4.1. The insurer is exempt from the payment of insurance indemnity (collateral) in cases provided by the legislation of the Russian Federation, as well as in cases:
4.1.1. exposure to nuclear explosion, radiation or radioactive infection;
4.1.2. hostilities, as well as maneuvers or other military events and their consequences;
4.1.3. civil war, folk unrests of all kinds or strikes and their consequences;
4.1.4. Insured intent (beneficiary, insured person), as well as persons acting on their instructions aimed at the offensive of the insured event.
4.2. Unless otherwise provided by the insurance contract, according to this Regulation, the events listed in clause 3.1, which have occurred as a result of:
4.2.1. suicide or suicide attempts to the insured person during the first two years of the insurance of the insurance contract, as well as injuries and diseases obtained as a result of an attempted suicide, during the action of the insurance contract, except in cases where the insured person was brought to suicide by unlawful actions of third parties;
4.2.2. intentional members of the insured person, except in cases where the insured person was brought to such a state with unlawful actions of third parties;
4.2.3. Violations of the health of the insured person, the cause of which was proven in the procedure established by the legislation of the Russian Federation, the fact of committing the insured person of unlawful actions;
4.2.4. accidents or diseases that occurred during the stay of the insured person in places of deprivation of freedom, imprisonment or execution of a judicial act (with the exception of cases that occurred with employees of penitentiary institutions);
4.2.5. accident or disease during the insured person of the actual service in any armed forces of any state or direct participation in military exercises, testing of military equipment or other similar operations as a military personnel, law enforcement officer, or a civil servant;
4.2.6. any events associated with the use of the insured person, the testing of them or the storage of weapons, ammunition, explosives or poisoning substances;
4.2.7. alcohol poisoning of the insured person, poisoning as a result of the use of the insured person of narcotic, toxic, potent, psychotropic and drug substances (drugs) without the prescription of the doctor, diseases caused by alcohol, narcotic or toxic substances;
4.2.8. the events that occurred with the insured person who was in a state of alcoholic, narcotic, toxic intoxication, when the causal relationship between the state of alcoholic, narcotic or toxic intoxication and the event was proved;
4.2.9. the management of the insured person by any vehicle, the apparatus without the right to such control and / or in a state of alcoholic, narcotic or toxic intoxication, as well as the transfer of the person's management, is obviously for the insured person who did not have the right to control or in a state of alcohol, narcotic or toxic intoxication;
4.2.10. practicing dangerous sports and outdoor activities (airports (including Delta - and paragliding), motor racing, mountaineering and climbing, beasedjamping, buoral sport, extremal cycling (including Mountainbike, dejumpjing, etc.), ski jumps (from springboard, with helicopter), skiing at unprepared tracks, ski cross, diving in underwater caves, kayaking, jumping parachute, parkur, skycerfing, speleotourism (speleology), speedway, windsurfing, freedive, freestyle, motorboats, catamarans, roofs and small courts; riding on mopeds, motorwires, scooters, motorcycles, quad bikes or other two-wheeled (three-wheeled) motorized vehicle);
4.2.11. accident / disease / accidents / terrorist act / aircraft crash / shipwrecks that occurred before the conclusion of the insurance contract;
4.2.12. the participation of the insured in any aviation flights or movements on water ships, with the exception of moving it as a passenger of an air / water vessel licensed to transport passengers and managed by members of the air / water vessel crew, having a corresponding certificate;
4.2.13. cases that occurred as a result of nerve or mental diseases or disorders (including epilepsy), as well as accidents that occurred with insured, which suffer from alcoholism, drug addicts, toxicomicia;
4.2.14. treatment received from specialists practicing unconventional practices;
4.2.15. non-compliance with the insured recommendations of the attending physician and therapeutic and security regime; refusal of the insured against the proposed treatment, as a result of the disabilities of the insured or tightening the recovery process;
4.2.16. AIDS diseases, HIV infection, disease in the presence of HIV infection;
4.2.17. diseases and states that are indicated as exceptions to the insurance coverage in the list of diseases (Appendix No. 3, 4, to this Regulation), insurance payments (applications No. 13 of this Regulation);
4.2.18. The worships of the insured claims for labor protection and labor safety;
4.2.19. Putabilities arising from the bite of insects and animals (with the exception of poisoning poison);
4.2.20. hospitalization or surgical surgery insured due to disease / accident diagnosed / incurred before the conclusion of the insurance contract;
