Additional insurance conditions and insurer's rules. Insurance consultant. How to correctly determine an insured event

Based on the current legislation of the Russian Federation, the insurer enters into voluntary property insurance contracts with legal entities and individuals - policyholders.

List of dangers from which insurance must be taken depends on the nature of the risk. For industrial risks, these are considered to be fire, explosion, breakdown of machinery and mechanisms, natural disasters, leaks of toxic substances, for environmental risks - pollution or other damage to the environment, for investment risks - various events leading to the loss of investment objects or profits as a result of investing funds.

The list of dangers within a specific insurance coverage is also determined by the choice of type of insurance. There is an established practice of combining in one insurance contract several risks that are similar in the reasons for their occurrence, the nature of the impact, the nature of the losses, etc. In this case, a situation may arise when various risks can be combined within the same insurance coverage. Therefore, the main task is not to determine in detail the conditions for the provision and types of insurance coverage (this task is solved jointly with the insurance company), but to understand what type and extent of coverage should be provided for individual risks.

Maximum insurance liability for each type of danger and type of loss must correspond to the amount of insurance compensation provided for individual risks in the event of the most unfavorable situation. It is advisable to set its maximum amount at the level of the maximum acceptable amount of loss determined in the process of risk analysis.

In general, the complex of insurance conditions includes the following components:

Conditions for providing insurance coverage;

Insurance scheme;

Conditions limiting the insurer's liability;

Amount and terms of payment of the insurance premium;

Responsibilities of the insurer;

Responsibilities of the policyholder;

Terms of concluding an insurance contract;

Conditions for the insurer's refusal to pay insurance compensation;

Procedure for payment of insurance compensation;

Conditions for the transfer of the policyholder's rights after payment of insurance compensation;

Other conditions.

The policyholder needs to determine the most important types of insurance for him.

As already mentioned, the classification of risks does not fully correspond to the classification of types of insurance. Many traditional types, such as property insurance for legal entities, include protection against various risks. Conversely, the same risk can be expressed in different types of insurance. For example, credit risk can be insured both under a liability insurance contract for non-fulfillment of obligations and under a financial risk insurance contract.

The policyholder has the opportunity to choose under which types of insurance it is desirable to receive insurance protection. Fundamentally, there are two different types of insurance contracts: special, which provide protection against only one type of risk or cover only one type of loss, and complex, which provide protection against all or most risks for the selected insurance object.

Concluding complex contracts has a number of attractive aspects for the policyholder. For example, this reduces the time spent on insurance negotiations, pays out insurance compensation faster, and achieves a better understanding of the interests of the parties. The complex tariff rate is always less than the sum of individual insurance tariff rates for the same set of risks. However, there is one complicating factor: the complex risk of an individual policyholder may be so great that it may not be possible to cover it within the framework of a separate insurance company.

From the general list of risks subject to insurance, it is useful to highlight those that are subject to mandatory insurance within the framework of the law or due to contractual circumstances.

For compulsory types of insurance provided by law, there are various restrictions on the conditions for concluding insurance contracts. For example, some conditions for concluding insurance contracts for liability for damage caused by hazardous production facilities are enshrined in the Law of the Russian Federation “On Industrial Safety of Hazardous Production Facilities” dated July 21, 1997 No. 116-F3, in particular the minimum amount of the insurance amount depending on the degree of danger of the facility.

According to the current civil legislation, contracts for compulsory insurance can only be concluded with state insurance companies.

There may be contractual obligations to obtain insurance under other agreements or contracts. The insurance condition may be one of the conditions for granting a loan or making an investment. Both the direct risk of non-repayment of the loan and the property provided as collateral may be subject to compulsory insurance.

In the insurance market, the policyholder deals with several types of partners: insurance companies, associations of insurers - insurance pools, insurance brokers, agents and consultants.

The purpose of concluding an insurance contract is to acquire the policyholder's right to compensation for damage incurred caused by events recognized as insurable.

The object of insurance may be property owned by the insured, as well as property that the insured disposes of under contracts of hire, lease, rental, accepted on commission, storage or as collateral, if this property is not insured by its owner.

Property constituting fixed and working capital can be insured:

Buildings, structures, transmission devices, vehicles, machinery, equipment and other fixed assets;

Inventory assets acquired by this organization;

Inventory assets of own production;

Unfinished construction projects;

Products in the process of production or processing.

All property or a certain part of it can be insured. The object of insurance may also be the following reasonable expenses incurred by the policyholder upon the occurrence of insured events:

Expenses for measures to dismantle and/or move buildings, structures, equipment to a new location, undertaken to save property and/or to reduce losses.

Expenses for cleaning the territory specified in the insurance contract from debris (residues) of property damaged as a result of the insured event. The expediency of the listed expenses is determined by the insurer.

The following are not subject to insurance:

Buildings and structures, the structural elements and systems of which are in disrepair, as well as the property located in them;

Property located within the territory of insurance coverage that does not belong to the policyholder and was not received by him as a result of contractual relations.

Property is considered insured in the territory specified in the insurance contract. If the insured property is removed from this territory, insurance coverage is terminated.

Under the insurance contract, the insurer undertakes to compensate the policyholder for damage in the event of damage or loss of property upon the occurrence of insured events for the following types of risks:

Fire (accidental occurrence and spread of fire over an object, inside an object or from object to object);

Water supply network failure;

Sewer system failure;

Heating system failure;

Flooding, water penetration from neighboring premises;

Action of groundwater;

Explosion;

Soil subsidence;

Theft, robbery;

Damage to property as a result of illegal actions of third parties.

At the request of the policyholder, property can be insured against all or certain of the listed groups (types) of risks. In this case, the above groups (types) of risks must be specified depending on the reasons for their occurrence.

Coverage may be provided under schemes proportional and disproportionate insurance. Non-proportional insurance includes first risk insurance, deductible insurance, and marginal loss insurance.

Conditions limiting the insurer's liability include specific situations for which, although there are signs of an insured event, insurance compensation is not paid. For example, these are conditions when the insured event was the result of the insured’s malicious intent or the result of his collusion with third parties. Insurers often limit their liability in the event of government intervention in the activities of the enterprise. Force majeure events are also grounds for refusal to fulfill obligations to pay insurance compensation.

In all cases, damage resulting from:

Any kind of hostilities and their consequences, acts of terrorism, civil unrest, strikes, rebellion, lockouts, confiscation, requisition, interruption of work, arrest, destruction or damage to property by order of civil or military authorities, forced nationalization, declaration of a state of emergency or special state, rebellion , riot, putsch, coup d'etat, conspiracy, uprising, revolution;

Natural disasters when the territory of insurance coverage is declared a natural disaster zone before the conclusion of the insurance contract;

Exposure to nuclear energy in any form;

Intentional actions or gross negligence of the insured or his employees;

Failure by the policyholder to comply with instructions for storage, operation and maintenance of the insured object, as well as the use of this object for purposes other than those for which it is intended;

Spontaneous combustion, fermentation, rotting, aging, corrosion and other natural properties of objects and others.

When concluding an insurance contract, it is necessary to pay special attention to such clauses, since they are usually the reason for justifying the refusal to pay insurance compensation.

