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24 Nov. 2024

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When can a car insurance claim be denied and how to appeal?

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Insurance
When can a car insurance claim be denied and how to appeal?

A refusal to pay a claim under CTPCI may be an unexpected and unpleasant event for drivers, but it is not always a final decision. Find out what reasons insurers can give for refusing to pay out and whether you can appeal against this decision

Apply for a car insurance policy at Visit Ukraine - guaranteed protection on the road in just 5 minutes!
Apply for a car insurance policy at Visit Ukraine - guaranteed protection on the road in just 5 minutes!
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Taking out a motor third party liability (MTPL) policy gives car owners confidence in protecting their interests in the event of a road traffic accident. However, situations where an insurance company refuses to pay out are not uncommon. Let's find out what a refusal to pay insurance claims is, when it is possible, and what to do if you are denied.


What is an insurance claim denial?


An insurance claim is an official decision of the insurance company that it will not compensate for the loss specified in your insured event.


Such a decision may be due to a breach of the contract, lack of necessary evidence, or other reasons provided for by law or insurance rules.


The main reasons for refusing to pay out a motor third party liability insurance claim


▪️Отсутствие or expiry of the CMTPL policy at the time of the accident.

▪️Использование of the car for a purpose not specified in the contract (for example, commercial transport when taking out a policy for personal use).

▪️Управление by a car under the influence of alcohol or drugs.

▪️Грубые violations in recording information about an accident or falsely stated information. Distortion of information about the accident.

▪️Нарушение the deadline for submitting documents and applications to the insurance company.

▪️Ошибки when the owner takes out an MTPL policy.

▪️Пострадавший in the accident was involved in an alcohol or drug intoxication examination.

▪️Владелец of the MTPL policy, as a possible culprit, fled the scene of an accident for various reasons (alcohol intoxication, nervous disorders).


Also, a refusal may be due to suspicion of fraud. For example, if the insurance company believes that the accident was staged or the documents provided show signs of forgery, it may refuse to pay until the investigation is completed.


What should I do if I am denied payment?


According to the law, the insurance company is obliged to provide you with an official refusal with reasons. This is an important document that you will need to appeal. If you do not agree with the insurer's decision, you need to take several steps.


First of all, you should check the legitimacy of the refusal: compare the reasons stated in the refusal with the terms of your insurance contract; make sure that you have not violated the deadlines for submitting documents or other obligations.


If you were denied due to a lack of information or documents, supplement your case: provide photos from the accident scene, dashcam footage, and witness statements.


Submit a second application, indicating why you believe the refusal is unlawful. Attach all additional evidence and copies of documents.


If the dispute cannot be resolved, file a complaint with the MTIBU (in Ukraine) or a similar organisation in your country. They regulate the activities of insurance companies and can mediate the dispute.


You also have the right to go to court, but consult a lawyer before doing so and make sure you have sufficient evidence.


Some tips for insurance recipients


1. Read the terms of the contract before signing it. Pay attention to the exclusions and obligations of the parties.

2. Follow the rules for submitting documents. After an accident, immediately notify the insurance company and provide all the necessary certificates.

3. Keep track of the policy validity period. Do not allow breaks in insurance coverage.

4. Record all the circumstances of the accident. Take photos and videos from the scene, ask for information from the police.

5. Use the services of trusted insurance companies. Companies with a reliable reputation are less likely to refuse to pay without a good reason.


Visit Ukraine portal offers to take out a reliable CTP insurance policy for an electric car from trusted insurance companies that have all the necessary licences. The insurance will be a reliable protection and guarantee of financial security in the event of a road traffic accident.


We remind you! MTPL is a mandatory insurance policy for all vehicles in Ukraine, including electric vehicles. Earlier, we wrote how to take out an online CTPCI for an electric car in just a few minutes and how much it costs.

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