What is the content of all-insurance auto insurance claims?

At present, there is a great demand for cars. Basically every household will have a car. Newly bought cars will be forced to buy insurance, which is what we are familiar with. This is mandatory by law. If the owner has a traffic accident, he can ask the insurance company to pay for it. So what is the content of all-insurance auto insurance claims? I. Auto insurance claims Auto insurance claims are claims made by car owners to insurance companies after a traffic accident. The basic process of claim settlement includes: reporting the case, surveying and determining the loss, signing the claim settlement document, adjusting and rechecking, examining and approving, and closing the claim. The work of auto insurance claims has obvious characteristics: the publicity of the insured, high payout ratio and small loss range, great liquidity of the subject matter, great control by the repair shop and widespread moral hazard. Characteristics of auto insurance claims Auto insurance is different from other insurances, and its claims work also has remarkable characteristics. Claims workers must have a clear and systematic understanding of these characteristics, and understanding and mastering these characteristics is the premise and key to do a good job in automobile claims. (1) Publicity of the Insured In China's auto insurance, the insured used to be mainly units and enterprises. However, with the increase in the number of vehicles owned by individuals, the proportion of single car owners among the insured will gradually increase. The characteristics of these insured people are that they are passive in buying insurance, and because of the limitation of culture, knowledge and accomplishment, they know little about insurance, traffic accident treatment and vehicle maintenance. On the other hand, driven by interests, there are great obstacles for surveyors and adjusters in the process of claim settlement and communication with them. (2) Another feature of payout ratio auto insurance with high loss range is that although the loss amount of insurance accidents is generally small, the frequency of accidents is high. Insurance companies need to invest a lot of energy and expenses in the operation process. Although some accidents are not big, they still involve the service quality of the insured, and insurance companies should also pay enough attention to them. On the other hand, judging from the individual case, the amount of compensation is not large, but every little makes a mickle will also have an important impact on the operation of insurance companies. (3) The subject matter is highly mobile. Due to the functional characteristics of the car, it is determined that it has considerable liquidity. The location and time of vehicle accidents are uncertain, which requires insurance companies to have a fully functional service system to support claims service. The main body is an all-weather report acceptance mechanism and a huge and efficient inspection network. (4) The repair shop plays an important role in auto insurance claims, and the repair price, construction period and quality of the repair shop directly affect the auto insurance service. Because most of the insured think that the insurance company must be responsible for repairing the vehicle after the accident, they rarely ask questions after the vehicle is handed over to the repair shop. Once there are problems such as vehicle maintenance quality, construction period and even price, the insurance company and the repair shop will share the responsibility. In fact, the insurance company only undertakes the economic compensation obligation stipulated in the insurance contract, and is not responsible for the repair of accident vehicles and related matters. (5) Moral hazard is widespread in the property insurance business. Auto insurance is the "hardest hit" of moral hazard. Automobile insurance has the characteristics of strong liquidity of the subject matter, defects in household registration management and asymmetric insurance information, as well as imperfect automobile insurance clauses, imperfect relevant legal environment, and some problems and loopholes in automobile insurance management, which give lawless elements an opportunity, and automobile insurance fraud cases occur from time to time. Precautions for auto insurance claims Everyone wants to have a safe trip when driving, but if there is an unfortunate traffic accident, don't worry too much. At this time, the insurance company that collects our premium every year will bear the responsibility. The following are the routine steps to apply for claims, and some misunderstandings in using auto insurance are analyzed. After 48 hours, the insurance may refuse to pay. Most vehicles are insured with commercial insurance as well as compulsory insurance. However, some car owners don't know how to get claims after the accident, which items should be paid by insurance companies, or even the claims process. This leads to being very passive when claiming compensation from insurance companies. After a traffic accident, if it is a minor accident, you can take photos of the scene and disassemble them yourself, and go to the traffic accident quick settlement center for settlement. If the accident is serious or the loss is large, the driver should keep the first scene and report the case to the insured insurance company in time. 48 hours after the general accident, the insurance company has the right to refuse compensation. After the staff of the insurance company arrive at the scene, the driver shall provide the original insurance policy, the valid identity certificate of the insured, the driving license of the insured vehicle that has passed the annual inspection and the driver's driving license at the time of the accident. After that, the staff can survey the scene of the accident. When the loan car is in danger, the repayment certificate must be submitted. All car losses caused by insurance accidents must be determined by the insurance company before they can be repaired, so as to verify the loss items and amount. Damaged vehicles can only be repaired after the damage assessment is completed. Compensation for personal or property damage to a third party must also be recognized by the insurance company, and the relevant evidence and amount can be used to settle the claim. After the accident is handled, the accident notice, loss list, invoice, copy of the insured's valid identity document and the insured's bank account (savings account) shall be handed over to the insurance company. If it is a loan vehicle, a timely repayment certificate issued by the bank must be submitted. If the traffic police department needs to make a ruling, it needs to produce a summary ruling or a formal ruling. If someone is injured, you need to provide