Relations arising from an insurance contract are governed by Chapter 48 "Insurance" of the Civil Code of the Russian Federation (hereinafter referred to as the Civil Code of the Russian Federation), as well as other regulatory legal acts about insurance. Taking into account the foregoing and the provisions of Article 39 of the Law of the Russian Federation "On Protection of Consumer Rights" dated February 7, 1992 No. 2300-1 (hereinafter referred to as the Law of the Russian Federation), this law applies to relations arising from these agreements in part general rules, and the legal consequences of violations of the terms of this agreement are determined by the Civil Code of the Russian Federation and other legislation on insurance.
Taking into account the provisions of the above article of the Law of the Russian Federation, relations arising from contracts for the provision of certain types of services with the participation of a citizen, the consequences of violation of the conditions of which are not subject to Chapter III of the Law of the Russian Federation, should be applied general provisions Law of the Russian Federation, in particular on the right of citizens to provide information (Articles 8-12), on liability for violation of consumer rights (Article 13), on compensation for harm (Article 14), on compensation for non-pecuniary damage (Article 15), on alternative jurisdiction ( paragraph 2 of article 17), as well as on exemption from payment of state duty (paragraph 3 of article 17) in accordance with paragraphs 2 and 3 of article 333 36 tax code Russian Federation.
Lack of sufficient knowledge among consumers, length of insurance periods during which legislation may change and economic conditions in the country significantly complicates the possibility of a real assessment of the service and protection of consumer rights in the event of a conflict. Therefore, the consumer initially faces a number of problems:
In order to solve the above problems and make the right choice of service, it is advisable to analyze the offers of various insurance service providers, having studied the content of the contracts they offer. When analyzing the contract, the consumer should evaluate the completeness of information about the service provided and the degree of protection of the consumer's interests. (The complexity of the problem lies in the fact that the rules of insurance and the text of the contract are developed by the insurer. At the same time, complex insurance conditions can be introduced into the rules and the contract, the meaning of which may not be understood by all insurers. The purpose of such traps is to free the insurer from liability to the insured in the event of insured event.
The insurance contract must be concluded in writing. Failure to comply with the written form shall entail the invalidity of the insurance contract, with the exception of the compulsory state insurance contract.
An insurance contract can be concluded by drawing up one document or by delivering it by the insurer (insurance organization) to the insured (consumer, insured) on the basis of his written or oral application insurance policy(certificate, certificate, receipt) signed by the insurer.
In the latter case, the consent of the insured to conclude a contract on the terms proposed by the insurer is confirmed by the acceptance of documents from the insurer. When concluding an insurance contract, the insurer shall have the right to apply the standard forms of the contract (insurance policy) developed by him or the association of insurers for certain types of insurance.
With regard to the order of payments, the consumer should pay attention to whether inflation is taken into account in the contract when determining the amount of payments. If a currency clause is applied, it is necessary to indicate at what rate (buying or selling) the consumer is obliged to pay insurance premiums and, most importantly, insurance compensation. An obligatory issue that should be stipulated in the contract is the order of payment terms.
The reality of receiving compensation due to the consumer for non-compliance with the terms of the contract by the insured is assessed by the presence of property (preferably immovable) from the company with which he enters into contractual relations, as well as the location legal entity.
The consumer of insurance services has the right to ask to show a license for the type of insurance of interest to him and has the right to demand the provision of the necessary and reliable information about the insured, the mode of his work and the services he provides, and also in accordance with Article 10 of the Law of the Russian Federation, the insured is obliged to provide the consumer with the necessary and reliable information in a timely manner. information about services to enable them to be selected correctly.
Article 12 of the Law of the Russian Federation provides for the liability of the contractor for improper information about the insurance service. If the consumer is not given the opportunity to immediately receive information about the service upon conclusion of the contract, he has the right to demand from the insurant compensation for losses caused by unjustified avoidance of concluding the contract, and if the contract is concluded, to refuse to execute it within a reasonable time and demand the return of the amount paid for the service provided and compensation for other damages.
Unless otherwise provided by the legislation on insurance, the consumer has the right to refuse to execute the contract for the provision of services at any time, provided that the insurance company pays the expenses actually incurred by it related to the fulfillment of obligations under this contract (Article 32 of the Law "On Protection of Consumer Rights") .