The conditions for the insurer's refusal to pay insurance compensation are usually written out as a separate block in the insurance contract. In addition to restrictions on the liability of the insurance company under various circumstances, these conditions may include the following points: failure by the policyholder to notify of the occurrence of an insured event within the agreed time frame, failure to comply with the terms of payment of the insurance premium, failure by the policyholder to provide all necessary documents, lack of certificates from government bodies confirming the occurrence insured event, etc.

The insurance contract also specifies insurance rates for individual risks and the amount of the insurance premium that the company must pay. The procedure for paying the insurance premium is also determined, which can be paid in a lump sum or in installments.

The insured amount is established by agreement of the parties on the basis of documents confirming the value of the property.

The insurance amounts are set within the value of the insured property at the time of conclusion of the contract.

The cost of the insured property is determined:

When insuring buildings and structures - based on the cost of construction in a given area of ​​a building or structure similar to the one insured, taking into account its wear and tear and operational and technical condition;

When insuring machinery, equipment and inventory, based on the amount required to purchase an object similar to the insured, taking into account its wear and tear;

When insuring inventory items (including raw materials, semi-finished products) purchased by the policyholder based on the costs required for their re-acquisition:

When insuring inventory items manufactured by the insured - based on the production costs necessary for their re-production;

When insuring property obtained as a result of contractual relations - in the amount of the property liability of the insured, but not higher than the value of the property determined in accordance with the insurance contract;

When insuring the finishing of premises, both owned by the insured and transferred to the insured under a rental agreement, without indicating their assessment based on the costs incurred by the insured or the lessor for repairs and/or finishing of the premises before the conclusion of the contract.

The insurance amounts are established separately for each insured object or for the totality of objects specified in the insurance contract.

The insurance amount for insured expenses is established separately from the insurance amount for the insured property.

The policyholder may set the insurance amount below the value of the insured property. In this case, insurance is valid as a share of the value of the property (incomplete insurance).

In this case, the difference between the insured amount established in the insurance contract and the value of the property is not covered by insurance protection, and payments upon the occurrence of insured events are made in proportion to the insured amount to the value of the insurance object.

The insurer is liable within the insured amount.

Tariff rates are set depending on the category of property, type and degree of risks, and the nature of the insurer’s activities.

When concluding an insurance contract, by agreement of the parties, a limit of the insurer's liability (the maximum insurance compensation paid) per one insured event and a deductible (the part of the damage that is not subject to compensation by the insurer) are established. If there is a deductible, the policyholder may be given a discount on the insurance premium.

The insurance premium is calculated based on the sums insured, tariff rates, insurance period, taking into account the benefits and discounts provided.

Payment of the insurance premium is made in cash or by bank transfer.

When concluding an insurance contract for a period of at least one year, the policyholder may be given the right to pay the insurance premium in two terms. The first part of the insurance premium in the amount of at least 50% of the annual insurance premium is paid upon concluding the insurance contract, but no later than 10 days from the moment the contract is signed by both parties. The remaining portion of the insurance premium is due no later than 3 months after the entry into force of the contract.

When insuring for a period of at least one year, the insurance premium (Pg) is calculated using the formula:

Pg = C x T/100 x M/12,

where: C - sum insured; T - tariff rate in %; M is the insurance period in months (a partial month is considered a full month).

When insuring for a period of more than one year, the insurance premium is subject to recalculation every year, starting from the date of entry into force of the insurance contract.

For insurance for a period of less than one year (short-term insurance), the insurance premium is paid at a time when concluding an insurance contract, but no later than 10 days from the moment the contract is signed by both parties. The calculation of the premium in this case (Pk) is made according to the formula:

PC = Pg x K,

where Pg is the insurance premium for insurance for one year; K is the short-term coefficient. During the validity period of an insurance contract concluded for a period of at least one year, by agreement of the parties, changes may be made in terms of the amount of the insured amount and tariff rates, as well as the types of risks for which insurance is provided.

If the insured amount increases, an additional insurance contract is concluded and the policyholder makes an additional payment of the insurance premium, calculated based on the full months remaining until the end of the contract. In this case, an incomplete month is taken as a full one.

A reduction in the sum insured can be made only on the condition that the policyholder has not previously been paid insurance compensation under this agreement. If the insured amount decreases, part of the insurance premium (B) is returned to the policyholder, the amount of which is determined by the formula:

D = (P2-P1) x T/P. B = (N x P1-P2) x T/P,

where: D - additional payment of premium; B - refundable part of the premium; P1, P2 - premiums for the initial and final insurance amounts, respectively; T - the number of full months until the expiration of the insurance contract from the moment the insured amount changes; P - insurance period in months (incomplete month is considered full). Coefficient H takes into account the insurer's standard expenses for conducting business.

After payment of the insurance indemnity, from the moment the insured event occurs, the insured amount under the contract is reduced by the amount of the indemnity paid. When restoring or replacing damaged property, the amount of the insured amount can be restored to its original value.

Policyholders who continuously insure property and do not apply for insurance compensation during the term of the insurance contract are given an annual discount on the insurance premium in the amount of 5%, but not more than 50% in the aggregate, when renewing the insurance contract. To conclude an insurance contract, the policyholder provides the insurer with a written application in the prescribed form or otherwise declares his intention to conclude an insurance contract.

An insurance contract is concluded on the basis of an application from the policyholder and the results of an inspection (examination) of the insured property. To draw up an insurance contract, additional documents may be required that characterize the degree of risk.

When concluding an insurance contract, a certificate or inventory is drawn up indicating the value of the property, which is certified by the signature of the manager and chief accountant, and the seal of the enterprise (for legal entities). If necessary, a written description of the object is drawn up. After drawing up an insurance contract, these documents become an integral part of it. The policyholder is responsible for the accuracy and completeness of the data provided in the contract and certificate (inventory).

The preparation of a certificate or inventory of property owned by the policyholder and property that he disposes of under contractual conditions is carried out separately. An insurance contract may be concluded in favor of a third party - the beneficiary. This person may be appointed by the policyholder upon concluding the insurance contract, or he or she may be the legal heir(s) and/or successor(s). An insurance contract can be concluded for a period of up to one year, for a year or more than a year. An insurance contract is considered short-term if it is concluded for a period of up to one year.

After drawing up an insurance contract, the policyholder pays the insurance premium or its first installment:

When paying in cash - simultaneously with receiving an insurance policy.

For non-cash payments - within ten days from the date of signing the insurance contract by both parties.

The insurance contract comes into force after the policyholder pays the insurance premium or the first part thereof:

When paying in cash - from 00 o'clock on the day following the day the insurer's representative receives the money;

For non-cash payments - from 00 o'clock on the day following the day the bank writes off money from the policyholder's current account for crediting to the insurer's current account.

The insurer bears liability under the insurance contract within the period stipulated by the contract. If the policyholder loses the insurance policy during the validity period of the insurance contract, he is issued a duplicate. Once a duplicate is issued, the lost insurance policy is considered invalid and no payments are made under it.

The insurance contract is terminated from 00 o'clock on the day recognized as the day of termination of the contract. Changes to the terms of the insurance contract are made by mutual agreement of the policyholder and the insurer based on an application from one of the parties within five days from the receipt of the application by the other party.

If any of the parties does not agree to make changes to the insurance contract, the issue of the validity of the insurance contract on the same terms or its termination is decided within five days.

