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Insurance case ? 10 important tips to get paid!

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The first and probably the most important.
Insurance companies must always work for profit, and many even large brands have a very bad reputation in connection with payments, as well as poor quality service after the conclusion of an insurance contract.

The second problem lies in the insurance products themselves.
When clients come to us to insure a house, dacha, apartment, etc., they denote everything in a slightly simple language, for example: Insure my house from fire.

A good insurance agent will ask “what do you mean when you call the word fire”, as there are different understandings about the risk of “fire” in the insurance rules and the designated risks, and in different companies all this can be interpreted in different ways. For example, spontaneous combustion of electrical wiring will already be considered a short circuit, but a fire from this short circuit will be a consequence, therefore, the risk of a short circuit is most often insured separately.

Insurance companies probably won’t tell you such things, so get 10 important tips from us to get an insurance claim without any problems!

First tip, and most important!
If you are insuring directly with an insurance company, be sure to ask and read the insurance rules!
Here I will make a short digression, the insurance rules always go separately from the insurance contract. Many people mistake the text on the back of the policy for insurance rules. No, these are not rules, the rules go either in a separate book, or they are downloaded on the site in each insurance company with a pdf file.

Remember that the rules are not the same. For example, there are CASCO insurance rules, there are apartment insurance rules, there are house insurance rules, and these will all be different rules, and accordingly the conditions will be different!

Second, no less important advice!
Has an insured event happened? If it’s on fire, call the firefighters. Theft, call the police.
The insurance company will definitely request from you certificates and copies of certificates stating that you promptly contacted the police, doctors and other relevant authorities.

Third tip!
Always look at the payout table for voluntary insurance!
In order not to be left with nothing, you must understand that with life insurance for three million rubles, they will be paid, but only if, as sad as it may sound, death. For all other cases, there is a paytable. It will be calculated as a percentage of the sum insured. Thus, substandard life insurance can look like this. Broke his arm – the payment will be 0.9% of the insured amount, injured his head – 10% of the insured amount, and this will already be a more or less human paytable.

Fourth tip!
Insurance depreciation percentage.
Whether you like it or not, almost all companies have a certain percentage of wear and tear during the insurance period. In some insurance companies, when insuring the interior decoration of an apartment, the percentage of depreciation can reach up to 20% per year or more. OSAGO in this sense is limited to no more than 50% wear and tear. The second part of the depreciation can be obtained in monetary terms, let me know in the comments if you are interested in the topic: how to get the remaining amount by the percentage of depreciation? And I will write a separate detailed article on this topic!

There are companies that do not take into account the percentage of depreciation, and pay the same amount, the cost of which is made up of finishing materials and work. Most often, the conditions for such insurance will sound like “New for old”. At a percentage of depreciation, there will be a condition “Old for old”. In CASCO it is called GAP, it is most often included as an additional service and accordingly increases the insurance premium (cost of insurance).

Fifth tip!
Always keep receipts and ordering outfits!
As you know, everything tends to fall in price. In planned insurance, when purchasing for repairs, try to always keep receipts for the purchase of materials. If you insure property, keep receipts for it, or better yet, make copies of receipts, attach the main receipt, and, along with the insurance contract, store all this stuff in a fire safe. Why make copies of receipts? Everything is easy and simple, more often companies make a check in such a way that the inscriptions of this check come off the check paper within a year. This is beneficial for the company when the warranty period is more than one year.

Otherwise, the insurance company will pay at the average market value of the materials.

If you have life and health insurance, bought insurance for traveling abroad, in case of an insured event, it may happen that expenses will begin before the insurance payment. You can always show your checks to the insurance company and you will be reimbursed for your expenses. But keep in mind that the costs must be justified. For example, there should be a doctor’s appointment, then a check, and with the original or copies you go to your insurance company with a claim for reimbursement.

Tip number six!
Do not break the deadlines for contacting the insurance company!
Almost all companies set deadlines for applying for an insurance claim. Most often – this period is 7 days from the date of the insured event. At a minimum, you must notify the insurance company that the insured event has occurred.

If the deadline for claiming a loss is missed, the insurance company may refuse to pay, in which case you will have to defend your interests in court and the deadline for receiving the payment will drag on for a long time. The most important thing to remember is that violation of the deadlines for declaring a loss does not give the insurer the right to refuse insurance compensation!