In case of poor-quality provision of services under an insurance contract or in case of termination of the contract, the consumer must contact the insurance company with the appropriate requirement. The claim is written in two copies, one copy is given (sent) to the insurer, insurance organization.
According to Article 11 of the Civil Code of the Russian Federation and Article 17 of the Law of the Russian Federation, the protection of violated civil rights carried out by the court. Thus, in case of non-satisfaction of your requirements by the insurer, you have the right to file a claim with the court. AT statement of claim present the following requirements: to pay the amount according to the contract and monetary compensation for non-pecuniary damage. The amount of moral damage must be justified.
1. When considering civil cases, the courts should take into account that relations, one of the parties to which is a citizen who uses, acquires, orders or has the intention to purchase or order goods (works, services) exclusively for personal, family, household, domestic and other needs, non-implementation entrepreneurial activity, and the other - an organization or an individual entrepreneur (manufacturer, performer, seller, importer) selling goods, performing work, providing services, are relations regulated by the Civil Code of the Russian Federation (hereinafter - the Civil Code of the Russian Federation), the Law of the Russian Federation of February 7, 1992 of the year N 2300-1 "On the Protection of Consumer Rights" (hereinafter referred to as the Law on the Protection of Consumer Rights or the Law), other federal laws and other regulatory legal acts of the Russian Federation adopted in accordance with them.
2. If certain types of relations with the participation of consumers are also regulated by special laws of the Russian Federation containing civil law norms (for example, an agreement on participation in shared construction, an insurance contract, both personal and property, a bank deposit contract, a transportation contract, an energy supply contract), then the Consumer Rights Protection Law applies to relations arising from such contracts to the extent not regulated by special laws.
Taking into account the provisions of Article 39 of the Consumer Rights Protection Law, the general provisions of the Consumer Rights Protection Law, in particular on the right of citizens to provide information (article 8 -), on liability for violation of consumer rights, on compensation for harm, on compensation for moral damage, on alternative jurisdiction (paragraph 2 of article 17), as well as on exemption from payment of state duty (paragraph 3 of article 17 ) in accordance with paragraphs 2 and 3 of Article 333.36 of the Tax Code of the Russian Federation.
A) Based on the preamble of the Consumer Protection Law and Article 9 federal law dated January 26, 1996 N 15-FZ "On the Enactment of Part Two of the Civil Code of the Russian Federation" enjoys the rights granted to the consumer by the Law and other legal acts issued in accordance with it, as well as the rights of the party to the obligation in accordance with the Civil Code of the Russian Federation not only a citizen who intends to order or purchase or ordering, acquiring goods (works, services), but also a citizen who uses the goods (works, services) acquired (ordered) as a result of such relations on a legal basis (heir, as well as a person to which the thing was subsequently alienated, etc.).
At the same time, one should keep in mind the cases provided for by the Law, when the liability of the seller (executor) arises only to the citizen who has concluded an agreement with him (for example, in accordance with paragraph 1 of Article 12 of the Law, require the seller (executor) to compensate for losses caused by unreasonable evasion from concluding an agreement, only the consumer who was denied the opportunity to immediately receive information about the product, work or service at the conclusion of the contract is entitled);
b) goods should be understood as a thing (things), defined either by generic (number, weight, measure) or individual characteristics, intended for sale or other introduction into civil circulation;
c) work should be understood as an action (a set of actions) that has a materially expressed result and is performed by the performer in the interests and at the request of the consumer on a reimbursable contractual basis;
d) a service should be understood as an action (a set of actions) performed by the performer in the interests and at the request of the consumer for the purposes for which a service of this kind is usually used, or corresponding to the purposes that the contractor was informed of by the consumer when concluding a reimbursable contract;
D) under financial service should be understood as a service provided to an individual in connection with the provision, attraction and (or) placement Money and their equivalents, acting as independent objects of civil rights (provision of credits (loans), opening and maintaining current and other bank accounts, attraction bank deposits(deposits), maintenance bank cards, pawnshop operations, etc.).
4. To the relations of the parties preliminary contract(Civil Code of the Russian Federation), under the terms of which a citizen actually expresses an intention to order or purchase goods (works, services) on a reimbursable basis in the future exclusively for personal, family, household, household and other needs not related to entrepreneurial activities, the legislation on protection is applied consumer rights.
5. Legislation on the protection of consumer rights also applies to relations for the purchase of goods (works, services) under a paid contract, if the price in such a contract is not indicated.