The insurance contract terminates:

If the policyholder fails to pay the entire insurance premium or the first part thereof from the agreed date after the date of signing of the contract by both parties;

If the policyholder fails to pay the remaining part of the insurance premium from the agreed date of the fourth month of insurance after the day of payment of the first part of the premium;

After the expiration of the period specified in it, from the day following the day specified in the policy as the day of termination of the contract;

When paying insurance compensation in the amount of the insured amount, from the date of final settlement;

If the court makes a decision to declare the contract invalid;

If the policyholder loses the right of ownership of the insurance objects or in the event of liquidation (reorganization) of the policyholder from the day following the date of signing the relevant documents. The policyholder or his successor may reissue (renew) the insurance contract within an agreed period from the date of termination. In this case, the agreement re-enters into force from the next day after its re-registration (renewal) and is valid until the end of the period specified in the previous agreement;

Upon liquidation of the insurer in the manner established by legislative acts of the Russian Federation.

The insurance contract may be terminated early at the request of the policyholder or insurer. The parties are obliged to notify each other in writing of their intention to terminate the insurance contract early no less than the agreed number of days before the expected date of termination of the insurance contract. In this case, from the date of receipt of the notice by one of the parties until the moment of termination, the validity of the insurance contract is suspended.

In case of early termination of the insurance contract, the insurance premium is returned to the policyholder in full.

The insurance contract may be renewed if it was terminated due to failure by the policyholder to pay the second part of the insurance premium. To renew the contract, the policyholder must pay a penalty in a certain amount of the entire amount of the insurance premium and the unpaid part thereof. The validity period of the contract will not be extended. The insurer is not liable under the insurance contract during the period from the moment of its termination until the moment of its renewal.

The insurance contract is considered invalid from the moment of its conclusion if:

This is provided for by the current legislation of the Russian Federation;

It was concluded after an event recognized as insurable in accordance with the insurance rules;

The object of insurance is property subject to confiscation on the basis of a relevant court decision that has entered into legal force.

The insurance contract is declared invalid by a court, arbitration or arbitration tribunal.

If the insurance contract is declared invalid, the insurance premium is returned to the policyholder minus the insurer's expenses for conducting the business, and the insurance compensation paid is returned to the insurer in full.

The insurer who paid the insurance indemnity receives, within the limits of the amount paid, the right of claim that the insured (or other person who received the insurance indemnity) has against the person responsible for the damage caused.

If the policyholder has received compensation for damage from third parties, the insurer pays only the difference between the amount payable under the terms of insurance and the amount received from third parties. The policyholder is obliged to immediately notify the insurer of the receipt of such amounts.

The policyholder is obliged to return to the insurer the paid insurance compensation (or the corresponding part thereof) if a circumstance is discovered that completely or partially deprives the policyholder of the right to insurance compensation.

Disputes arising under the insurance contract are resolved through negotiations, with the involvement, if necessary, of a specially created expert commission.

If an agreement is not reached, the dispute is referred to the court (arbitration court) in the manner prescribed by the current legislation of the Russian Federation.

Payment of the premium occurs in a lump sum at the beginning of the insurance period. When calculating a lump sum payment, the insurer must take into account the possible increase in the insured value of the property as a result of inflation. If there is an increase or decrease in the sum insured during the insurance period, it is possible to pay the insurance premium with cost reduction . This method consists in the fact that at the end of the insurance period the insurance premium is recalculated, and one party compensates the other for the resulting difference.

Payment of premium in installments may in many cases be more preferable for the policyholder, since it reduces the severity of loss of funds with a large lump sum payment. However, the total insurance premium when paid in installments is higher than when paid in a lump sum.

The responsibilities of the insured include a standard set of obligations of the parties to pay the insurance premium, payment deadlines, fines for late payment, obligations to provide information, documents and other obligations of the insurer, including both ordinary general civil ones and specific ones for the payment of insurance compensation.

The policyholder is obliged:

When concluding an insurance contract, provide the insurer with all the information required from him, characterizing the circumstances that are important for the insurer to assume responsibility. Important are those risk circumstances that may influence the insurer’s decision to enter into an insurance contract or its content;

Inform the insurer about all insurance contracts concluded or being concluded in relation to this insurance object and the amount of insured amounts. If at the time of the occurrence of the insured event other insurance contracts for similar risks were also in force in relation to the insured property, compensation for damage is distributed in proportion to the ratio of the insurance amounts in which the insurance object is insured by each insurance organization. The insurer pays compensation only to the extent that falls to its share. The amount of compensation paid is reduced by the amount of the deductible if there is one;

Pay the insurance premium in the amount and manner determined by the insurance contract;

Take all reasonable precautions to prevent damage and increased risk;

Follow the instructions for storage, operation and maintenance of the insured object, and use this object only for its intended purpose;

If the degree of risk changes, within three days, notify the insurer in writing about this with a view to terminating or re-issuing the insurance contract;

Immediately inform the insurer of the location of the lost insured property, if the latter is found.

If damage occurs, the policyholder is obliged to:

Take all possible measures to reduce damage and save the insured property, including those recommended by the insurer;

Within 24 hours from the moment the damage is discovered, notify the insurer about it and immediately report it to the competent authorities;

Submit a written application in the established form for payment of insurance compensation, indicating the circumstances of the loss, as well as all documents requested by the insurer confirming the fact, causes and amount of damage;

Provide the insurer with the opportunity to inspect or survey damaged property, investigate the causes and extent of damage, and participate in measures to reduce damage and salvage the insured property;

At the request of the insurer, provide him in writing with all the information necessary to judge the amount and causes of damage or loss of the insured property;

Provide the insurer with an inventory of damaged, destroyed or lost property. These inventories must be submitted within the time period agreed with the insurer, but in any case no later than one month from the date of the insured event. Inventories are compiled indicating the value of damaged items on the day of the insured event. The costs of compiling the inventory are borne by the policyholder;

Preserve the damaged property in the same condition as it was after the insured event. Changing the picture of a loss is possible only if it is dictated by safety considerations and/or the desire to reduce the amount of damage;

Submit all documents to the insurer and take all measures to ensure that the insurer exercises its right of claim against the perpetrators.

The obligations of the policyholder arising from the contract, with the exception of the obligation to pay the insurance premium, apply equally to the beneficiary. Failure by the beneficiary to fulfill these obligations entails the same consequences as failure to fulfill them by the insured.

The policyholder has the right:

To receive insurance compensation in the amount of direct actual damage within the limits of the insured amount, taking into account the specific conditions stipulated in the insurance contract;

To conclude an insurance contract in favor of third parties. In this case, the person who owns the insurance policy enjoys the rights to receive insurance compensation under the insurance contract;

To change the terms of the insurance contract;

To terminate the insurance contract;

To receive benefits under an insurance contract.

The insurer has the right:

Check the information provided by the policyholder and the compliance of the insurance object with the description;

Check the condition of the insured object, as well as the compliance of the information about the insurance conditions communicated to him by the policyholder with the actual circumstances, regardless of whether these conditions have changed;

Participate in the rescue and preservation of the insured property, as well as give written recommendations to reduce damage, which are mandatory for the insured. However, these actions cannot be considered as recognition of the insurer’s obligation to pay insurance compensation;

Independently find out the causes and circumstances of the insured event;

Proceed to inspect the damaged property without waiting for the insured to notify of the loss.

