Again and again, it happens that an insurance company does not pay for damage and thus causes great annoyance among the insured. Motor vehicle insurance is taken out in order to be protected against any damage to others and to your own car. There are various reasons why an insurance company does not want to pay for claims settlement. Ultimately, it is decisive whether the refusal to pay the motor vehicle insurance is justified. A common reason given by the insurance company for refusing to provide benefits is: “You have violated an obligation in the general terms and conditions for motor vehicle insurance (AKB).” The insured person, therefore, violated a contractually regulated duty of behavior. This means that the insurance is free of benefits or, depending on the amount of damage, can reduce the benefit. This means, As an insured, you remain “seated” on your loss. In other words, you will not receive any money or only part of the amount agreed for such a case. We will clarify the reasons why insurance may refuse to provide benefits and what you, as an insurance customer, can do about it to get your money in the event of damage if the car insurance does not pay.
* What car insurance are there?
* What are the obligations for policyholders?
* What should you watch out for in the event of a dispute?
* Errors in the “General Conditions” of car insurance become a stroke of luck for “sinners”
* Who can benefit from insurers’ mistakes?
* Motor vehicle insurance does not pay: Worsened regulation of motor vehicle liability claims
* What can you do if the car insurance does not pay
What car insurance are there?
There are basically three well-known motor vehicle insurance policies, motor vehicle liability, partial coverage, and comprehensive coverage. The automobile liability insurance is required by law for every driver and covers personal injury and property damage caused by the insured in others. In contrast, comprehensive insurance is voluntary. With comprehensive insurance, the insurance pays for damage to the insured person’s car.
What damage does a comprehensive insurance cover?
Comprehensive insurance covers incalculable, non-self-inflicted damage caused by fire or explosion, storm, flood, hail, lightning, marten infestation, or a glass breakage and game accidents on your own vehicle. Insurance also applies if the car is stolen.
Fully comprehensive insurance covers all damage to the vehicle mentioned above and also covers accidental damage caused by you. It also pays in the event of vandalism or if the opponent of the accident has attempted to flee the driver. If the person causing the damage is not solvent, comprehensive insurance is also liable in this case.
In which cases do car insurance not pay?
Intentional or grossly negligent action can result in insurance being excluded. For example, if you take part in road traffic with your vehicle without a valid TÜV, you are already risking your insurance cover. Drunk driving or inability to drive caused by drug use also means that you have to bear your own costs in the event of damage. Other clear cases of grossly negligent behavior include operating the cell phone while driving, kissing at the wheel, escaping from the driver and excessive speed or disregarding traffic rules and illegal car racing.
Even in the event of a delayed damage report, it can happen that the insurance does not pay and you “stay” at your own expense. In the latter case, insurance companies usually cite the breach of a contractual obligation by the policyholder, the so-called obligation, as the reason for the exclusion from benefits.
Motor vehicle liability insurance takes policyholders into recourse
In principle, the policyholder can be sure that the damage will initially be regulated by the insurance company since it is statutory insurance and is therefore obliged to pay. In the event of a breach of a contractual obligation by the policyholder, a so-called breach of duty, the insurance company can, however, reclaim the payment made up to an amount of EUR 5,000. The insurance, therefore, takes the insurance customer into recourse.
What are the obligations for policyholders?
The insurance customer’s duties of conduct result from statutory provisions and contractual agreements, which either apply before the contract is concluded or only when an insured event occurs.
Regulations applicable before the conclusion of the contract include the obligation to pay premiums and to truthfully provide data. If, for example, the insured person ceases to pay his premiums, his insurance cover also expires automatically. Furthermore, insurance companies only pay if the driver is in possession of a valid driver’s license and the driver is authorized to drive the vehicle (black driver clause).
In the event of damage, other insurance regulations must be observed. For example, insured persons are obliged to report claims to the insurance company within one week ( so-called notification obligation ). In addition, they must contribute to the complete clarification of the facts and provide all the information required in this regard ( duty to provide information and information). When the car is repaired, the insurer’s instructions must be obtained beforehand ( obligation to obtain instructions ).
