culprit. Thus, even in the event of a negative result, the owner of the damaged car should not be offended by his insurer. True, in reviews of insurance companies there are complaints about the sluggishness of payers when transferring documents to the auto insurer of the culprit of the accident, though for Last year such reviews have become noticeably less.
Rights and obligations
It is worth emphasizing that the interaction of insurance companies in the described circumstances takes place in accordance with the PES agreement. This document, prepared by specialists from the Russian Union of Auto Insurers (RUA), contains a description of all aspects of the relationship between the two auto insurers in direct compensation for damage, including the rules for financial transactions. Unfortunately, there is no way to get acquainted with the current version of this agreement, since its outdated version is posted on the official website of the PCA.
By the way, quite often there is news about the exclusion of a company from the PES agreement. As a rule, such sanctions are applied to companies experiencing serious financial difficulties, so such news can be used as an indicator of the reliability of an auto insurer. Yes, during the existence of the agreement there were cases when, after the elimination of any violations, the company was taken back, but this is extremely rare.
What if the insurer goes bankrupt?
Since we are talking about the financial well-being of auto insurers, it is impossible not to mention how to get reimbursed in the event of bankruptcy of an insurance company. It is known that the cost of OSAGO in different companies, although it differs, but not much. That is why some motorists still do not bother too much with the choice of insurer. This is skillfully used by small insurance companies on the verge of ruin. They are doing everything possible to increase sales of compulsory auto insurance in anticipation of their own financial collapse, resulting in a sharp increase in the number of insurance contracts.
So, where do clients of such organizations apply for reimbursement under the PES system? Everything is extremely simple: if the company that sold the CMTPL policy to a motorist loses its license, it is necessary to draw up a payment from the insurer of the culprit of the accident. There are also cases when the liability of the perpetrator of the accident and the owner of the damaged car is insured in companies deprived of a license. In this case, you should apply to the RSA for insurance compensation.
Irresponsible car owner
Even the most responsible and far-sighted car owner is not able to predict a meeting with a reckless driver without an OSAGO policy. It is known that in the presence of such circumstances it will not be possible to receive a refund from your auto insurer. Previously, the only way to get justice was to file lawsuit to an irresponsible driver driving a car without mandatory auto insurance. However, today injured motorists and other road users have the opportunity to receive compensation payments in the RSA.
True, they can only count on compensation for harm to health or life, because property claims can be made only if the person responsible for the road accident has an OSAGO agreement. And even if the culprit is insured in a bankrupt company. At the same time, the victim must remember that the compensation payment for harm to health or life can be up to five hundred thousand rubles. By the way, the same procedure for compensating for damages applies in a situation where the culprit of the incident has not been identified.
A class above
Sometimes policyholders who have a CASCO policy prefer not to apply for a "car insurance" payment, as they are afraid of losing a discount for accident-free driving. As already mentioned, the cost of compensation for damage in any case falls on the insurer responsible for the accident, and in case of bankruptcy, payment is made from the compensation fund. For these reasons, the fears of policyholders regarding the loss of discounts are unfounded. If the accident occurred through the fault of another motorist, the victim has the right to count on maintaining the current value of the bonus-malus coefficient. It is easy to verify the veracity of this statement by examining the tariff guide for compulsory auto insurance. The document can be viewed on the website of the Central Bank of Russia.
I am insured under OSAGO. I had an accident. I am the injured party. Do I need to contact the company at fault or can I contact my insurance company?
If you are an injured party as a result of an accident, then you need to contact your insurance company for compensation for damage under OSAGO, this is a direct compensation for losses (DCL). In this case, 3 conditions must be met (depending on the date of the accident):
The accident occurred before September 26, 2017:
1. in an accident, only vehicles were damaged (people or other property were not injured);
2. The accident occurred as a result of a collision of only two vehicles (the trailer is considered part of the vehicle);
3. both participants have valid OSAGO policies.
The accident occurred after September 26, 2017:
1. * in an accident, only vehicles were damaged (people or other property were not injured);
2. * The accident occurred as a result of a collision between two or more vehicles (the trailer is considered part of the vehicle);
* all participants in the accident have valid OSAGO policies. If at least one of the conditions is not met, then for damages it is necessary to apply to the company of the culprit.
What is the deadline for submitting an application for payment of insurance indemnity?
A victim who intends to exercise his right to insurance payment is obliged to notify the insurer of the occurrence of insured event.