The policyholder has no right to prevent the insurer from doing this;

Require from the policyholder the information necessary to establish the fact of an insured event or the amount of insurance compensation to be paid, including information constituting a commercial secret;

If necessary, send a request to the competent authorities for the provision of relevant documents and information confirming the fact and reason for the occurrence of the insured event;

Receive into your ownership the remains of the insured property or the property itself for which the insurance compensation has been fully paid.

The insurer is obliged:

Familiarize the policyholder with the insurance rules;

Do not disclose information about the policyholder and his property status, except for cases provided for by current legislation;

Upon receipt of the policyholder's notification of a change in the terms of insurance, within five days, make changes to the insurance contract or terminate it, notifying the policyholder about this;

After receiving an application for payment of insurance compensation, the insurer is obliged to:

Inspect the insurance object within 48 hours from the date of receipt of the policyholder's application (not counting weekends and holidays);

With the participation of the insured, draw up a report on the occurrence of damage;

Together with the insured, draw up an estimate of the damage and determine the amount of insurance compensation;

If the event is recognized as insured, pay the insurance compensation in cash;

If a refusal to pay insurance compensation occurs, the insurer is obliged to notify the policyholder in writing with a reasoned explanation of the reasons for the refusal.

Damage means the value of stolen property and/or the lost value of destroyed (damaged) property. The amount of damage is determined by the insurer on the basis of an examination, taking into account the value of the damaged property at the time of concluding the insurance contract. Each party has the right to request an independent examination. The examination is carried out at the expense of the party that requested it. The costs of conducting an examination for cases recognized as non-insurable after its completion are borne by the insured. Experts cannot be persons who are competitors of the policyholder or have business contacts with him, as well as their employees.

Damage is determined:

If property is stolen - in the amount of its value at the time of concluding the insurance contract;

In case of loss of property - in the amount of its value minus the value of existing remains suitable for further use based on the application of prices in force at the time of concluding the insurance contract;

In case of damage to property - in the amount of costs for its restoration, using prices and tariffs at the time of concluding the insurance contract.

Restoration costs include:

Costs of materials and spare parts required for restoration;

Costs of paying for restoration work.

Restoration costs are determined minus the cost of wear and tear of materials and spare parts replaced during the restoration (repair) process.

Restoration costs do not include:

Expenses associated with changes and/or improvement of the insured object;

Expenses caused by temporary (auxiliary) repairs or restoration.

Payment of insurance compensation is made after receipt of the insurance premium or its part established in the insurance contract to the insurer's current account.

Insurance compensation is paid within the limits of the insured amount. In this case, the insured amount from the moment of the occurrence of the insured event is reduced by the amount of the insurance compensation paid.

If the insured amount at the time of the insured event was lower than the value of the property currently insured, then the insurer compensates for damage only in proportion to the insured amount to this value. The amount of insurance compensation (IC) in this case is determined by the formula:

SV = U.S/SI - F,

where: Y - the amount of damage based on the value of the insured property at the time of concluding the insurance contract; C - sum insured; SI - the value of the property at the time of concluding the insurance contract; F - deductible (if available).

If changes have been made to the insurance contract regarding the amount of the insured amount, the insurer shall compensate for damage taking into account the latest change.

The insurer is not obliged to pay the policyholder compensation that exceeds the amount of damage, even if at the time of the insured event the insured amount exceeded the value of the insured property.

Without the consent of the insurer, the policyholder does not have the right to refuse the property remaining after the insured event, even if it is damaged. The residual value of such property is subject to deduction from the amount of damage.

Payment of insurance compensation is made within an agreed period after establishing the fact of an insured event, confirming this fact and determining the amount of compensation made on the basis of relevant documents. The payment day is the date the money is written off from the insurer's current account. In the case of reinsurance of large risks, the period for payment of insurance compensation may be extended, which must be reflected in the insurance contract.

If the insurance payment is not made on time, the insurer pays the policyholder a fine in the amount of one percent of the amount of the insurance payment for each day of delay.

In some cases, if the time interval between the establishment of the fact of an insured event and the end of determining the amount of damage exceeds two weeks, the insurer, at the request of the policyholder, may make an advance payment of insurance compensation. The amount of the advance payment is determined by the insurer, which is subsequently taken into account in final settlements.

The insurer has the right to defer payment of insurance compensation if:

He has reasonable doubts about the eligibility of the policyholder to receive insurance compensation. No compensation will be paid until the required evidence is provided;

The relevant internal affairs bodies have initiated a criminal case against the policyholder or persons authorized by him and are conducting an investigation into the circumstances that led to the damage. No compensation will be paid until the investigation is completed;

If the stolen insured property was returned to the policyholder, he is obliged to return to the insurer the insurance compensation received for it minus the costs associated with the theft for repairing or putting in order the returned property. If the policyholder refuses to return the insurance compensation to the insurer, all rights to this property pass to the insurer.

The insurer has the right to reduce the amount of insurance compensation if the policyholder, after the occurrence of the insured event, did not ensure the safety of the surviving (fully preserved or partially damaged) property;

Insurance compensation is not paid, and the contract may be terminated due to loss of confidence in the policyholder, if the policyholder (any of his full representatives and/or persons working for him):

Did not take measures agreed with the insurer in the insurance contract aimed at preventing damage and reducing the degree of risk;

Intentionally or through gross negligence committed or allowed an action (inaction) that led to damage;

Did not comply with the instructions for storage, operation and maintenance of the insured object, and also used this object for purposes other than those for which it was intended;

Did not report and/or provided the insurer with incorrect (knowingly false or incomplete) information about the object and conditions of insurance requested by the insurer;

Did not inform the insurer about the change in the degree of risk;

Did not take measures to prevent or reduce damage;

Failure to notify the insurer of the occurrence of damage, as a result of which it became impossible to determine the cause and amount of damage.

Did not submit the application and the documents and information requested by the insurer to the insurer;

Obstructed the insurer or its representatives in determining the circumstances of occurrence, nature and extent of damage;

Intentionally misled the insurer or its representatives when determining the causes and/or amount of damage;

Received full compensation for damage from the person responsible for causing it;

Relinquished the rights of claim against the guilty persons (or the exercise of these rights turned out to be impossible due to his fault). If the insurance indemnity has already been paid, the policyholder is obliged to return the amount of the paid indemnity to the insurer.

The procedure for calculating and paying insurance compensation is highlighted in the insurance contract as a separate block. At the same time, the procedure for filing a claim by the insured for an insured event, the documents required for consideration of the claim, methods for determining the amount of losses that are taken into account when calculating insurance compensation, and the timing of payment of compensation are established.

The conditions for the transfer of the rights of the policyholder to the insurer after payment of insurance compensation relate to the possibility of filing recourse claim on behalf of the insurer to the persons responsible for the occurrence of the insured event, as well as the possible transfer of rights to the remains of property destroyed as a result of the insured event. In addition, liability insurance contracts may contain conditions stipulating the transfer of rights to property not to the insurer, but to the beneficiary the policyholder. Personal insurance contracts usually stipulate the transfer of the right to receive insurance compensation (security) to the heirs in the event of the death of the insured person.

It is also possible to include any other conditions of a general civil and special nature, for example, confidentiality, dispute resolution procedures, cooperation in eliminating losses and limiting the amount of damage, etc.