4.2.21. hospitalization or conducting surgical operations insured due to abortion, teeth treatment (their implantation, removal, recovery, etc.), due to plastic or cosmetic surgery, except when it is necessary for the treatment (elimination of consequences) of bodily damage obtained due to an accident that occurred during the insurance period;
4.2.22. Hospitalization or conducting surgical operations insured due to sterilization, fertilization, animation or treatment of infertility, with the treatment of impotence, with the treatment of generic injury, congenital anomaly or hereditary disease, with pregnancy or childbirth, due to a venereal disease or disease in the presence of HIV infection , in connection with the mental disorder, in connection with the diagnosis of biopsy, endoscopy, laparoscopy and arthroscopy, due to the officially recognized case of the epidemic or natural disaster;
4.2.23. hospitalization or surgical surgery insured for his medical examination; accommodation in the clinic or sanatorium to pass the restoration (rehabilitation) course of treatment; Detention of the insured due to quarantine or other preventive measures of the official authorities;
4.2.24. hospitalization or conduct of surgical surgery insured in connection with an attempt to commit suicide, regardless of the term of the insurance contract at the time of the insured event;
4.2.25. medical treatment, as well as medical examinations that are not related to the occurrence of the insurance case; obtaining treatment associated with disease prevention;
4.2.26. Food toxicoinfection, pathological fractures, familiar and / or repeated dislocations, sublifiers, congenital diseases.
4.3. The insurance contract may be provided for as the risks specified in P.P. 3.1.3 - 3.1.6, 3.1.8, 3.1.10, 3.1.14, 3.1.15 of these Rules, are not recognized by the insured events that occurred as a result:
4.3.1. oncological disease;
4.3.2. diseases of the central or peripheral nervous system;
4.3.3. diseases of the cardiovascular system, blood, blood-forming organs (IBS, hypertensive disease III - IV degree, atherosclerosis, heart failure, cardiac asthma, etc.);
4.3.5. liver diseases (hepatitis of viral and non-liberal nature, cirrhosis of the liver of any etiology, etc.) and the gastrointestinal tract in the terminal stage;
4.3.6. diseases of the respiratory system (COPD - chronic obstructive pulmonary disease, bronchial asthma, tuberculosis, etc.);
4.3.7. diseases of the intestine, stomach, kidneys;
4.3.8. any innate disease;
4.3.9. diseases associated with pregnancy and childbirth and / or complications them.
4.4. The decision to refuse to recognize the case of insurance (the absence of grounds for insurance payments) is communicated to the beneficiary (insured, insured) in writing with the substantiation of the reasons.
5 .Insurance amount
5.1. The insurance amount is a certain amount of monetary amounts established for each insurance risk separately and / or for all / some insurance risks together (aggregated), based on which the size of the insurance premium and insurance payment is determined. The insurance amount can be established in the insurance contract or by specifying a specific monetary amount, or by specifying the method of calculating the sum insured.
5.2. Insurance amount is determined by agreement of the insurer and the insured.
5.3. By agreement of the parties, the insurance amount during the insurance period may be increased or decreased, while the insurer recalculates the insurance premium. The increase and decrease in the sum insured is issued by an additional agreement to the insurance contract, unless otherwise provided by the insurance contract.
5.4. The insurer has the right to set the maximum / minimum amount of the sum insured, depending on the insurance conditions, while the insurer has the right to refuse to the insured in changing the conditions of the insurance contract, if the requirements of the insurer do not meet the limitations on the minimum / maximum insurance amount established by the insurer.
Rustam Akhmetgareyev
(No) insurance case
As follows from the decision of the Arbitration Court of the city of Moscow, in February 2016, Anna 2001 LLC insured to 93 million p. Two-storey wooden office building with a total area of \u200b\u200b557.4 square meters. m, located on an agricultural street in Moscow. For insurance, Anna 2001 LLC paid 358 thousand rubles. Prizes.
In August 2016, the building caught fire, as a result of which the roof was completely collapsed and the back side of the house. The cost of suitable residues was estimated at 4.1 million rubles. (less than 5% of the sum insured).
Experts of the forensic expert center of the federal fire service in the city of Moscow called the most likely cause of what happened "to ignite the vapor of combustible fluid from the source of the flame burning used to artificially initiate a fire mechanism." In October 2016, a criminal case was initiated on the signs of Art. 167 h. 2 of the Criminal Code of the Russian Federation (intentional destroying of property by arson). However, the perpetrators were not installed.