certificates, medical invoices, cases, proof of lost time and other related materials. At that time, the insurance company will remit the indemnity to the account of the insured. It is not the right process to repair the car first and then claim for compensation. In the daily accident handling, some car owners think that the insurance company pays compensation, and the responsibility determination in the accident is not important. Therefore, when the responsibility is determined, these car owners will take the initiative to take responsibility. But they don't know that for the third party liability insurance, the insurance company has formulated different compensation ratios according to the responsibility of the owner. Therefore, if it is not your own responsibility, you must not bear it, because the insurance company will not bear all the expenses. In addition, after the vehicle is in danger, it is necessary to develop the habit of reporting the case to the insurance company at the first time. Some car owners don't report the accident to the insurance company immediately after the accident, but go to the repair shop first, and then go to the insurance company for reimbursement after the car is repaired. In this way, if the insurance company determines that the repair cost is higher than the fixed loss cost, the difference shall be borne by the owner himself. "No deductible" also has a scope limit. "No odds" means that insurance companies set up separate exemption rules for some specific accidents in order to prevent moral hazard. These exemption rates are not within the scope of no deductible, such as multiple accidents, driving beyond the scope, and incomplete claims documents. If the owner violates the rules, not only the insurance company has the right to refuse compensation, but also the deductible is deducted, so the owner is not worth the loss. According to reports, some car owners will ask the repair shop to repair the damage caused by the accident after the accident, and make claims through insurance procedures. If this behavior is verified by the insurance company, the owner will not only bear the responsibility, but also leave a bad record in the insurance company, which will lead to an increase in the rate next year. Therefore, you must not be smart when making claims. The principle of auto insurance claims is that auto insurance claims involve a wide range and the situation is more complicated. In the process of compensation, especially in the investigation of automobile accidents, we must put forward due requirements and adhere to certain principles. (a) establish the guiding ideology of serving the insured, adhere to the principle of seeking truth from facts, and reflect the economic compensation function of insurance in the whole process of claim settlement. When an automobile insurance accident happens, the insurer should be anxious for the insured, do everything possible to avoid the loss from expanding, minimize the impact caused by disasters and accidents, arrange the repair of the accident vehicle in time, and ensure that the original technical performance of the vehicle is basically restored so as to put it into production and operation as soon as possible. Handle claims in time and pay compensation to ensure the continuous production and operation of transport production units (including individual transport households) and the stability of people's lives. In the field investigation, accident vehicle repair, damage assessment and compensation cases, we should adhere to the principle of seeking truth from facts, analyze specific problems on the basis of respecting objective facts, that is, deal with them flexibly according to the actual situation in strict accordance with the provisions, so as to satisfy all parties. (2) Whether the insurer abides by the contract, keeps its promise and acts according to law or not depends on whether it strictly fulfills its obligation of economic compensation. Therefore, when handling compensation cases, the insurer must strengthen the legal concept, strictly follow the terms and conditions, and pay the compensation in full according to the compensation standards and regulations; Losses that do not fall within the scope of insurance liability should not be compensated indiscriminately. At the same time, it is necessary to explain the truth to the insured, and the part that refuses to pay compensation should focus on facts and evidence. We should act in accordance with the law and adhere to the principle of honoring contracts and keeping promises. Only in this way can we establish the credibility of insurance and expand its positive influence. (III) Resolutely implementing the "eight-character" claim principle "initiative, quickness, accuracy and reasonableness" is the experience summed up by insurance claims personnel in their long-term work practice, and it is the most basic requirement for quality service in insurance claims work: (1) initiative: that is, insurance claims personnel are required to actively investigate, understand and survey the scene, grasp the accident situation and analyze the accident. (2) Timeliness: It means that the insurance claims personnel are required to quickly survey and determine the loss without delay, pay close attention to the settlement of claims, verify claims accurately, compile claims calculation documents quickly, and review and approve them quickly, so that the insured can get claims in time. (3) Accuracy: that is, the survey, damage determination and even compensation calculation are required to be accurate, and compensation should be done well, and compensation should not be exceeded. (4) Rationality: it means that in the process of claim settlement, in the spirit of seeking truth from facts, we insist on doing things according to the terms. In many cases, it is necessary to accurately characterize specific cases, especially in the process of determining the damage degree of accident vehicles, and to reasonably determine the maintenance scheme of accident vehicles. The "eight-character" principle of claim settlement is the unity of syndrome differentiation and cannot be neglected. If one-sided pursuit of speed, no in-depth investigation and understanding, no concrete analysis of specific circumstances, blind conclusion, or inaccurate calculation, hasty treatment, may lead to misjudged cases, and even cause legal disputes. Of course, if we only pursue accuracy and rationality and ignore speed and work efficiency, the compensation case will be delayed for a long time, which will have a very bad social impact and damage the image of the insurance company. The general requirement is to proceed from reality, consider the insured, and pay equal attention to speed and quality. (IV) Pay attention to the evidential role of traffic accident liability determination. traffic accident