At the same time, the term limitation period for claims arising from the liability risk insurance contract for obligations arising as a result of causing harm to life, health or property of other persons, is three years.
I am the victim of an accident that occurred through the fault of your client. Where can I go to apply for a payout?
I am a client of AlfaStrakhovanie JSC. I had an accident in which I was recognized as a victim. I would like to apply to my insurance company for insurance compensation. Where can I go to apply for a payout?
You can get up-to-date information about the location of all document acceptance points and their work schedules around the clock. free number AlfaStrakhovanie JSC 8 800 333-0-999 / 0999 (from mobile phone) or 8 495 788-0-999 (for Moscow and the region), as well as on our website
What documents do I need to submit to the insurance company in order to receive an insurance payment under OSAGO?
To receive reimbursement under OSAGO, you will need the originals of the main documents and documents about the accident from the traffic police, if the accident was documented with the participation of the traffic police. The application can be written by the owner of the vehicle or a representative by notarized power of attorney, with the right to receive insurance compensation and represent the interests of the owner in the insurance company.
List of main documents:
1. Notice of an accident, completed and signed by both participants on the front side. On the reverse side, the participant fills out his copy of the notice.
2. Vehicle registration certificate or vehicle passport
3. RF passport of the applicant.
4. If the insured event is not declared by the owner of the vehicle, then a notarized power of attorney is required, with the right to represent the interests of the owner and receive compensation (for individuals)
5. Bank details for reimbursement payment (PERSONAL ACCOUNT, CURRENT ACCOUNT, CORRECTION ACCOUNT, BANK BIK, BANK TIN, BANK NAME) (for individuals)
6. OSAGO policy and a payment document confirming the payment of the policy
7. Documents of the traffic police, if the accident was registered with the traffic police (more detailed information in clause 6)
For legal entities, additionally required:
8. The applicant's power of attorney for the right to represent the interests of the owner in the insurance company, certified by a seal.
9. Authorization letter for damages, certified by the seal and signature of the authorized person.
10. A copy of the contract or other document confirming the rental, leasing or rental of the vehicle.
What are the requirements for filing an accident report?
Documents about the accident
1. Ruling in the case of administrative offense(additionally, a protocol on an administrative offense, if drawn up) or a ruling on the refusal to initiate proceedings on an administrative offense. offense
2. Appendix to the above documents, if it was drawn up.
3. In case of causing harm to life/health, a protocol of the place where adm. offenses.
4. Please note that the traffic police documents must contain information about:
* Vehicles involved in the accident (brands, models, state registration plates, and in their absence, VIN);
* drivers (last name, first name, patronymic, place of residence);
* OSAGO insurance policies (series, number, name of the insurance company);
* list of visible damage to vehicles.
Attention! In accordance with the OSAGO rules, drivers of vehicles involved in an accident are required to fill out accident notification forms, regardless of whether the documents are processed by police officers.
According to the Vienna Convention on Road Traffic, as amended on 28.09.2004, for documents containing information in the national language of the state, a written translation of documents certified by a notary is required.
In some cases, the list of documents may depend on the civil law relations between the victim and the tortfeasor.
How long does it take to pay insurance compensation under OSAGO?
Within 20 calendar days from the date of submission of the full package of documents and the vehicle for inspection to the insurance company.
What form of reimbursement is provided?
In accordance with the Federal Law "On compulsory insurance Civil Liability of Vehicle Owners” No. 40-FZ under contracts concluded after April 28, 2017: Insurance compensation for damage caused to a passenger car owned by a citizen and registered in Russian Federation, is carried out (with the exception of cases established by paragraph 16.1 of this article) in accordance with paragraph 15.2 of this article or in accordance with paragraph 15.3 of this article by arranging and (or) paying refurbishment damaged vehicle of the victim (compensation for damage in kind).
Payment in cash can be made if there is an agreement in writing between the insurer and the beneficiary.
Where can I get a calculation of the cost of repairing a vehicle (calculation)?
For information about possible way to receive a calculation of the cost of repairing a vehicle (calculation) for a declared loss or a copy of the act of an insured event under OSAGO, you need to call 8 800 333-0-999 (toll-free within Russia) or 8 495 788-0-999 (for Moscow and area).
Important!
For accidents that occurred since October 1, 2019:
If there is no disagreement:
- up to 400 thousand rubles
- up to 100 thousand rubles- without fixing the circumstances of the accident in the mobile application "Accident. Europrotocol" / GLONASS
In case of disagreement:
- up to 100 thousand rubles- the circumstances of the accident were recorded using mobile application RSA "DTP. Europrotocol") or GLONASS technical means of control.