LLC "Anna 2001" appealed to the Arbitration Court of the city of Moscow with a claim to VSK for recovery of 88 million p. Insurance compensation. The insured stated that they were insured by the risks of "fire" and "losses as a result of the unlawful actions of third parties", but no refund was obtained.
The court indicated that, according to the signed by the insured by the RC insurance rules, arson is excluded from the Risk groups "Fire" and "the unlawful actions of third parties aimed at the destruction or damage to property" - and under no circumstances can be recognized as an insured event.
On this basis, the court refused Anna-2001 LLC in the satisfaction of the requirements.
Anna-2001 LLC refused to comment on the situation. The response of the press service of the VSK is indicated that in accordance with the RV insurance rules, the risk of "arson" is not an absolute exception to the insurance coverage. "It can be added to the insurance contract at the request of the client as part of insurance against" unlawful actions of third parties. " Of course, the inclusion of any additional risk increases the size of the insurance premium, "indicates the response of VSK.
What is there other insurers
ASN analyzed the insurance rules of the 10 largest assets of the property of legal entities in 2017. This "SOGAZ", Ingosstrakh, Alfactory, VTB Insurance, Reso-Guarantee, VSK, Rosgosstrakh, "Consent", "Capital Insurance" and "Zurich Reliable Insurance".
The exclusion of arson from the risks of the fire and the unlawful actions of third parties, except for Vos, was only at the "consent". "Podzhoga is an insured event: such an opportunity is provided for by the insurance rules of our company. Insurance of this risk is provided to the insured as an additional option, "said" consent ". - Insurers interested in the insurance of this risk are undergoing more thorough underwriting. The tariff depends on the customer's insurance and profile object. Separate policyholders are provided free of charge, some clients receive a refusal. "
In the rules of Ingosstrakh, it is indicated that arson is not an insured event at the risk of "fire" and is refunded solely when insuring the risk of "unlawful actions of third parties."
Zurich Reliable Insurance, on the contrary, included arson into a fire risk and excluded third parties from unlawful actions.
What are insurance brokers think about this
Vice-President of the Insurance Broker Marsh In Russia, Armen Guluman told ASN that his company met several times such an exception to two or three major insurers when analyzed the policies of new customers. To exclude such cases, Armen Gulumyan recommends to insure property on the "all risks" system.
The representative of another major insurance broker said that there were no such exceptions in practice. However, the Jurlitz usually carefully study exceptions to the insurance coverage, and it is surprising that such a omission is done, he said. The broker also suggested that "maybe there was a different reason than inattention."
The general director of the insurance broker Mains Group Sergey Khudyakov indicates that, in fact, the insurer was excluded the key risk - and when an understanding of this, the insured would not conclude a contract. At the same time, the policy of the insured could get at a lower price due to a decrease in the amount of insurance protection. "In order for insurance to be trusted in the market, there must be ethics of business relations, in which, according to the spirit of insurance, obvious risks should be covered," says Sergei Khudyakov.
Examination of the Insurer from paying and exclusion from the coverage
Recovery from insurance organizations of controversial payments remains a problem that most often leading their customers into court. In this article, we will consider what conditions Russian insurers include in contracts in order to reduce insurance payments or free themselves, and what the courts think about it.
Civil law (Art. 421 of the Civil Code of the Russian Federation) provides for freedom of parties to the contract, including the insurance contract, under its conclusion. This is primarily expressed, first of all, in the ability to determine the terms of the contract at its discretion, except in cases where the content of any condition is prescribed by law.
Of course, the principle of freedom of the contract is applicable, among other things, voluntary insurance agreements.
Since the terms of contracts in practice are formed mainly by insurers, they pay close attention to the reflection in the exemption contract from insurance coverage and grounds for exemption from payments.
Against the rules
Violation of any rules (construction, road safety, safety, etc.) significantly increases the risk of occurrence of various adverse effects for insured facilities.
Therefore, insurers are trying in every way to minimize their risks, including the conditions for insurance of the reservation on the exemption from the payment in case of violation of such rules by the insured (the person who has entered into an agreement) or the beneficiary (the recipient of insurance compensation).
It should be noted that in fact violation of various norms and rules are manifestations of gross negligence.