responsibility confirmation (hereinafter referred to as the Letter of Confirmation) plays a decisive role in the adjustment of the interests of the parties to the accident and the insurance parties, and is an indispensable evidential material in insurance claims. Because it is not within the scope of judicial review of civil litigation cases, insurers are accustomed to adopting "takenism", which will inevitably bring huge evidence risks and operational risks to insurance companies. According to the relevant provisions in the Measures for Handling Road Traffic Accidents promulgated by the State Council (hereinafter referred to as the Measures) and the Procedures for Handling Road Traffic Accidents formulated by the Ministry of Public Security, the confirmation letter does not belong to the scope of judicial review of civil litigation. Because of its special status, insurance companies have formed a mindset, which regards it as irrefutable evidence in claims settlement and adopts "takenism", leaving huge evidence risk and operational risk for insurance companies. Therefore, "takenism" should not be adopted in the confirmation letter, and it should be accepted as evidence after evidence review to prevent risks. (1) Judging from the situation of the parties to the accident, the authenticity of the confirmation letter as evidence has been affected and destroyed, which objectively requires insurance practitioners to review the authenticity of their evidence. According to Article 34 of the Measures, if mediation fails to reach an agreement or any party fails to perform mediation after mediation takes effect, and the public security organ no longer mediates, the parties may bring a civil lawsuit to the people's court. It can be seen that in the process of handling traffic accidents, although the accident handling organ has certain administrative compulsory measures, its mediation effect is weaker than judicial mediation and has no legal coercive force. Once in the litigation procedure, the litigation cost of the insured will increase accordingly. The most obvious example is that according to the relevant provisions of the General Principles of the Civil Law and the Interpretation of the Supreme People's Court on Several Issues Concerning Determining the Liability for Compensation for Mental Damage in Civil Torts, the court can support the claim for compensation for mental damage by the disabled or their families. According to the automobile insurance clauses formulated by various insurance companies (hereinafter referred to as clauses), the insurer is not responsible for the mental damage caused by the insurance accident. Due to the difference between this clause and relevant laws in terms of damages, the insured chose administrative mediation to some extent. However, the road to administrative mediation is not smooth. In the process of mediation, the disabled or their families do not make reasonable and legal claims to the vehicle side according to their own responsibilities in the accident through legal procedures and methods, but force the vehicle side to submit through some tangible or intangible coercive means to achieve their own goals. First, in order to avoid entering the litigation procedure, and second, in order to solve the accident compensation dispute as soon as possible, the insured is often forced to make a compromise. It is a common fact to bear damages heavier than liability. On the other hand, insurance compensation is legal but not necessarily reasonable. Due to the above reasons, when the insured pays a certain amount of compensation to the third party, the liability is lighter and the insurance compensation is less; Heavy responsibility, get more insurance compensation; It is also an indisputable fact that insurance has become an economic lever, which virtually encourages car owners to bear heavier accident responsibilities and is in a more favorable position in compensation. Take the lesser of the two evils and the heavier of the two benefits. Therefore, in the case of a traffic accident between an insured vehicle and an uninsured vehicle or pedestrian, especially in the case where the owner has no liability insurance, the driver will take the initiative to cover all the accidents stipulated in Article 20 (the parties intentionally destroy, falsify the scene and destroy evidence) and Article 2 1 (one party has the conditions to report the case but fails to report it or fails to report it in time) of the Measures, or other circumstances. (2) From the subject of responsibility identification, the authenticity of confirmation has been affected and destroyed, and evidence review is also needed. Objectively speaking, the letter of confirmation is a qualitative and quantitative analysis conclusion made by the responsibility appraiser on the role played by the parties in the traffic accident according to the on-site investigation materials and relevant laws and regulations. Compared with other materials, it should be said that it has unparalleled superiority, authority and objectivity, and its credibility is high, but it does not represent all. Whether the confirmation letter can reflect the objective situation of the accident is restricted by many factors. First, practical experience, whether the handlers can collect comprehensive and sufficient on-site materials, whether they can get rid of the rough and the fine, discard the false and keep the true, and put forward objective materials reflecting the true nature of the accident; Second, legal knowledge and related professional knowledge, whether the handling personnel can organically combine the materials in their hands with relevant laws and regulations; Third, professional ethics factors, whether the case-handling personnel can be selfless, selfish and enforce the law impartially; The fourth is the identification procedure and evidence collection method. Whether the contents of qualified legal documents or administrative documents are legal or not depends not only on the legality of the subject, but also on the legality of the procedure. Therefore, the confirmation letter is inevitably restricted by subjective and objective factors, and it is very arbitrary and subjective to some extent. Needless to say, in the case of traffic accidents between cars and pedestrians, appraisers tend to be emotionally inclined to the vulnerable group of the injured. In order to facilitate their mediation of damages more quickly, they naturally or unnaturally favor the injured party when dividing their responsibilities. The details of all-insurance auto insurance claims are arranged as above. Insurance is still very necessary for us. Although we don't want to have a traffic accident when buying a car, if there is a traffic accident, insurance can pay for it, so we don't have to worry about the compensation fee for the accident.