Seventh tip!
Always mark that the insurance company has received documents from you!
I don’t know on purpose or not, but quite often the company loses documents. With a sober mind, you can understand that this is being done deliberately, because if you were not marked that the insurance company accepted the documents, then it will be almost impossible to prove that you gave them without that very mark. We always advise our clients to make copies of the original documents, draw up a list on a separate sheet of those documents that you provided to the insurance company, then we do this:

  • We collect sets of documents in duplicate. Original and copy, insurance companies often take the original documents.
  • We come to the claims settlement department and provide the documents.
  • Please put a stamp on the copies with a mark on the acceptance of documents.
  • We postpone the whole thing in a fire safe in case the company announces the loss or says that it did not receive these documents from you, and we keep them for three years from the date of payment of the sum insured.
    Tip number eight!
    Never underestimate the cost of property, apartment, decoration, house, etc. in order to reduce the cost of insurance!
    Let’s take a simple example. In fact, your house is worth 10 million rubles, you decided to save money and set the cost at 7 million, for some reason you decided that this amount would be enough for you in the event of complete destruction of the property.

In this example, in case of an insured event, the following formula will be used to calculate the payment of the sum insured:

Formula for calculating the payment of the insured amount
Where:

Q – Insurance indemnity.
T – The actual amount of damage.
S – Sum insured under the contract.
W – The cost estimate of the insurance object.
The insurance object worth 10 million rubles was insured for 7 million rubles, for example, in the event of a fire, the amount of damage was 5 million rubles. In this case, the amount of the insurance payment is determined as follows: 5 million * 7 million / 10 million = 3 million 500 thousand.

Thus, we got a payout ratio of 0.7 (7 million divided by 10 million), if the amount was equal, then we would get a coefficient = 1, and we would also receive the full cost of damage. Therefore, it is better to play it safe and make the cost of the insurance object a little higher.

Tip number nine!
Insurance conditions are no less important than insurance rules!
Before signing the insurance policy, read its terms and conditions. Here I will take credit insurance conditions as an example. In the bank, when you buy a loan, most often you are manipulated by the fact that if you are not insured for risks, you will be denied credit.

Yes, credit insurance is good, but the conditions are just as important. Thus, my close friend was imposed insurance on the loan, she had already paid for it, and I undertook to read the contract, being carried away by insurance two years after the loan was issued.

In the conditions it was prescribed that people with chronic diseases, diabetics, hypertensive patients cannot apply for payments. Age restrictions are also indicated. Naturally, no one in the bank asked about illness or other conditions. In fact, it turned out that the policy was purchased at a high cost and useless. It will no longer work under any circumstances. You signed, which means you agree with the restrictions and everything that is described there.

Tip number ten!
Use the services of a lawyer in insurance!
No one better than an insurance lawyer can help you get your insurance claim without any problems. A lawyer is a lawyer, so choose only qualified specialists, especially if the case has already reached the court, then most often the insurance company is wrong. Thus, all legal costs will be reimbursed if the lawsuit is won. A highly qualified lawyer will already tell you how realistic it is to win this or that lawsuit!

The second problem lies in the insurance products themselves.
When clients come to us to insure a house, dacha, apartment, etc., they denote everything in a slightly simple language, for example: Insure my house from fire.

A good insurance agent will ask “what do you mean when you call the word fire”, as there are different understandings about the risk of “fire” in the insurance rules and the designated risks, and in different companies all this can be interpreted in different ways. For example, spontaneous combustion of electrical wiring will already be considered a short circuit, but a fire from this short circuit will be a consequence, therefore, the risk of a short circuit is most often insured separately.

Insurance companies probably won’t tell you such things, so get 10 important tips from us to get an insurance claim without any problems!

First tip, and most important!
If you are insuring directly with an insurance company, be sure to ask and read the insurance rules!
Here I will make a short digression, the insurance rules always go separately from the insurance contract. Many people mistake the text on the back of the policy for insurance rules. No, these are not rules, the rules go either in a separate book, or they are downloaded on the site in each insurance company with a pdf file.

Remember that the rules are not the same. For example, there are CASCO insurance rules, there are apartment insurance rules, there are house insurance rules, and these will all be different rules, and accordingly the conditions will be different!

Second, no less important advice!
Has an insured event happened? If it’s on fire, call the firefighters. Theft, call the police.
The insurance company will definitely request from you certificates and copies of certificates stating that you promptly contacted the police, doctors and other relevant authorities.

Third tip!
Always look at the payout table for voluntary insurance!
In order not to be left with nothing, you must understand that with life insurance for three million rubles, they will be paid, but only if, as sad as it may sound, death. For all other cases, there is a paytable. It will be calculated as a percentage of the sum insured. Thus, substandard life insurance can look like this. Broke his arm – the payment will be 0.9% of the insured amount, injured his head – 10% of the insured amount, and this will already be a more or less human paytable.

Fourth tip!
Insurance depreciation percentage.
Whether you like it or not, almost all companies have a certain percentage of wear and tear during the insurance period. In some insurance companies, when insuring the interior decoration of an apartment, the percentage of depreciation can reach up to 20% per year or more. OSAGO in this sense is limited to no more than 50% wear and tear. The second part of the depreciation can be obtained in monetary terms, let me know in the comments if you are interested in the topic: how to get the remaining amount by the percentage of depreciation? And I will write a separate detailed article on this topic!