However, taking into account the position set out in paragraph 9 of the information letter of the Presidium of the Russian Federation of 28.11.2003 No. 75, insurers are trying to avoid the formulation of "coarse negligence" when describing exceptions and grounds for exemption from payments in contracts and regulations.
The Presidium of the Supreme Arbitration Court of the Russian Federation pointed out that the condition of contracts (rules) on refusal to pay compensation due to the coarse negligence of the insured or the beneficiary is insignificant.
This is explained by the fact that such a condition is contrary to para. 2 p. 1 Art. 963 of the Civil Code of the Russian Federation, according to which liberation due to coarse negligence can only be provided by law (but not a contract).
Worn in two concepts
In the insurance contracts with which we, as a law firm, are faced in the work, insurance companies formulate the conditions that, as it seems to be, should exclude payments in cases of incidents arising from violations of various norms and rules.
Basically, such restrictions use the following sections:
"Exceptions from insurance coverage";
"" The foundations of the liberation of the insurer from paying "insurance contract.
Our experience shows that often insurers mix these concepts, considering them identical.
Meanwhile, there is a significant difference:
if the event is excluded from the insurance coverage, then the insurer does not have the obligations to pay due to the unaccompanies of the insured event;
the basis, freeing the insurer from the payment, allows him to not pay when the insured event occurred.
It would seem that the courts, as direct law enforcements, when considering a huge number of insurance disputes, many of which reach higher instances, should strive to develop uniform positions.
However, the same courts take diametrically opposite solutions according to the same issues.
Often they themselves are confused in the concepts of "exemption from paying" and "exclusion from the coating", unreasonably mixing and identifying them.
After analyzing the practice, we tried to identify the general trends of its development.
Payment conditions from payments
The grounds for the release of the insurer from payments are listed in Art. 963, 964 and paragraph 4 of Art. 965 Civil Code of the Russian Federation.
In this case, the dispositionability (it is allowed that it is not forbidden) Art. 964 allows parties to include in the insurance contract and other grounds for liberation.
However, in one of the cases under consideration below, we will see that this freedom is still not absolute.
The largest number of insurance cases considered by the courts is traditionally connected with the automotive insurance due to its widespread prevalence.
The question of the inclusion of additional grounds for the release of payment insurers often rises in connection with the consideration of this particular category of affairs.
Then the positions expressed by the courts on "car affairs" are transferred to cases associated with the insurance of other types of property.
Very often in judicial practice there are cases related to the presence of insured cars with keys left in them and / or registration documents.
In accordance with the insurance rules (i.e., the documents contained by the main insurance conditions) of the overwhelming number of Russian insurers, such an incident is not an insured event.
Approximately half of the cases, this condition is described in the treaties as the exempt payment of the insurer.
However, there are other edits of insurance rules.
In the definition of you of the Russian Federation of 29.05.2009 No. A56-13413 / 2008 No. A56-13413 / 2008, the court noted the presence of the insurance company's right in the insurance rules to refuse to pay compensation when the vehicle is embedded with the registration documents left in it.
In definition, the court indicated the disposition of Art. 964 of the Civil Code of the Russian Federation, i.e. On the ability of the parties to form the terms of the contract.
Since the insurance rules contained the above grounds for exemption, in the transfer of the case to the Presidium of the Court of Russia, the liberation of the insurer from the payment was refused and the release of the payment was recognized by the relevant law and the contract.
If the insured is to blame
In the decision taken a little later, the Decree of the Presidium of the RF dated 23.06.2009 No. 4561/08 The court on this issue took a different position that the lower courts consistently adhere to.
The resolution also indicates the disposition of Part 1 of Art. 964 of the Civil Code of the Russian Federation, according to which the parties can establish otherwise in the contract, in addition to the laws provided by law, the grounds for the release of the insurer from paying.
However, the Presidium of the Russian Federation believes that the insurer can be released from paying only if the actions of the insured person contributed to the occurrence of the insured event.
In particular, leaving the insured documents in the car does not contribute to theft of car theft.
Apparently, the courts can release insurers from payments on the basis of violation by insured by various norms and rules, if this violation has led to the occurrence of the insured event.
So, in case No. A28-11704 / 2009, the condition was considered to include the conditions for the release of the insurer from the payment in the event of an insurance case due to the fault of the insurer.
In the case, a violation of the fire safety standards from the employee of the Insured was established (determination of the WEP of the Russian Federation of 14.10.2010 No. You-13494/10).