Selecting an insurance partner is an important part of developing an insurance strategy. The policyholder may prefer to deal directly with several insurance companies, each time choosing the most suitable one to insure a certain type of risk. Otherwise, it can turn to the help of a broker or consultant, entrusting him with the work of selecting a partner and the optimal insurance scheme.

In the case of independently searching for a suitable insurance company, the enterprise analyzes the capabilities of each of them with a view to providing the most favorable insurance conditions. It is also necessary to check the financial statements of each company in order to ensure its financial stability and solvency, as well as its ability to bear the required amount of risks.

The most preferable method for insuring large risks is to use insurance pools, which make it possible to attract the combined capital of many companies to insure risk and thus provide a significant margin of solvency for each of its participants in the event of a large insurance payment. There may be already established groups of insurers in the market to insure risks of a certain type, and the entire group is managed by a company - the leader of the pool or an insurance broker.

Contacting an insurance broker can bring significant benefits to the company in providing favorable insurance conditions. The broker has significantly more complete information about the state of the insurance market. He can be entrusted with selecting a suitable company, forming an insurance pool, as well as choosing a general risk allocation scheme. He can make recommendations on the best combination of insurance and non-insurance risk management methods, selection of deductibles or other methods of non-proportional insurance.

An insurance broker may also be entrusted with the settlement of losses upon the occurrence of an insured event. As a rule, brokers manage the entire document flow of the insurance pools they create, distribute risk and losses between pool members, and control cash settlements.

Therefore, choosing the right insurance broker is essential to manage risk through insurance. An analysis of the supply on the brokerage firm market should focus on the experience, size and location of the firm, the services it provides, the availability of qualified specialists, additional or specialized services.

Brokerage firms can be ranked according to the following criteria:

Availability of a license;

Size of brokerage office, staff of specialists;

Field of activity;

Technical equipment;

Compliance of the services offered with the needs of the enterprise;

Advantages over competitors;

Efficiency;

Quality of examination;

Cost of services.

In addition to insurance brokers, similar services for selecting partners and choosing insurance schemes can also be provided by consulting firms, and independent consultants.

Voluntary insurance contract - a legal form that serves the purpose of creating insurance funds of insurance organizations at the expense of policyholders.

Insurance policy, or insurance certificate, - a document of a standard form, which is issued by the insurer to the policyholder (insured) and certifies the fact of concluding an insurance contract.

Duration of the insurance contract - the time stipulated by the insurance conditions during which the insurer’s insurance liability is valid, i.e. his obligation to make an insurance payment upon the occurrence of an insured event. There are short-term insurance contracts, the validity of which does not exceed one year, and long-term insurance contracts, the validity of which is at least one year.

Insurance contract

Voluntary insurance is carried out on the basis of an insurance contract, which must be concluded in writing. Along with the law “On the organization of insurance business in the Russian Federation,” the legal norms governing the insurance contract are presented in Chapter 48 of the Civil Code of the Russian Federation.

An insurance contract is an agreement between the policyholder and the insurer. Under this agreement, the insurer undertakes to make an insurance payment to the policyholder in the event of an insured event, and the policyholder undertakes to pay insurance premiums on time.

Underwriting

The procedure for concluding an insurance contract is preceded by underwriting.

Underwriting is the process of dividing potential policyholders into classes based on the appropriate classification of risks in order to assign them a suitable tariff. The underwriter decides whether or not to accept the risk presented in the application for insurance. It is customary to distinguish between the procedures inherent in individual and group underwriting. Group underwriting evaluates group characteristics, demographics, and past losses. In individual underwriting, the policyholder must provide information confirming that his risk is insurable (for life or health insurance) or specific details regarding his property or vehicle (for property or business insurance). With life insurance, the individual policyholder's risk must be approved by the insurance company's underwriter (this procedure can take a long time). A common practice is for the policyholder to fill out questionnaires containing questions about his lifestyle, smoking, and the health status of the policyholder himself and his family members. When insuring life for large sums, the policyholder is required to undergo a medical examination.

If the underwriter decides to accept the risk for insurance, the next thing he must do is apply the correct premium rate. Premium rates are assigned for each class of policyholder by the actuarial department. The role of the underwriter is to determine which class a particular insured should be classified into. The insurance business cannot avoid some discrimination; Otherwise, the resulting anti-selection will make insurance unaffordable for many. Anti-selection can occur when price categories are so broad that both favorable and unfavorable risks for the insurer are combined into one group, and policyholders pay the same price for them. Under such circumstances, for policyholders with high risks, insurance is more profitable due to the price being lower than necessary to create an insurance fund, and for policyholders with insignificant risks, the price will be too high. Consequently, policyholders with insignificant risks will not be interested in insurance on such terms, since the deal is not profitable for them. If only unfavorable risks are accepted for insurance, it will become very expensive. In order to prevent this market error, insurers must charge lower premium rates for small risks, i.e., the price of insurance must be differentiated.

The main purpose of the underwriter's work is to obtain confidence that that the insurance premium assigned to each policyholder actually reflects his risk, and therefore insurance operation is profitable.

The underwriting procedure consists of the following stages:

1st stage: make a risk assessment based on the insurance application or more detailed research;

2nd stage: decide whether to accept this risk for insurance;

3rd stage: offer the policyholder the most optimal option for insurance conditions for both parties;

4th stage: calculate the insurance rate.

The underwriting process involves assessing risk based on an insurance application or more detailed research. The legislation reserves the right of the insurer to independently assess the risk. This is necessary to decide whether to accept this risk for insurance. Next, the insurer develops insurance conditions and calculates the insurance premium. Underwriting is an extremely responsible procedure in the activities of an insurance organization. The consequences of an underwriter's error in assessing risk can lead to an incorrect calculation of the insurance premium, and consequently to an unprofitable operation (in the worst case, to the insolvency of the company).

In some cases, the information contained in the insurance application is sufficient to conclude an insurance contract. But from the perspective of the most accurate risk assessment, such an approach is considered risky for the insurer. If the information contained in the application is not enough to assess the risk, then the underwriter (a highly qualified specialist in the field of insurance business who has the authority from the management of the insurance company to accept the proposed risks for insurance, determine tariff rates and specific terms of the insurance contract for these risks), based on norms of insurance law and economic feasibility, has the right to request additional information from the policyholder.

Insurance Application

The procedure for concluding an insurance contract begins with filling out an insurance application form. An oral or written statement from the policyholder serves as the basis for concluding a contract. Unlike Russian insurance practice abroad, a written application is required. Based on this application, the insurance company draws up an insurance contract and issues a certificate or policy.

The application has a standard form for an insurance organization and contains the information necessary for the insurer to assess the risk of a potential client - the applicant. The application form includes questions to characterize the risk at the time of concluding the insurance contract.

The insurance application is the main source of information about the risk and contains a number of points regarding the characteristics of the risk. In some cases, the information contained in the insurance application is sufficient to conclude an insurance contract. But from the perspective of the most accurate risk assessment, such an approach is risky for the insurer. If the information contained in the application is not enough to assess the risk, the insurer has the right to request additional information from the policyholder.

When filling out the application, the applicant must be aware that all the information provided by him will subsequently act as the basis of the insurance contract. The applicant must be informed of the consequences of deliberate misrepresentation of his or her health status. The first responsibility of the future insured is to comply with one of the basic doctrines of the insurance business - the principle of supreme good faith.