6. To relations on the commission of notarial acts by a notary, as well as to relations on the provision of professional legal aid Lawyers do not apply consumer protection laws.
7. Legislation on the protection of consumer rights does not regulate the relations of citizens with associations of homeowners, housing construction cooperatives, housing savings cooperatives, horticultural, horticultural and dacha non-profit associations of citizens, if these relations arise in connection with the membership of citizens in these organizations. On relations regarding the provision by these organizations to citizens, including members of these organizations, paid services(works) Consumer Protection Act applies.
8. The rights and legitimate interests of citizens who have the right to state social assistance and use goods or services in the course of its implementation are subject to protection in the manner prescribed by legislation on the protection of consumer rights. Claims may be made against the manufacturer (seller) of these goods, the service provider.
9. To relations on the provision of medical services to citizens, provided by medical organizations within the framework of voluntary and mandatory health insurance consumer protection laws apply.
10. In accordance with paragraph 9 of Article 4 of the Federal Law of December 30, 2004 N 214-FZ "On Participation in Shared Construction apartment buildings and other real estate objects and on amendments to certain legislative acts of the Russian Federation" to relations arising from an agreement on participation in shared construction concluded by a citizen for the purpose of acquiring ownership of residential premises and other real estate objects exclusively for personal, family, home, household and other needs not related to the implementation of entrepreneurial activities, consumer protection legislation is applied to the extent not regulated by this law.
11. On relations related to the implementation by legal entities and individual entrepreneurs intermediary services on the real estate transaction market (real estate services, which consist, in particular, in the selection of real estate options for their subsequent sale and purchase, lease by citizens for purposes not related to entrepreneurial activity, assistance in concluding sales and other transactions by these citizens in relation to real estate objects, organization of the sale of real estate objects on behalf of these citizens), the Law on the Protection of Consumer Rights applies.
12. Based on the meaning of paragraph 4 of Article 23 of the Civil Code of the Russian Federation, a citizen who carries out entrepreneurial activities without forming a legal entity in violation of the requirements established by paragraph 1 of this article is not entitled to refer, in relation to transactions concluded by him, to the fact that he is not an entrepreneur. The court applies consumer protection laws to such transactions.
The development of the market providing the service naturally leads to the development of the insurance services market. For a long time, insurers and consumer protection advocates have been arguing about the correct application of the Consumer Protection Law to an insurance contract.
In the article, we will adhere to the point of view that the latter falls within the legal scope of this law, especially in the case of the provision of services of inadequate quality.
Insurance can be compulsory and voluntary. More and more people are thinking about life, health, and property insurance. Without going into the details of the insurance business, we propose to discuss the forms and methods of protecting consumers - users of insurance services, guaranteed by law, namely if Insurance Company refuses to fulfill obligations in the event of an insured event, stipulated by the insurance contract.
Here is a list of legislative acts regulating the topic we are discussing:
Let's look at the nuances that must be observed when concluding an insurance contract. In this section, we will talk about voluntary insurance. individual, because the mandatory ones - health insurance and OSAGO - are described in detail in the legislation and do not imply deviations from it, and, in more detail, we will discuss them in the third section of our article.
Prior to the conclusion of the contract, the insurer provides the policyholder with comprehensive and true information about its activities, legal form, legal address, etc. It is advisable to require a copy of his license, since the insurance business is a licensed type of activity.
We remember that according to our specialized law protecting consumers, the provision of information is an important link in the process of forming an informed choice of the consumer (insurant). The insurer may be held administratively liable for providing false information, moreover, the policyholder may challenge the validity of such an agreement through the court.
The contract is concluded in writing, otherwise the contract is considered invalid, is voluntary, bilateral, aimed at protecting the life, property and health of a person and paying a sum of money in the event of an insured event, formed from the paid insurance premiums.
The insurance contract determines the parties - the insurer and the policyholder, describes in detail the insured event, determines the amount of the sum insured and the expiration of the contract. The above provisions are considered essential in the insurance contract.
The contract is considered concluded from the moment the insurance policy is issued and the first payment is made. insurance premium the insured.
In this section, we will talk about the types of compulsory insurance in the Russian Federation.
Let's start with the most famous compulsory health insurance, provided by the state in order to guarantee the provision of medical care, if necessary, to all citizens of the country. Employers pay insurance premiums. Compulsory insurance is convenient because you can use the services of medical organizations throughout the country.
