The premise of automobile insurance is natural disasters and accidents. The objective existence of natural disasters and accidents makes people look for measures to deal with various natural disasters and accidents, but the prevention and control are obviously limited, so people think of economic compensation, and the insurance industry has entered people's lives as an effective economic compensation measure. The following are the key points of auto insurance claims that I share with you. Welcome to read and browse.
1 The meaning of automobile insurance
Before we know about automobile insurance, let's introduce the meaning of insurance. The insurance mentioned in People's Republic of China (PRC) Insurance Law refers to the commercial insurance behavior that the applicant pays the insurance premium to the insurer according to the contract, and the insurer will be liable for the property losses caused by the possible accidents agreed in the contract when the insured dies, suffers from disability, illness or reaches the age and time limit agreed in the contract.
Motor vehicle insurance is the most important type of insurance. Motor vehicle insurance is a comprehensive insurance, which belongs to the category of property insurance and is a kind of transportation insurance. It covers the loss of the vehicle itself and related interests caused by natural disasters or accidents, the reasonable expenses paid for taking measures, and the civil liability of the insured for personal injury and property losses to a third party according to law.
2 Classification of automobile insurance
Motor vehicle insurance is divided into main insurance and additional insurance according to the underwriting conditions, as shown in the following table.
Motor vehicle loss insurance in motor vehicle main insurance covers the risks arising from the use of motor vehicles, that is, the losses caused by the vehicles themselves; The third party liability insurance covers the risks arising from the use of the vehicle, that is, when the insured should be liable for personal injury and property losses caused by the use of the vehicle to others according to law, the insurer is responsible for compensation.
The purpose of motor vehicle additional insurance is to exempt the liability of insurance clauses in the main insurance. Insuring these types of insurance can make auto insurance more perfect, insurance more comprehensive and accident resolution more comprehensive.
3 auto insurance claims and claims process
3. 1 Claim Definition
Claim settlement refers to the obligation and responsibility of the insurer to compensate the insurance money when the insured has an insured accident agreed in the insurance contract. The process of fulfilling this obligation and responsibility is usually called insurance claims, or claims for short. In order to better grasp the claim, we must understand the claim and rejection.
In the process of commercial transactions, buyers and sellers often have disputes over their rights and obligations. After a dispute occurs, if one party breaches the contract and directly or indirectly causes losses to the other party, the injured party demands compensation from the breaching party within the time limit stipulated in the contract to make up for its losses, which is a claim.
If the breaching party accepts the claim for compensation, the amount or type of compensation, the expenses related to repair, processing and finishing, or agrees to exchange goods, it is a claim. If there are sufficient reasons to explain clearly, those who do not accept the compensation request are refusing compensation. Disputes and claims often occur in commercial transactions, which directly affect the economic rights and interests of all parties to commercial transactions. Therefore, all parties attach great importance to claims and settlement, and stipulate relevant clauses in the contract to safeguard their own interests. From a legal point of view, the breaching party should be liable for compensation, and the other party has the right to demand compensation until the contract is terminated. Only when a force majeure accident occurs during the performance of the contract, so that one party can't perform the contract or can't perform the contract as scheduled, can it be exempted from liability according to the provisions of the contract or the law.
Claims settlement is the behavior of insurance companies to fulfill their contractual obligations, which is based on insurance contracts, insurance-related laws and international practices, and there is no other reason or explanation that can be used as the basis for insurance claims settlement.
3.2 claim process
4. Characteristics and working principles of automobile claim settlement.
4. 1 Characteristics of claim settlement work
4. 1. 1 announcement by the insured. The insured in China's auto insurance used to be mainly units and enterprises, but with the increase of the number of vehicles owned by individuals, the proportion of single owner among the insured will gradually increase. The characteristics of these insured persons 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.
4. 1.2 has a high loss rate and a small loss range. Another feature of auto insurance is that although the loss 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.
4. 1.3 Strong liquidity. 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. 1.4 is more subject to the repair shop. Repair shops play an important role in automobile insurance claims, and the repair price, construction period and quality of repair shops directly affect the service of automobile insurance. 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.
4. 1.5 Moral hazard is common. Is auto insurance a moral hazard in property insurance business? The hardest hit area? . 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.
4.2 Basic principles of claim settlement work
4.2. 1 Establish the guiding ideology of serving the insured and adhere to the principle of seeking truth from facts. 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 transportation production units 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.
4.2.2 The principle of honoring contracts, keeping promises and acting according to law. Whether the insurer fulfills the contract depends on whether it strictly fulfills its obligation of economic compensation. Therefore, when dealing with compensation cases, the insurer must strengthen the concept of legal system, act in strict accordance with the terms, and pay the compensation that must be paid 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 be based 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.
4.2.3 Adhere to initiative, rapidity, accuracy and rationality? Eight-character proposition? Principle. ? Active, fast, accurate and reasonable? It is the experience summed up by insurance claims personnel in their long-term work practice, and it is the most basic requirement of quality service in insurance claims work.
Claims work? Eight characters? Principles are dialectical and unified, 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.
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