Insurance is an activity aimed at protecting the rights of policyholders from various risks. But even in this area, disputes arise that are considered in court, as well as not reaching it. Resolution of conflict situations occurs by various methods. Disputes with insurance companies usually force you to file a lawsuit with the court.
Contract study
Most often, conflict situations arise due to inattentive study by the client of the contract. It is necessary to read all the information presented in the document. Usually, consumers perceive the information that was voiced by the insurance agent, after which they decide on the policy.
You should not sign a document until the text has been studied. Particular attention should be paid to small print. Usually, wording is revealed there, which can then be used by insurers to refuse to pay compensation or to reduce the amount.
It is advisable to familiarize yourself with the contract at home, in a relaxed atmosphere. Better yet, consult with a lawyer before signing the document. Particular attention should be paid to the information, which indicates cases in which the company does not pay compensation. If something does not suit you, it is possible to contact another company.
Drawing up a claim
The easiest way to resolve a dispute is to file a claim with the policyholder. This is done according to some rules:
- the application must be submitted in writing;
- The claim must be clearly stated;
- it is important to set a timeline for meeting requirements;
- the document should be made in 2 copies.
For the resolution of disputes with the insurance company to be successful, you need to identify links to laws. In this case, the requirements are considered reasonable. It is necessary to prevent emotional phrases related to the personal interests of the parties.
Further actions
When a claim for settlement of disputes with an insurance company is filed, it is necessary to wait for a decision. This period is indicated in the contract. During this time, it is permissible to resolve everything in a peaceful way. If no reaction has followed, then the policyholder has the right to go to court.
Litigation with an insurance company is considered the most effective because some companies do not want to negotiate in a peaceful manner. If in this case the decision is positive, then the applicant has the right to restore his rights, as well as to recover compensation for non-pecuniary damage from the insurance agency.
How to win the court?
Please note that disputes with insurance companies are considered on an individual basis. Therefore, it will be difficult to suggest a decision, since the judge will consider and study each case.
To win the trial, you need to seek help from a specialist. You can deal with your rights independently, but there are no guarantees that all documents will be drawn up correctly and personal interests can be defended in the course of the proceedings.
Drawing up a claim
If disputes with insurance companies reach the court, then you need to be able to draw up a statement of claim. It should have:
- name of the parties to the case and court;
- circumstances with arguments, arguments and evidence;
- requirements for the insurance company.
Before going to court, you need to make sure that the rights have indeed been infringed, and that the actions of the insurance company are justified. For example, a company requires additional documents from a client to make payments. And the client does not understand why this is necessary, starts a conflict and decides to go to court. During the meeting, it is determined that the company was right, the documents were required by law. Then the court rejects the application of the insured.
Common problems
Usually disputes with insurance companies arise due to insurance payments. The reasons for this are the following factors:
- insurance companies try to reduce the size of payments or not to provide them at all;
- the insurer is delaying the payment procedure, because of which the whole case goes to court.
This does not mean that every company has such difficulties. Before concluding a contract, you must carefully read the terms and conditions. It is difficult for a non-specialist to understand the intricacies of legislation in order to understand the principles of work of firms.
Disputes with insurance agencies, which are resolved independently, usually lead to adverse consequences. Due to legal ignorance, the policyholder may choose the wrong strategy to protect their interests. It is best to seek the help of a lawyer who will conduct the whole case.
Types of lawsuits
Disputes with insurance companies are most often resolved through the courts. This option is most effective if the company does not provide timely payments.
Claims are of the following types:
- claims are made regarding disagreement with the amount of payments;
- if there was a waiver of payments;
- when the event the company does not relate to the insured event.
For whatever reason the lawsuit is filed, it is necessary to correctly file a statement. A competent strategy to protect your rights is also important.
Causes of Conflict
The law has many documents that disclose the rules of work of insurance companies. But even with this in mind, a dispute with insurance for damages is a frequent occurrence. Firms find various leads in order not to pay compensation to their customers. Some actions have no legal justification. Insurance disputes arise because such companies conduct their own business where losses are not needed. It turns out that extra payments should be avoided.
Often spores appear after an accident. They are commonplace. The decision of the trial depends on how the parties prove their case. In practice, in many cases, the insurance company is considered the losing party. If at least some violations of rights have been discovered, the policyholder must urgently act. This will protect your interests and recover damages.
Why should I contact lawyers?
A professional disputes the refusal of an accident to be recognized as an insurance event. If this happens, the company is obliged to indemnify. This is prescribed in the contract, which also indicates the types of such cases. Get payments only from a persistent client.
The specialist will seek compensation. To do this, he will gather evidence that the case is insurance. He will also draw up a claim and forward it to the insurance company. If this fails, a lawsuit will be filed. In this case, it will be possible to receive not only compensation, but also compensation for non-pecuniary damage, payment of legal expenses.
The lawyer will consider materials that indicate the reasons for the refusal or decrease in the amount of payments. Usually the reports do not indicate the amount that was put by the victims. Then the lawyer turns to independent appraisers who can determine the amount of compensation. Then he draws up a claim to Rospotrebnadzor. When there is no action, then an appeal to the court follows.
Specialists help in disputes about compensation for health damage that arose due to poor-quality medical care. Assistance in this service is vital when inappropriate services harm a person. After all, the consequences of this can be different - from a little harm to disability.
If the insurance company does not wish to pay compensation for the damage caused, then evidence of the damage must be collected. Written disclaimers will help. Lawyers communicate with representatives of insurance companies, make claims, collect evidence of damage. As a result, there is a high probability that the rights of the client will be protected and he will receive the necessary compensation.