Compulsory insurance for various transportations was introduced by the legislator in order to cover the safety and interests of passengers and ensure that the latter receive payments. The insurance contract is concluded between the carrier and the insurer and provides insurance for the entire route of the passenger's route, keep the ticket and insurance document: policy or check.
Mandatory social insurance citizens. A law-abiding employer pays a percentage of wages worker in social fund, which allocates funds for various social benefits: for children, pensioners, disabled people, large families etc. Thus, the state performs the function of caring for and supporting socially vulnerable segments of the population. A citizen is assigned an individual number, which is abbreviated as SNILS, on which information about the career and the amount of contributions made are available.
Continuing the list of types of compulsory insurance carried out by employers, we point out the compulsory life and health insurance for military and officials. Thus, the state creates comfortable service conditions for people whose lives may be in danger in the performance of official duties.
Another mandatory type of insurance is insurance of civil liability of the owner of an object of increased danger, for example, mines, mines, oil refineries, etc. in relation to workers engaged in labor activities in conditions that threaten their life and health.
The last type of insurance that we list is issued by car owners - compulsory motor third party liability insurance. An insured event occurs in the event of an accident on the road, so ensure that the insurance policy is always available in the car.
In the article we discussed legislative framework protecting the interests and rights of consumers - users of insurance services, settled on essential conditions insurance contracts and listed compulsory types of insurance. We hope the information will be useful to you.
At present, the courts of motorists with insurance companies (IC) have become so commonplace that the Supreme Court of the Russian Federation (SC RF) has to periodically come up with clarifications, definitions and resolutions regulating the law enforcement practice of courts in cases related to auto insurance.
In these cases, the courts receive applications from both car owners and insurance companies.
The first complain about refusals or delays in the payment of insurance compensation, as well as their insufficient amount.
The second - to the increasing cases of fraud on the part of policyholders.
And not without reason: by no means isolated cases have been registered when motorists, having concluded an agreement, for example, for voluntary insurance responsibility (DSAGO), the limit for which is determined by a particular insurance company and reaches - in the limiting case - 15 million rubles, organize the "arrangement" of previously damaged expensive cars on the road, call the traffic police, and then try to repair the damage at the expense of the insurance.
This serves as a reason for insurers to "reinsure themselves" and in disputable cases to avoid in every possible way even the payments required by law. Legislation until recently supported them in this. And arbitrage practice testified that OSAGO and the Law on Consumer Rights Protection (ZZPP) were “not friends” with each other.
If according to the CASCO Plenum Supreme Court In 2012, the Russian Federation adopted Decree No. 17 (“On consideration by courts of civil cases in disputes on the protection of consumer rights”), relating, generally speaking, to all types of property and personal insurance- and the courts began to use the provisions of the RFP in their work, the practice regarding OSAGO, until recently, remained ambiguous.
The reason is that the claim for OSAGO is brought by a third party who did not conclude an agreement with the insurance company, which must make the payment - and in this sense, it is not a “consumer”. A number of courts were also guided by the fact that the relationship between the victim and the insurance company of the culprit of the damage is regulated by the OSAGO Law, which does not provide for payments regulated by the ZZPP.
Adopted a law protecting the rights of consumers insured under OSAGO
And only this year (January 29, 2015) the Plenum of the RF Armed Forces was held, which adopted Decree No. 2 “On the application by courts of legislation on compulsory insurance of civil liability of vehicle owners”, the full text of which can be found . It deals with 66 controversial issues, which are given specific and detailed answers. At the same time, the protection of consumer rights is at the forefront. OSAGO insurance in the sense is now no different from the same CASCO insurance: both types of auto insurance are unconditionally subject to the provisions of the RFP, which is clearly stated in paragraph 2:
“On the relations arising from the contract of compulsory insurance of civil liability of vehicle owners, the Law on the Protection of Consumer Rights applies in cases where insurance is carried out exclusively for personal, family, household, domestic and other needs not related to the implementation of entrepreneurial and other economic activities” .
Yes, there are restrictions related to entrepreneurship. Yes, the RFP does not apply to compensation payments made by a professional association of insurers in case the IC is unable to pay the money. But here, you see, not to fat. On the whole, however, the turn of the insurance legislation to face the consumer is obvious (a tautology is quite appropriate here).