The courts of all instances the insurer was exempt from payments with reference to the disposition of Art. 964 of the Civil Code of the Russian Federation and the ability of the parties to provide additional grounds for the liberation of the insurer.
The solution is true, no motive
The same position was occupied by the courts and when considering the case No. A32-3666 / 2010.
As a result of the operation of a faulty car, an accident occurred, this fact was recorded in the protocol and decree on the case of an administrative offense.
Insurance rules provided that "losses arising due to an accident resulting from the maintenance of a technically faulty vehicle are not covered."
If we consider this condition literally, in our opinion, it should rather relate to exceptions from insurance coverage.
However, the court considered this condition to the foundation for the liberation of the Insurer from the payment provided by the Treaty.
In recovery from the insurer, it was denied, that is, it was decided in fact correct, but the wrong reasoned decision.
From the considered practice, it can be concluded that if the insurance contract was included in the insurance contract, subsequently influenced by the occurrence of the insured event, the insurer could be released from it.
However, as seen at this stage, the insurer's wine liberation should be confirmed by the relevant documents (for example, in the case of an accident - a decree on the case of an administrative offense).
Exception from insurance coverage
And insurers, and practicing lawyers are well known for paragraph 9 of the information letter of the Presidium of the Supreme Arbitration Court of the Russian Federation of November 28, 2003 No. 75.
As mentioned above, it says that the terms of insurance contracts for the refusal of paying due to the rough negligence of the insured are insignificant.
In the case considered by the court, it was about insurance in case of failure or destruction of building machines and mechanisms.
The insurance rules provided that the accident at the construction site, which occurred due to the coarse negligence of the insured, is not an insured event.
That is, it was about exclusion from the coating, and not about the reasons for exemption from the payment.
The court, however, interpreted this exception from the coating as a basis for exemption from the payment, which violates Art. 963 of the Civil Code of the Russian Federation, and recovered compensation.
After that, most insurers began to avoid the formulation of "coarse negligence" in their insurance rules, actually replacing the coarse negligence by the description of its manifestations (in the form of violations of various rules and norms).
Loud process
Interesting and, our view, the right position took you to the Russian Federation when considering another loud case, which at one time watched the entire insurance market.
The rules of voluntary insurance of the Avangard-Garant insurance company, the Avangard-Garant insurance company, was made to exclude from the insurance coverage of events that occurred in connection with the violation of the traffic police officer.
Since traffic violation often also leads to an accident, this insurer denied its policyholders in paying, since under the contract the coverage for such cases did not apply.
At the same time, paying on the occasions where the culprit was another driver, the insurer subsequently charged the paid reimbursement in the order of subrogation (that is from drivers-culprits).
Meanwhile, the tariffs of this insurer were approximately the same as in companies that such risks were not excluded.
Thus, the policyholders for the TC the same money was offered significantly lower defense.
The Federal Insurance Supervision Service (FSSN) issued an order to the insurer who concerned this point of rules, but this prescription was successfully challenged.
The Russian Federation in the definition of 15.10.2007 No. 12235/07 indicated that an accident with the insured car occurred due to the occurrence of the risk excluded from the insurance coverage, and that the payment of compensation under such circumstances contradicts the terms of the insurance contract.
The position of the Russian Federation is based on literally reading the terms of the contract and, our view, is the right (although not aimed at protecting the weak side - the policyholder).
What is interesting, the Supreme Court of the Russian Federation in the definition of 23.12.2008 No. 4-B08-23 by complicated interpretation took another position in the dispute on the same item of the regulations of the same insurer, actually giving an indication of the lower courts to collect the insurance indemnity in the presence of such exceptions.
In the form of exception
The question of applying exceptions from insurance coverage was considered in case No. A40-30245 / 08.
The property of a legal entity was insured, including in case of fire.
In the rules of insurance as an exception from the insurance coverage, the events that occurred on the intent or coarse negligence of the insured, expressed, in particular, in violating them rules and fire safety standards. A decree of the termination of the criminal case was established violation of the rules of fire safety.
The court of first instance satisfied the lawsuit, referring to violation of Art. 963 of the Civil Code of the Russian Federation.
This decision was canceled by the decision of the appeal instance, the claim was denied (the decision of the ninth Arbitration Court of Appeal dated September 30, 2008 No. 09 UP-11767/2008-GK).
The position of the appellate instance was supported by higher courts.
The Court of Appeal rightly noted that the violation by the insured of fire safety rules is not a reason for refusing to pay insurance compensation, and the risk that the insurance coverage does not apply.