Car insurance does not pay: what should you watch out for in the event of a dispute?
Anyone who concludes an insurance contract must adhere to the statutory provisions and contractual agreements of the insurance company in order to receive benefits in the event of damage. If the policyholder violates this obligation, the insurer can terminate the contract or claim exemption from benefits. First, you should inform yourself about the exact regulations before concluding the contract. Because: A dispute about compliance with these behavioral obligations is not only unpleasant for the insured person but also rarely leads to success, especially without legal representation. However, such a dispute can also be avoided if it turns out that the insurer has made a mistake in the General Motor Insurance Conditions (AKB). If this is the case,
Car insurance has not paid or does not want to pay? Contact one of our specialist lawyers in insurance law and describe your concerns conveniently in our online form. We will assess your case immediately and show you your options in an initial consultation as to how you can proceed against the insurance.
Errors in the “General Conditions” of car insurance become a stroke of luck for “sinners”
The contractual obligations, ie the behavioral obligations of the insured, are agreed in the “General Conditions” for car insurance. These must be formulated in a transparent and understandable manner so that the insured can clearly see what is required of them and under what circumstances they lose their insurance coverage. The general conditions for motor vehicle insurance therefore also regulate when the insurer does not have to pay due to a breach of duty by his insured. However, in the interests of the insured, the legislator has set strict requirements. For example, the sanction clause must inform the policyholder
Has a claim occurred and your insurance company refuses to pay? If your insurance company has not informed you about the legal consequences of breaching an obligation, there is a good chance that you will get your money. Use our free initial consultation to describe your case to one of our insurance law specialists.
Who can benefit from insurers’ mistakes?
Basically everyone who is denied insurance benefits and in the general terms and conditions for car insurance, the separate notification of a breach of duty in text form is missing. Since the model conditions of the comprehensive insurance companies failed to refer to this insured-friendly legal consequence, the error can be found in the general conditions for the motor insurance of many insurers, which were based on the model.
Incidentally, not only can insured persons benefit from the ineffective sanction rule in the event of a current dispute over an insured benefit to be granted, but claims can be made retrospectively for up to 10 years. This means that anyone who was once refused a benefit may still have the opportunity to get the money from his insurance company that he himself had to spend to repair the damage. Claims for recourse by motor vehicle insurance are also included in this argument.
Have you had a claim in the past and your insurance company refused to pay? During an initial consultation, contact one of our lawyers. We will examine your chances of success and show you options for action.
Car insurance does not pay: Worsened regulation of liability claims
When choosing a car insurance, two factors are usually decisive for insurance customers: first, the lowest possible price for the insurance and second, the claims settlement. But exactly with the latter there are always problems. Because: The regulation of motor vehicle liability claims has worsened over the past five years, according to a survey by the Forsa Institute among traffic lawyers. Insurance customers either have to expect very long processing times and delay tactics, accept reductions in benefits or are often illegally rejected by the insurance company. This was stated by 72% of the 1072 lawyers surveyed. The HUK-Coburg, Allianz, and VHV perform particularly badly in the survey. 68% of lawyers said that especially at HUK-Coburg there are often problems with the regulation of liability claims. The large insurance companies cannot shine in the “processing times” category either. According to 50% of the lawyers surveyed, Allianz has the longest waiting times. But there are also positive things in the survey: Aachen Münchener and Gothaer performed particularly well in both categories.
Here is an overview of the results of the Forsa survey:
What can you do if the car insurance does not pay
It is often not easy to assess in which cases of damage, comprehensive auto insurance can reduce or refuse payment. Especially when it comes to large amounts of money, insured persons cannot always hope for an uncomplicated and timely settlement of the claim by the insurance company. Insureds often have to expect disproportionately long processing times and delayed benefits. In the event of a reduction in payment or complete refusal of benefits by the insurance company, it can sometimes prove useful to commission an expert and have the case assessed independently. It is also advisable to check the insurance contract for any errors. The report can help you insist on full regulation and avoid disputes with the insurance company.