Disputes with insurers

What is happening

Fire broke out at a warehouse. The insurer ordered an investigation, requested dozens of documents and months later refused, citing a fire safety breach that had nothing to do with the cause of the fire.

The corporate fleet is covered by comprehensive motor insurance. Repairs at the insurer's chosen garage drag on, the vehicle is off the road, and the garage wants a top-up payment. Or the insurer declared a total loss and calculates the payout net of salvage using its own method.

Cargo was damaged in transit and the insurer relies on an exclusion in its rules that nobody considered when the policy was taken out. The question is whether the exclusion is lawful and whether it covers what happened.

What the law says

• The relationship is governed by Chapter 48 of the Civil Code and Law of the Russian Federation No. 4015-1 of 27 November 1992 "On the Organisation of Insurance Business in the Russian Federation".
• Insurance rules bind the policyholder if the contract refers to them expressly and they were handed over or attached; provisions of the rules that contradict the law do not apply.
• The grounds on which an insurer is released from paying are set by the Civil Code; courts examine whether the breach alleged against the policyholder is connected with the occurrence of the insured event and the amount of the loss.
• For vehicle fleets, Federal Law No. 40-FZ of 25 April 2002 "On Compulsory Insurance of Civil Liability of Vehicle Owners" (the OSAGO Law) applies; a claim letter must be sent to the insurer before going to court.
• The limitation period for property insurance claims is two years, while liability insurance claims are subject to the general three-year period (Civil Code).
• The amount of the loss is the main issue in most disputes; it is supported by an independent valuation and, in court, by a court-appointed expert examination.

What we do

• We examine the policy, the insurance rules and the correspondence and test the grounds for refusal or the method used to calculate the payout.
• We help assemble the loss documents and answer the insurer's requests fully and on time, so as not to give formal grounds for refusal.
• We arrange an independent valuation of the loss and prepare objections to the insurer's calculation.
• We send a claim letter, including under the procedure in the OSAGO Law.
• We prepare a claim for the indemnity, sanctions and interest and represent the company in court.
• We deal separately with subrogation claims, where an insurer has paid a third party and is seeking recovery from your company.

What we will need from you

• The policy or insurance contract and the rules on which it was concluded.
• Documents on the insured event: reports, certificates, protocols, findings of the competent authorities.
• Correspondence with the insurer: the claim notification, requests, the refusal or the payout calculation.
• Evidence of the loss: estimates, invoices, valuation reports, photographs.
• Information on the value and condition of the property before the event, if the amount is disputed.