- EP is not possible- if there is no fixation of the circumstances of the accident by technical means of control (mobile application of the RSA "Accident. Europrotocol")
- up to 100 thousand rubles- between road accident participants there are no disagreements, or the circumstances of the accident are recorded and transferred to the OSAGO AIS system using a mobile application or technical means of control (GLONASS device) and there are disagreements between the participants in the accident;
Information
Until 08/02/2014, the party injured in an accident could apply to the insurer for damages in two ways:
- Appeal to the insurer responsible for the accident. In this case, the victim had to find the office of the insurance company of the culprit, and then contact the company's employees and resolve the situation;
- Claiming direct damages (DDR) from your insurer, which was only possible in cases where two cars were involved in the accident and no one was injured in the accident.
Such an approach to compensation for losses led to the fact that insurers, by hook or by crook, tried to send the victim to another insurance company. Very often, employees of insurance companies deliberately made it difficult to submit the necessary papers so that the driver refused to pay.
At the same time, some drivers could also abuse the position. For example, applications were often submitted to two insurers at once.
To exclude such actions and form a system of insurance payments for OSAGO, a document on uncontested direct compensation for losses was created by law. In other words, the injured party can apply for an insurance premium only to their insurer. In turn, the insurer cannot refuse to consider the case.
Direct compensation for losses implies that the party injured in a road traffic accident can apply for an insurance premium to their insurer, with whom the OSAGO agreement was signed.
Although such points were clarified by law and the two-sidedness of the situation was removed, the negative side of the new rules is that the PES was limited to some circumstances that must occur during a vehicle accident. If at least one of the items listed below is not included in the insured event, then your insurer will not be able to use the PES.
Conditions for using direct damages
You can apply for a payment to your insurer if you comply with the following:
- Two cars were involved in the accident, and each driver has a valid OSAGO policy.
- Only cars were damaged in the accident. There was no harm to the health and life of people.
- There is no mutual fault of the drivers (there is one culprit and one victim).
- The insurance company has a valid license to issue OSAGO policies.
The driver will not be able to obtain a PES under an OSAGO agreement if:
- The insurer of the perpetrator of the traffic accident has already received an application for this insured event;
- Participants of the road accident decided to use the simplified system of registration of the accident without police officers, but the documents about the accident were incorrectly filled out;
- The applicant requires the insurance to reimburse him moral injury or a benefit that was lost due to a traffic accident;
- The accident occurred with the participation of a training car, during official racing competitions, etc.;
- During the accident, damage was done securities, cash, art, antiques, etc.;
- The fact of violation of traffic rules, which caused the accident, is the reason for the trial;
- In other cases, which are prescribed in the agreement of the members of the Russian Insurance Association.
Direct indemnification is easy enough to teach. The driver must hand over a set of correctly executed papers, after which he will be sent for examination. At correct design documents and obtaining a positive decision from the insurer responsible for the accident, cash will be transferred to the driver's account, which must be indicated in the application. Everything else that follows (litigation between insurers, disputes, courts, etc.) does not apply to the party injured in the accident.
It should be taken into account that many insurance companies try to minimize the amount of direct compensation for losses. In addition, if the size of the insurance premium is significant, then the insurer of the victim will by all means send the driver to the insurance company of the culprit.
It should be noted that:
- It is often impossible to resolve all issues of direct compensation for losses only because the documents submitted by the injured party are incorrectly or incompletely executed, which allows the insurance company to claim that they received false information about the accident. Because of this, it will not be possible to resolve what happened with your insurer under the PES.
- IN latest amendments the law says that the injured party can apply to his insurance company for an insurance premium for OSAGO for direct compensation for losses, regardless of whether the driver is marked in the policy of the insured or not. In the past, it was very common for insurance companies to deny any PES payout if the insured and the owner of the vehicle on the policy did not match.
- Motorists should also take into account that only one form of a certificate from the traffic police, which is provided to the insurer along with other papers for obtaining a PES, complies with OSAGO rules. This is form 748, which is approved by the relevant order of the Ministry of Internal Affairs of Russia.
- If the accident did not cause harm to human health, the amount of damage caused vehicle, does not exceed 50,000 rubles, two cars were involved in the accident, both drivers have valid OSAGO policies, and the circumstances of the incident do not cause disputes among the participants in the accident, then direct compensation for damage under OSAGO is issued without the participation of the police.