At the same time, the payment of compensation under these circumstances is contrary to the conditions of insurance contract.
The specified ruling is interesting because despite the fact that the texts of the judicial acts did not follow the intent of the policyholder, and in the very wording of exception, the term "coarse negligence" was present, the courts applied to the specified exception from the coating and refused the lawsuit.
Condition one, use different
The trial took another position when considering the case No. A56-38799 / 2009.
The insurer was insured by the decoration of the premises and the property in it.
As a result of a fire, the property of the policyholder was destroyed.
The insurer recognized the insured event that happened and paid insurance, partially submitted the damage caused.
The dispute was transferred by the Client to the Court in connection with the incomplete payment of compensation.
By the decision of the court of first instance, left without a change in higher courts, the claim was partially satisfied (the decision of the Arbitration Court of St. Petersburg and the Leningrad Region of December 23, 2009).
It is curious that the insurer claimed the absence of an insured event with reference to the rules point excluding the insurance cases that arose due to violation of fire safety rules.
Camusing compensation, the courts proceeded from the fact that the insurance company did not prove the unaccompanies of the insured event.
The decision is motivated by the fact that evidence of the violation of fire safety standards is not represented.
The courts also pointed to the inconsistency of the specified elimination to the imperative standards of the law (Art. 963 of the Civil Code of the Russian Federation), thereby giving it to understand that even if such evidence was presented, this condition would not have been applied anyway.
Thus, we see absolutely different plows by the courts of very similar treatments.
Matter of chance
To the conclusion of the suggestion of the insured event, the courts came when considering the case No. A40-90205 / 08 (Resolution of the FAS of the Moscow District of October 14, 2009 No. KG-A40 / 10315-09; Determination of the Supreme Arbitration Court of the Russian Federation of 12/22/2009 No. Yourso-16429/09).
In this case, cash cash at the checkout was insured.
Insurance was carried out, including the risks of "theft with hacking" and "robbery".
The attack on the cashier, unknown persons seized the keys from the door of the cashier (not under guard) and stole money.
Grounds for refusal
The insurer refused to pay compensation, referring to the unaccompanies of the insured event, as in accordance with the terms of the contract, the damage arising from the violation or non-compliance with the instructions for storing, exploiting, the maintenance of the insured property is not an insured event.
The courts reasonably agreed with the arguments of the insurer and refused to recover compensation.
The reference of the plaintiff for violation of the specified clause of the contract of Art. 963 of the Civil Code of the Russian Federation rejected, noting that this item does not establish grounds for the liberation of the Insurer from the payment upon the occurrence of the insurance case.
It determines those signs, in the presence of which, as the part of the contract agreed, this fact is causing the damage property is not an insured event.
Decision for the court
Summing up our analysis, we note that it is aimed at finding general trends in judicial practice so that it is possible to predict the outcome of those or other situations faced by insurers, their customers and lawyers.
Unfortunately, uniformity in the logic of ships was not detected.
During the review, confirmations were obtained that the judges in different ways approach the same issues.
This strengthens the legal uncertainty of the position of the insurance contract parties and entails new and new legal proceedings.
So, how to act in each case, in fact, it solves an exclusively court.