The policyholder, in turn, is obliged to provide the insurer with all the information necessary to assess the risk. If the insurer is not provided with the specified information, he has every reason to refuse to conclude the contract.

This is explained by the fact that only the policyholder knows everything about his risks. The insurer only knows what he is told. For a correct risk assessment, it is important to know all the essential circumstances
insurance - risk circumstances that can influence the decision of the insurance company to enter into an insurance contract or to introduce appropriate agreed conditions into its content.

In accordance with this, the policyholder is obliged to provide truthfully and completely all necessary information on the risk. This is called the principle of highest integrity in insurance.

• direct survey in the form of an application;
• inclusion in the contract of a condition that the client must independently inform the insurer about facts important for assessing the risk.

Failure to comply with this condition gives the insurer grounds to refuse insurance protection to the client. The obligation to disclose all material factors concerns the moment of conclusion of the contract, since this is a long-term contract. In property and liability insurance, this obligation exists not only at the time the contract is concluded, but also when it is renewed after a year.

In general, insurance companies are free to choose the form of application for insurance. The main thing is that this form meets the needs of the insurer. The decision on the structure and content of the documentation is the responsibility of the underwriter, and then it is approved by the marketing service, contract management and claims processing departments. The final decision regarding the insurance application form remains with the insurance product development (construction) department.

It is necessary to determine how reasonable and appropriate the questions in the application are, and whether they are offensive to the policyholder; in addition, it is necessary to exclude the possibility of misinterpretation of the questions.

Traditionally, the statement is prepared in such a way as to identify all the details and aspects that are considered material in relation to the risks.

Each insurance company has its own view on the questions included in the application, which largely depends on the balance of the needs of the underwriter and the marketing department. This is often a trade-off between the desire to extract as much information as possible and the need to shorten the statement so that it does not turn off potential clients.

Insurance contract form

In accordance with Art. 940 an insurance contract can only be concluded in writing. The exception is compulsory state insurance contracts, where written form is not required.

The forms of an insurance contract can be different: an agreement signed by two parties, or an insurance policy (certificate, certificate, receipt) signed by the insurer and drawn up on the basis of a written or oral statement from the policyholder.

Bearer insurance policy

In accordance with Art. 930 of the Civil Code, it is now possible for bearer policies to appear, which, although they are not, can circulate on the secondary market and thereby play the role of an investment object. Insurers should, however, be careful when placing such policies among citizens, since clause 2 of the Decree of the President of the Russian Federation “On protecting the interests of investors” dated June 11, 1994 prohibits such activities without an appropriate license.

General policy

One of the types of policies that is directly defined in the Civil Code as an insurance contract is a general policy
(Article 941). Let’s imagine a situation where it is necessary to systematically insure consignments of cargo, and the insurance conditions for different consignments are identical, and only the object of insurance itself differs (the consignment is different each time) and the insured amount, and therefore the payment. For such cases, a general policy or general insurance contract has been developed, which defines all insurance conditions, except for the insured amount and payment. The insurance object in the general contract is described by general characteristics, since at this stage it cannot yet be individually determined. The insured amount, payment and individual characteristics of the insurance object are determined by policies or certificates that are issued for each batch.

The agreement between the policyholder and the insurer, expressed by the general policy, in most cases cannot contain all the essential terms of the insurance contract, since the most important of them - the insured amount and the individual certainty of the insurance object - become known only for a specific batch of property.

Public nature of the personal insurance contract

Art. 927 of the Civil Code indicates that a personal insurance contract is public. This means that an insurer licensed for any of the types is obliged to enter into this agreement with anyone who applies to him “if possible”
(Article 426 of the Civil Code).

Terms of the insurance contract

Essential terms are required for certain types of contracts. The contract is considered concluded only if there is agreement between the parties on all essential points. If the parties do not reach an agreement on at least one of the essential conditions, then the contract cannot be concluded.

Those terms of the contract that are recognized as such in the relevant legislative and regulatory acts are considered essential.

In Russia, the list of essential conditions is somewhat different.

Art. 942 of the Civil Code establishes four essential conditions of an insurance contract, three of which are common to property and personal insurance: the nature of the insured event; sum insured; validity period of the insurance contract. The fourth condition is necessary for property insurance: the property or property interest that is insured. For personal insurance: the insured person.

It should be remembered that if an agreement is not reached between the parties on at least one of these conditions, the contract is considered not concluded.

A contract in which there is no insured amount is considered not concluded, since in accordance with Art. 942 of the Civil Code, the insurance amount refers to the essential terms of the insurance contract.

As a rule, the contract comes into force from the moment the insurance premium is paid by the policyholder, unless otherwise provided in it.

Individual agreements in insurance contracts relate to an individual specific risk. Moreover, such an individual agreement always has advantages over the general content of the contract. In practice, in such cases, it is recommended to use the following rule: the conditions developed on the basis of an individual agreement precede the standard conditions.

Insurance rules

Mandatory insurance rules

In the Civil Code, the mandatory nature of insurance rules for the insurer is established in Art. 943. It gives the policyholder and the beneficiary the right to refer to the rules if they are referenced in the insurance contract. In addition, the parties are allowed to agree in the contract on changes to certain provisions of the rules.

In order for the terms of the insurance rules to become mandatory for the other party to the contract (the policyholder and the beneficiary), this, firstly, must be established in the contract, and secondly, the rules must be an integral part of the contract. If they are only attached to the contract (policy), the fact of delivery of the rules to the policyholder must be recorded in the contract.

1. General provisions (basic terms and definitions).
2. Subjects of insurance (the range of subjects of insurance has been determined).
3. Object of insurance (objects of insurance are defined).
4. Insurance risks. Insured event (a list of insured events is defined in which the insurer is liable for insurance payments, and exceptions are cases when the insurer is exempt from payment, i.e. losses that are and are not subject to compensation. This paragraph also contains both basic and additional conditions).
5. Sum insured (the procedure for determining the insured value of property and establishing the insured amount).
6. Insurance premium (insurance premium) (basic insurance rates, procedure for paying the premium, actions of the insurer if the insured event occurs before the next insurance premium is paid).
7. Conclusion, validity period and termination of an insurance contract (i.e., the procedure for concluding the contract, the conditions for its entry into force and termination, other requirements for the contract).
8. Consequences of changes in risk level.
9. Rights and obligations of the parties (insurer, policyholder, insured, beneficiary).
10. Determination and payment of insurance compensation (grounds for payment, form and deadlines for filing a claim, terms for processing a claim and payment, determining the amount of payment, conditions, grounds for refusal to pay).
11. Changes and additions to the insurance contract.
12. Settlement of disputes.

The rules are accompanied by a basic table and a sample insurance policy.

Insurance is a service whose popularity in Russia is growing every year. Russians insure property, life and health. People who do not have special knowledge have many questions related to concluding a contract, one of which is: “What terms of the contract are considered essential!” Let's try to figure it out together.

About essential conditions

Essential terms are significant provisions that require agreement between the parties entering into a contract. If agreement is not reached on at least one point, the agreement will not enter into force.

The policyholder and the insurer should come to mutual agreement on the following issues:

• • subject of the agreement;
  • a number of conditions provided for by law;
  • conditions set by one of the parties as significant.