What will specifically improve for you and me - ordinary motorists and OSAGO insurers?
What should be done if the insurance company does not pay for OSAGO?
And this is only a small part of the opportunities provided by the STD and legislation on insurance business, which the consumer could not use before due to various interpretations of the provisions of the laws. Now the courts have been given quite clear guidelines on which their practice will be built - and is already being built. And a simple car enthusiast now knows exactly what to do: legally file a claim against the insurance company (pre-trial is now a mandatory stage of the dispute), and then - in the absence of a positive result - go to court. He will restore justice.
And to help restore it to those who have neither knowledge nor experience in matters of jurisprudence and litigation, auto-lawyers of our association can always help.
Call, ask - and you will be answered, advised, provided with the necessary legal assistance.
A life insurance contract is a type of personal insurance contract, under which the insurer, instead of the premium paid by the insured, undertakes to pay a lump sum or pay the amount (insurance coverage) stipulated by the contract periodically in case of harm to the life or health of the insured or the insured person, reaching a certain age or the onset in his life other stipulated by the agreement event insurance (clause 1, article 934 of the Civil Code of the Russian Federation).
In accordance with paragraph 2, clause 1, Article 927 of the Civil Code of the Russian Federation, a personal insurance contract is a public contract (Article 426 of the Civil Code of the Russian Federation). Distinctive feature public contract is that the parties to such a contract are always commercial organization and consumer.
The concept of a consumer is contained in the Law "On the Protection of Consumer Rights" of 07.02.1992. No. 2300-1 (as amended on 07/23/2008) (hereinafter referred to as the RFP Law), according to the provisions of which a consumer is a citizen who has the intention to order or purchase or ordering, acquiring or using goods (works, services) exclusively for personal, family, household and other needs not related to the implementation of entrepreneurial activities.
In order to correctly interpret and apply the norms of the Law on the RFP, in paragraph 3, clause 1 of the Decree of the Plenum of the RF Armed Forces dated 29.09.1994. No. 7 (as amended on 05/11/2007) "On the practice of consideration by courts of cases on consumer protection" (hereinafter referred to as the Resolution) contains an approximate list of contracts from which relations regulated by consumer rights protection legislation may arise, but this list is not insurance contract. However, this does not at all exclude the possibility of applying the RFP Law to relations between an insurance organization and a consumer citizen who concludes an insurance contract to meet personal, household and other needs not related to business activities. A personal insurance contract, being a public contract, meets all of the above criteria, therefore the CPP Law applies to the relations of the parties arising from a life insurance contract.
At the same time, it should be noted that the features and grounds for terminating an insurance contract are determined by Chapter 48 of the Civil Code of the Russian Federation “Insurance”, special laws and general provisions of the Civil Code of the Russian Federation. Therefore, in terms of terminating a life insurance contract, only the general provisions of the CPP Law (chapters one and four) apply.
With regard to the possibility of early termination of the life insurance contract, you can use one of the following options.
Firstly, the possibility for early termination of the insurance contract is provided for in clause 2 of article 958 of the Civil Code of the Russian Federation, according to which the policyholder has the right to refuse the insurance contract at any time, if by the time of refusal the possibility of an insured event has not disappeared.
To do this, you must submit a written application to the insurance company for early termination of the insurance contract and submit a number of documents, according to the list, as a rule, approved by the insurer in the rules for the relevant type of insurance (identity document, policy (insurance contract), etc.).
In case of early termination of the insurance contract in accordance with paragraph 2, clause 3, article 958 of the Civil Code of the Russian Federation, you are entitled to a refund of a part of the insurance premium paid to the insurer in proportion to the time during which the insurance was valid.
In addition, you should pay attention to the provisions of the life insurance contract you have concluded, as well as the provisions of the Rules for this type of insurance issued to you by the insurer, since these documents may contain additional conditions and grounds for terminating this contract.
Secondly, if your insurance company ceases to operate due to reorganization (transfer of its rights and obligations to another insurer), then in accordance with paragraph 2 of Article 60 of the Civil Code of the Russian Federation, you, as a creditor of the reorganized legal entity, have the right to demand early termination of the obligation. To do this, you also need to submit a written application for early termination of the life insurance contract in connection with the reorganization of the insurer and demand the return of part of the insurance premium on the basis of paragraph 2, clause 3, article 958 of the Civil Code of the Russian Federation.