There are companies that do not take into account the percentage of depreciation, and pay the same amount, the cost of which is made up of finishing materials and work. Most often, the conditions for such insurance will sound like “New for old”. At a percentage of depreciation, there will be a condition “Old for old”. In CASCO it is called GAP, it is most often included as an additional service and accordingly increases the insurance premium (cost of insurance).

Fifth tip!
Always keep receipts and ordering outfits!
As you know, everything tends to fall in price. In planned insurance, when purchasing for repairs, try to always keep receipts for the purchase of materials. If you insure property, keep receipts for it, or better yet, make copies of receipts, attach the main receipt, and, along with the insurance contract, store all this stuff in a fire safe. Why make copies of receipts? Everything is easy and simple, more often companies make a check in such a way that the inscriptions of this check come off the check paper within a year. This is beneficial for the company when the warranty period is more than one year.

Otherwise, the insurance company will pay at the average market value of the materials.

If you have life and health insurance, bought insurance for traveling abroad, in case of an insured event, it may happen that expenses will begin before the insurance payment. You can always show your checks to the insurance company and you will be reimbursed for your expenses. But keep in mind that the costs must be justified. For example, there should be a doctor’s appointment, then a check, and with the original or copies you go to your insurance company with a claim for reimbursement.

Tip number six!
Do not break the deadlines for contacting the insurance company!
Almost all companies set deadlines for applying for an insurance claim. Most often – this period is 7 days from the date of the insured event. At a minimum, you must notify the insurance company that the insured event has occurred.

If the deadline for claiming a loss is missed, the insurance company may refuse to pay, in which case you will have to defend your interests in court and the deadline for receiving the payment will drag on for a long time. The most important thing to remember is that violation of the deadlines for declaring a loss does not give the insurer the right to refuse insurance compensation!

Seventh tip!
Always mark that the insurance company has received documents from you!
I don’t know on purpose or not, but quite often the company loses documents. With a sober mind, you can understand that this is being done deliberately, because if you were not marked that the insurance company accepted the documents, then it will be almost impossible to prove that you gave them without that very mark. We always advise our clients to make copies of the original documents, draw up a list on a separate sheet of those documents that you provided to the insurance company, then we do this:

  • We collect sets of documents in duplicate. Original and copy, insurance companies often take the original documents.
  • We come to the claims settlement department and provide the documents.
  • Please put a stamp on the copies with a mark on the acceptance of documents.
  • We postpone the whole thing in a fire safe in case the company announces the loss or says that it did not receive these documents from you, and we keep them for three years from the date of payment of the sum insured.
    Tip number eight!
    Never underestimate the cost of property, apartment, decoration, house, etc. in order to reduce the cost of insurance!
    Let’s take a simple example. In fact, your house is worth 10 million rubles, you decided to save money and set the cost at 7 million, for some reason you decided that this amount would be enough for you in the event of complete destruction of the property.

In this example, in case of an insured event, the following formula will be used to calculate the payment of the sum insured:

Formula for calculating the payment of the insured amount
Where:

Q – Insurance indemnity.
T – The actual amount of damage.
S – Sum insured under the contract.
W – The cost estimate of the insurance object.
The insurance object worth 10 million rubles was insured for 7 million rubles, for example, in the event of a fire, the amount of damage was 5 million rubles. In this case, the amount of the insurance payment is determined as follows: 5 million * 7 million / 10 million = 3 million 500 thousand.

Thus, we got a payout ratio of 0.7 (7 million divided by 10 million), if the amount was equal, then we would get a coefficient = 1, and we would also receive the full cost of damage. Therefore, it is better to play it safe and make the cost of the insurance object a little higher.

Tip number nine!
Insurance conditions are no less important than insurance rules!
Before signing the insurance policy, read its terms and conditions. Here I will take credit insurance conditions as an example. In the bank, when you buy a loan, most often you are manipulated by the fact that if you are not insured for risks, you will be denied credit.

Yes, credit insurance is good, but the conditions are just as important. Thus, my close friend was imposed insurance on the loan, she had already paid for it, and I undertook to read the contract, being carried away by insurance two years after the loan was issued.

In the conditions it was prescribed that people with chronic diseases, diabetics, hypertensive patients cannot apply for payments. Age restrictions are also indicated. Naturally, no one in the bank asked about illness or other conditions. In fact, it turned out that the policy was purchased at a high cost and useless. It will no longer work under any circumstances. You signed, which means you agree with the restrictions and everything that is described there.

Tip number ten!
Use the services of a lawyer in insurance!
No one better than an insurance lawyer can help you get your insurance claim without any problems. A lawyer is a lawyer, so choose only qualified specialists, especially if the case has already reached the court, then most often the insurance company is wrong. Thus, all legal costs will be reimbursed if the lawsuit is won. A highly qualified lawyer will already tell you how realistic it is to win this or that lawsuit!

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