Essential terms of the insurance contract

The most important point of the contract that requires consideration and approval is the subject or object of insurance.

About the subject of the agreement and other significant conditions

Determining the subject of the contract is one of the biggest problems in . A peculiarity of the issue related to the subject of insurance is the fact that the legislation does not have an accurate description of the concept of the subject of the insurance contract. Therefore, when concluding an agreement, the concepts of subject and object are often mixed, or provisions are included that are not related to the document, etc.

Subject of insurance law

In principle, the subject of the contract is the activity of the insurer, which is paid for by the policyholder. That is, this is protection, which is essentially a product. A citizen who wants life or health buys this product. Hence we conclude: insurance protection is the subject of the contract.

Article 942 of the Civil Code of the Russian Federation provides for a number of conditions, in addition to the subject matter, on which the interested parties need to reach agreement.

• . Nature of the event and occurrence of the insured event.
• Conditions considered essential by one of the parties.
• Duration of the contract.
• Amount of monetary compensation and procedure for payment of funds.

The contract is not valid without mutual agreement of the interested parties on all of the listed points.

Differences between property insurance and personal protection

When protecting personal interests, the presence of an insured person is documented. But at the same time, there is a need to agree on personal intangible interests (life, health, honor, dignity, etc.), which must be described in the contract. Since it assumes the occurrence of cases of damage and harm to the main interest. You can consider the nuances using an example.

Accident insurance involves a description of the following points: the client’s health, his life, or life and health together.

For example, according to , the object is the civil liability of the owner of a documented car. But the agreement provides for a description of other characteristics of the object, for example: the life of the car, the functionality of individual elements.

The objects specified in business risk insurance intersect with the objects of property and civil liability insurance. The result of this intersection was serious restrictions for insured entrepreneurs.

Pros and cons of definition by generic characteristics

To understand what generic characteristics are, let’s look at an example. 5 blue mink coats are insured. The generic characteristics in this case are: 5 fur coats, blue mink. That is, exactly 5 fur coats (no more, no less) from blue mink (not from arctic fox or brown mink) will be considered the insured object.

Generic characteristics of things are number, weight, measure, quality and other characteristics inherent in all objects of the same kind. It is important to know that property defined in this way is fungible.

Despite the fact that the division of things into individual and defined by generic characteristics is considered classical and cannot be questioned, currently in the Civil Code of the Russian Federation there is no concept of an individually defined thing, and rules regarding such a definition.

However, the courts recognize that it is possible to agree on the terms of an object by indicating its generic characteristics. For example, you can legally insure:

• the goods are sold and in circulation;
• property, defining its location address;
• vehicles of the insured carrier, as well as drivers servicing the vehicle and passengers.

The absence of an accurate formulation of generic characteristics when establishing the insured property can lead to serious complications that will negatively affect the conclusion of the contract.

How to correctly determine an insured event

An event described in detail in the contract is called, upon the completion of which the policyholder is paid a certain amount of money, or compensation.

An event covered by the document has the following characteristics:

• probability of occurrence (may or may not happen);
• randomness (it is impossible to establish in advance the possibility of an attack);
• level of harmfulness (amount of damage).

An insured event is a life circumstance that does not depend on a person, his consciousness and will.

The event should be described taking into account the following aspects:

• dangers and exceptions;
• all types of damage and harm permissible in a particular case;
• cause-and-effect relationships between danger and harm, the description of which may vary depending on the contract.

For example, if property is insured against flooding, then the insurance will cover direct losses, reimbursing only the cost of property damaged by water.

If the property is not insured against a fire, during the extinguishing of which water got on things, things that were burned or damaged by fire will not be covered by the contract.

But if all causes of damage or loss of property caused by fire are insured, then compensation will be provided even if things are flooded with water when extinguishing the fire. This is considered consequential loss coverage.

The example shows that upon the occurrence of a life circumstance fixed in the contract, only in the case of a correctly described direct and indirect connection between danger and harm, the owner will receive the maximum amount of money as compensation.

How to avoid disputes when reviewing contract provisions

Most often they arise regarding the nature of the event that led to the insured event. For example: “Death or damage to a car due to theft.” The insurer refuses to pay compensation for a stolen car. At the same time, it is supported by the appellate and cassation courts, drawing attention to the fact that only theft, and not the death or damage of the vehicle, has an evidence base.

But theft can be considered as a danger, and damage or death of a vehicle can be considered as harm caused. If a car is stolen, it is not always lost or damaged. It is enough to include the loss of a car in such an agreement, and all problems would be solved instantly.

The policyholder's mistake lies in inattentively studying the contract, which was taken advantage of by an unscrupulous insurer by including an unfair condition in the document.

Amount and procedure for payment of monetary compensation

Legislation referred to as significant or necessary is essential. Among them is a description of the insurance premium and the procedure for paying out sums of money.

Amount of contributions

Standard contracts have a special column in which the amount of the insurance premium is entered. An empty column allows the contract to be declared invalid, since agreement between the parties regarding this clause was not reached. As a last resort, you need to check the document for possible typos.

Procedure for receiving insurance payment

Contracts concluded in a non-standard form must necessarily contain a clause on the amount and procedure for paying the insurance premium. Any discrepancy is suspicious. This is due to the fact that there is no free insurance; for any purchased product, which is protection, you must pay a certain amount. The amount of the insurance premium is completely dependent on the amount of risk determined by the insurer.

Period and procedure for depositing funds

The exact date of depositing funds may not be determined documentaryly, since according to clause 1 of Art. 957 of the Civil Code of the Russian Federation, the agreement will come into force only from the moment the contribution is paid. After the insurance contract comes into force, time ceases to have any legal meaning, since the deadline for paying the premium is the obligation to pay the insurance amount.

The payment procedure is less important than the amount of the premium, since without specifying the deadline for depositing funds, the contract can be considered valid.

Insurance compensation: features of approval

The insured amount is the monetary compensation paid by the insurer. The insurer can limit the total amount by agreeing with the policyholder on an essential condition specified in the contract as a “limit of liability.”

It is extremely unprofitable for the policyholder, due to the fact that it is considered an uncertain term of the contract.

In the event of an automatic change in the amount of monetary compensation during the validity period of the contract, the policyholder can restore it by making the necessary additional payment. Changing the amount automatically is possible in the case when the amount of the payment and the bonus are fixed in currency or conventional units.

Foreign currency is used as a unit of account, and payments are made in rubles at the current rate at the time of depositing funds.

Insurance contract

Essential terms are necessary for contracts of a certain type. The contract is considered concluded only if there is agreement between the parties on all essential points. If the parties do not reach an agreement on at least one of the essential conditions, then the contract cannot be considered concluded.

Those terms of the contract that are recognized as such in the relevant legislative and regulatory acts are considered essential. In international insurance practice, the following conditions are essential for insurance contracts:

events upon the occurrence of which the insurer is obliged to pay insurance compensation (sum insured);

the territory covered by the insurance contract;

object of insurance;

sum insured;

procedure and terms of payment of insurance compensation (sum insured);

validity period of the insurance contract;

period of liability of the insurer for obligations;

the amount and procedure for paying the insurance premium (contribution);

the procedure for making changes to the terms of the contract;

legal consequences in case of non-fulfillment or improper fulfillment of obligations by the parties under the contract;

procedure for resolving disputes between the parties to the contract.

