A claim is defined as "the occurrence of the damaging event envisaged and covered by the contract". In other words, the claim must correspond to the description of the risk covered by the insurer - the vehicle named in the contract must be the cause of the damage and the claim must also occurred in the circumstances covered by the contract (i.e. no cover in the event of theft of the vehicle, for example).
Two different situations may arise:
- either the insured owner/driver is the person responsible for the accident. If it is not possible to take action against a third party, only an omnium or comprehensive insurer will cover - possibly subject to an excess - the material damage;
- or the driver is not responsible for the accident or is only partially responsible.
The victim of an accident has a direct claim against the insurer of the liable party.
The insurer must send you, within three months of your request for compensation, a reasoned offer of compensation or a reasoned reply, if the liability or the application of Article 29bis (weak user) is contested or the damage is disputed. Failure to reply will incur a financial penalty.
If it was possible to apportion liability, it may not yet be possible to determine the extent of the damage. In such cases, the victim is entitled to an advance payment based on costs already incurred and future costs already known.
Even though the insurer must respect strict deadlines for the payment of the indemnity, the indemnity period can still be relatively long due to the slowness of the legal proceedings that must decide on the liability.
Insurers established procedures that deal either with property damage, physical injury, or a combination of both types of damage.
- Material damage
- The Direct Settlement system aims to create a rapid and amicable settlement of property damage resulting from collisions between motor vehicles. The victim is compensated by his own insurer on behalf of the opposing party deemed liable. After having indemnified his own insured party, the insurer of the victim will make a claim against the insurer of the liable person to obtain reimbursement of the sums paid. The direct settlement system is the result of an agreement between insurers and is only binding on those insurers who signed it up to. Consequently, the insured party has the right to choose compensation for his damage by application of ordinary law, i.e. by taking action against the insurer of the person liable.
- The "vehicle collision" agreement makes it possible to obtain compensation for damage caused by a vehicle to a building from an individual's own provider of fire insurance - insofar as the fire policy so provides. The payment is made on behalf of the civil liability insurer of the vehicle that caused the damage.
- Personal injury (bodily harm)
- The "Innocent Victims" agreement aims to speed up compensation for bodily injury suffered by the victim. This agreement is, therefore, an extension of the Direct Settlement arrangement. The agreement is without prejudice to the right of the victim or his heirs to bring the case before the courts, provided of course that a final agreement has not been reached.
- Material and physical damage
- The declaration of commitment "multi-vehicle accidents" consists of an indemnity commitment by the civil liability insurer towards its own insured party in the event of a multi-vehicle accident. However, the application of this declaration of commitment depends on a decision by a committee of insurers. This commitment avoids having to wait for the outcome of lengthy procedures to determine liability, which are moreover likely to lead to it being impossible to determine who is liable..
All these agreements pursue the same objective, namely to speed up compensation to the victim.