Polina Kondratyuk, Lawyer Clyde & Co (CIS), member of the Society of Insurance Lawyers (Oyry)
4.1. According to these Rules are not insured events:
4.1.1. Moral harm, missed benefit, simple, loss of income and other, indirect and commercial losses, losses and expenses of the policyholder, beneficiary, victims, such as: fines, hotel accommodation while repairing insured TS, travel expenses, losses related to terms supplies of goods and production of services;
4.1.2. Losses caused by damage to the property, which was in the insured TC at the time of the insured event;
4.1.3. Damage caused by the loss of the commodity cost of the vehicle or the damage of the vehicle due to corrosion and, natural wear of the vehicle and additional equipment due to their operation;
4.1.4. Damage caused by theft, damage, destruction of a set of tools, aid kits, fire extinguisher, emergency stop sign, stationary anti-theft means, car awnings (trailers and semi-trailers), decorative decoration and equipment of the cabin, devices, light and alarm and other equipment, if the lattes were not installed by the manufacturer or were not insured as additional equipment;
4.1.5. Damage caused by theft, damage, destruction of the insured car with a removable front panel (including the front panel), if the front panel was left in the insured vehicle during the lack of a driver in it;
4.1.6. Damage caused by theft of registration marks;
4.1.7. Damage caused by breakdown, refusal, failure of parts, nodes and vehicle aggregates as a result of its operation, including due to internal cavities of nodes and aggregates, as well as electronic blocks and electronic devices of foreign objects, animals, birds, substances, rain and thawed water and other liquids, as well as due to fluid from entering or other substances in the air intake inlet pipeline, leaving for the occurrence of hydraulic impact (s) in the cylinder (s) of the engine;
4.1.8. Damage caused by damage to tires, wheel drives and / or decorative caps, if it did not cause damage to other nodes or TC units;
4.1.9. Damage caused by point damage to the paintwork without damage to the part (chip);
4.1.10. Damage caused by point damage (chipped) Glass of body (windshield, rear, side, glass roof panel or glass hatch panel), external lighting devices (headlights, flashlight, pointer / rotation repeater, stop signal repeater), as well as damage caused by thermal destruction (cracks) of glass of body or external lighting devices in the absence of traces of external mechanical exposure, unless otherwise provided by the contract;
4.1.11. Damage caused by loss (including theft) keys, keyfobs, chips, electronic activation cards;
4.1.12. Damage caused by damage to the insured vehicle under unknown circumstances;
4.1.13. Losses arising from the non-return of the insured TC by the insured during the insured of the vehicle transmitted to the rental, leasing, lease, and the like;
4.1.14. The embezzlement of the insured vehicle together with the registration documents left in it (certificate of registration of the vehicle and / or passport of the TC), and / or keys from the ignition lock, and / or other devices used to start the engine, perthe exception of cases provided for by sub. d) part 2 art. 161 and Art. 162 of the Criminal Code . ;
4.1.15. The embezzlement of additional equipment or parts of the vehicle, if they were at the time of the insurance event separately from the insured vehicle;
4.1.16. The embezzlement of spare wheels TS and / or a spare wheel casing, if their embezzlement occurred without damage to the insured TC itself;
4.1.17. Damage as a result of an accident resulting from the use of technically faulty vehicle by the insured. Technically faulty is the TC, which has the faults specified in the "List of Faults and Conditions, during which the operation of vehicles" - "Annex to the main provisions for the access of vehicles for the operation and responsibilities of the safety of road safety."
4.1.18. Any damage or the embezzlement of the insured TC, imported into the territory of the Russian Federation with a violation of current customs norms and rules, and / or listed in the information databases of these authorities of the Russian Federation and / or Interpol organs as previously abducted.
4.1.19. The embezzlement of the insured vehicle during the shutdown period, break or remove from the service of the anti-theft system, if the insurance was carried out in the presence of a requirement for installing an anti-theft system specified in the insurance contract.
4.1.20. Damage caused by repeated damage to the elements (nodes, aggregates, etc.) of the insured TS, which had significant damage at the time of the conclusion of the insurance contract, and recorded by the Insurer (authorized by him) at the conclusion of the insurance contract in writing. There are significant damage to any damage to the vehicle, with the exception of point damage to the paintwork without damage to the part (chip s), point damage (chipping) of the glass of the body (windshield, rear, side, glass panel of the roof or glass panel of the hatch in the roof) and / or external lighting devices (Headlight, Lantern, Pointer / Rotation Repeater, Stop Signal Repeater), Damage caused by thermal destruction (cracks) Body glasses or external lighting devices in the absence of traces of external mechanical exposure, damage related to declared and unresolved insured cases, if the insurance contract Additionally, no otherwise provided;
4.1.21. The embezzlement of the insured vehicle using the stolen factory keys from the ignition lock and other devices used to start the engine / or the embezzlement of the insured vehicle with the lost or previously stolen registration documents of the vehicle, the impletion of cases provided for by sub. d) part 2 art. 161 and Art. 162 of the Criminal Code of the Russian Federation, in case the trimming of the vehicle occurred until the application, in accordance with the procedure provided for by these Rules, the owner of the TC on the embezzlement of factory keys from the ignition lock and other devices used to start the engine and / or the embezzlement or loss of TC registration documents by the insurer;