In Russian insurance law, the list of essential conditions is somewhat different. Article 942 of the Civil Code of the Russian Federation establishes four essential conditions of an insurance contract, three of which are common to property and personal insurance:

the nature of the event against which insurance is provided (insured event);

sum insured;

validity period of the insurance contract.

For property insurance: property or property interest that is insured. For personal insurance me: the insured person.

It should be remembered that if an agreement is not reached between the parties on at least one of these conditions, the contract is considered not concluded. And an unconcluded agreement is not valid simply because it does not exist.

In particular, a contract in which there is no insured amount is considered not concluded, since in accordance with Art. 942 of the Civil Code, the insured amount refers to the essential terms of the insurance contract. However, there is one exception to this rule. In Art. 4 Law of the Russian Federation “On medical insurance of citizens in the Russian Federation” standard forms of medical insurance contracts are provided, approved by Decree of the Government of the Russian Federation No. 41 of January 23, 1992. In accordance with this document, the insurer is obliged to pay for all medical services provided to the insured in accordance with the insurance program attached to the policy.

Usual terms of the contract- these are the conditions present in any contract and provided for by law in the event that the parties do not wish to establish anything else. This is information about the place where the agreement was concluded, the form of the agreement, and the moment it came into force. As a rule, the contract comes into force from the moment the insurance premium is paid by the policyholder, unless otherwise provided in it.

Mandatory terms of the contract are prescribed to the parties for agreement by law. In insurance contracts, this is, for example, the sum insured, the start date of insurance coverage, etc.

Initiative conditions are included in the contract at the request of the parties. The law allows the establishment of any conditions that do not contradict the law in a contract by mutual agreement, which contributes to maximum consideration of the wishes of the parties.

Individual agreements in insurance contracts relate to an individual specific risk. Moreover, such an individual agreement always has advantages over the general content of the contract. In practice, in such cases, it is recommended to use the following rule: the conditions developed on the basis of an individual agreement precede the standard conditions.

Along with the mandatory requirements and norms regarding insurance contracts contained in legislative acts, in world insurance practice there is the concept of customary law, which is also important for the developing Russian insurance. Common law is the so-called unwritten law, socially recognized and universally applied norms that are not included in any law due to their obviousness. For example, the following common law rules are relevant for insurance. The policyholder can trust the explanations of the insurance company's agents regarding the content and scope of insurance coverage. An insurance broker, although he represents the interests of the policyholder, has the right to make claims against the insurance company regarding the payment of commissions to him, since it is the insurance company that pays for his work.

Procedure for concluding an agreement. The conclusion of a contract is preceded by an agreement between the parties, which is achieved through negotiations. The basis for their initiation is an oral or written statement from the policyholder. A written statement is almost always used in relations with legal entities and, increasingly, with individuals. It serves as the document on the basis of which the insurance company draws up an insurance contract, issues a certificate or policy.

The use of a written statement is convenient in that it allows the insurer to check the circumstances of the case and after that accept or reject the client’s application. An insurance contract, if there is a written application, comes into force when the insurer notifies the applicant that his application has been accepted.

During negotiations prior to concluding a contract, the insurance company is obliged to familiarize the policyholder with the terms and conditions of insurance. The policyholder, in turn, is obliged to provide the insurer with all the information necessary to assess the risk. If the insurer does not provide the specified information, he has every reason to refuse to conclude the contract.

Essential terms of the insurance contract defined in Art. 942 Civil Code. The content of the contract is the totality of its terms or clauses expressing the will of the parties. In legal practice, the terms of a contract are usually divided into essential, ordinary, mandatory and individual.

Essential conditions are necessary for certain types of contracts. The contract is considered concluded only if there is agreement between the parties on all essential points. If the parties do not reach an agreement on at least one of the essential conditions, then the contract cannot be concluded.

Essential terms of the insurance contract:

In property insurance, the essential conditions of insurance include: the condition on the amount of the insured amount; condition on the duration of the contract; a condition about property or property interest that is the object of insurance; a condition on the nature of the event, in the event of which the insured event is insured.

In personal insurance, the essential conditions of insurance include: the condition of the insured person; condition on the amount of the insured amount; condition on the duration of the contract; a condition on the nature of the event against the occurrence of which in the life of the insured person insurance is provided (Article 942 of the Civil Code of the Russian Federation).

Article 434 of the Civil Code of the Russian Federation distinguishes two ways to conclude an agreement:

1) by drawing up one document agreed upon and signed by the parties;

2) by exchanging documents that would indicate the parties’ desire to conclude this agreement.

The document certifying the conclusion of the insurance contract must contain the following data:

1) name of the document;

2) name, legal address and bank details of the insurer;

3) last name, first name, patronymic or name of the insured’s organization and its address;

4) the amount of the insured amount;

5) indication of the insurance risk;

6) the amount of the insurance premium, the timing and procedure for its payment;

7) duration of the contract;

8) other (special) conditions by agreement of the parties, including additions to the rules or exceptions to them; procedure for changing and terminating the contract, etc.;

9) signatures of the parties.

Let us remind you that an agreement in which there is no insured amount is considered not concluded, since in accordance with Art. 942 of the Civil Code, the insurance amount refers to the essential terms of the insurance contract.

__________________________

There is one exception to this rule. In Art. 4 of the Law of the Russian Federation “On Medical Insurance...” provides standard forms of medical insurance contracts, which are approved by the Decree of the Government of the Russian Federation dated January 23, 1992 “On measures to implement the Law...”. From these standard forms it follows that the insurer is obliged to pay for all medical services provided to the insured in accordance with the insurance program and the possibility of limiting payment to any amount is not provided. Consequently, a person insured under a health insurance contract has the right to unlimited payment for medical services in accordance with the program attached to the policy, regardless of whether there is an insured amount in the contract or not (Article 970 of the Civil Code).

Along with the essential conditions, the contract also contains a number of conditions belonging to different categories.

Usual terms of the contract- these are the conditions present in any contract and provided for by law in the event that the parties do not wish to establish anything else. This is information about the place where the contract was concluded, the form of the contract, etc.

Mandatory terms of the contract are prescribed to the parties by law for agreement. In insurance contracts, these are, for example, details of the parties, terms of payment, start date of insurance coverage, etc. As a rule, the contract comes into force from the moment the insurance premium is paid by the policyholder, unless otherwise provided in it.

Unlike mandatory individual conditions are included in the contract at the request of the parties. The law allows the establishment of any conditions that do not contradict the law in a contract by mutual agreement, which contributes to maximum consideration of the wishes of the parties. Individual agreements in insurance contracts relate to an individual specific risk. Moreover, such an individual agreement always has advantages over the general content of the contract. In practice, in such cases, it is recommended to use the following rule: the conditions developed on the basis of an individual agreement precede the standard conditions.

Along with the mandatory requirements and norms regarding insurance contracts contained in legislative acts, in world insurance practice there is the concept customary law which is also important for the developing Russian insurance industry. Common law is the so-called unwritten law, socially accepted and universally applied rules that are not included in any law due to their obviousness, for example, compliance by the parties with the terms of a contract. By the way, the corresponding clause in Russian practice is usually included in the insurance contract. For insurance, such norms of customary law are important as the policyholder’s trust in the explanations of the insurance company’s agents regarding the content and scope of insurance protection.