4.1.22. Repeated damage to the elements (nodes, aggregates, etc.) TC, according to which the insurer previously carried out insurance payments or fully or partially refused to pay insurance compensation, excluding cases of refusal to pay insurance compensation on the basis of paragraph 4.1.9. and / or 4.1.10. of these rules, with the insured by the insured duty specified in paragraph 10.2.7. of these rules;
4.1.23. Love damage (harm) caused to victims as a result of illegal use (excretion) in other (third) persons insured by the TC;
4.1.24. The embezzlement of individual parts, parts, components, aggregates of the vehicle and / or additional equipment installed on it as a result of the unlawful actions of third parties if the insured vehicle is not insured at the risk of "embezzlement";
4.1.25. Damage as a result of the unlawful actions of third parties, according to which the internal affairs bodies refused to initiate a criminal case, or an institutional criminal case was discontinued at the following grounds / reasons (in any combination):
The lack of a crime event (paragraph 1 of Article 24 of the Code of Criminal Procedure of the Russian Federation);
The absence of a crime in the actions (paragraph 2 of Part 1 of Article 24 of the Code of Criminal Procedure);
Action (inaction) is not recognized as a crime (paragraph 2 of Article 14 of the Criminal Code of the Russian Federation)
4.2. Not recognized as insured events and are not covered by the real insurance of the event, which led to damage, death, loss (theft) of the insured vehicle, causing harm, life and health of insured persons, as well as harm to victims, if they occur as a result:
4.2.1. Intentional actions of the policyholder, the beneficiary, the persons admitted to the management of the insured TS under the insurance contract, passengers of the insured TS, aimed at the occurrence of the insured event, or when committing or attempting to perform the above-mentioned persons of the crime;
4.2.2. In the process of managing the insured TC by the person:
Not allowed to manage under insurance contract;
Not having the right to control TS;
No power of attorney on the right to control the insured TS or not specified in the track list;
In a state of any form of alcoholic, narcotic or toxic intoxication or under the influence of drug drugs, the use of which is contraindicated when controlling the vehicle or refused to undergo a medical examination (examination).
4.2.3. Loading and unloading of the insured vehicle, as well as the transport of TS as a cargo if the insurance contract is not provided otherwise;
4.2.4. Use of the insured vehicle in competitions, tests or to teach driving without written agreement with the insurer;
4.2.5. Transmission of the insured TC in leasing, rent, rental or deposit without written agreement with the insurer, unless otherwise provided by the insurance contract;
4.2.6. Violations by the insured or face admitted to the management of the insured TC under the insurance contract, the rules of operation of the vehicle, fire safety, transportation and storage of flammable and explosive substances and objects, safety requirements for the carriage of goods (according to traffic rules);
4.2.7. Exposure to nuclear explosion, radiation or radioactive infection;
4.2.8. Hostilities, maneuvers or other military events, civil war, folk unrests of all kinds or strikes, confiscation, seizure, details, arrest or destruction of the insured TS by order of state bodies;
4.2.9. The spontaneous movement of the parked TC (this restriction does not apply to the risks of "civil liability of vehicle owners" and "accident");
4.2.10. If the driver of the insured TC left (left, etc.) the accident site in violation of the rules of the road, established by the regulatory act of the Russian Federation;
4.2.11. If the policyholder (beneficiary) did not fulfill the duty specified in paragraph 10.2.4. and / or 10.2.5. of these rules.
Insurance cases do not apply and insurance does not cover the offensive of the civil liability of the insured (insured) due to:
- 1. Requirements for compensation for harm (damage) declared on the basis of contracts, contracts, agreements, as well as payments made in return to the fulfillment of obligations in kind or as sanctions under contracts, as well as any other policy of the Insured as part of the fulfillment of obligations to them contracts;
- 2. causing harm caused by the environment (environmental damage);
- 3. causing harm to life, health and property of the insured (insured), its employees, relatives, affiliated persons of the insured (insured);
- 4. Intentional harm to the insured (insured). At the same time, the damage or inaction is equal to the deliberate causality of harm, in which the possible attack of the loss is expected to be quite highly likely and consciously allowed by the person responsible for such actions;
- 5. The impact of the source of increased danger;
- 6. The insured by the insured during the circumstances agreed with the insurer, noticeably increases the degree of risk, on the need to eliminate which in accordance with generally accepted norms indicated the insurer;
- 7. wear of structures, equipment, materials used including over the regulatory life;
- 8. Caution of harm associated with copyright infringement, opening rights, invention or industrial sample, or similar rights, including unauthorized use of registered trade, branded or trademarks, symbols and names;
- 9. causing harm to the life, health and property of the tenant and / or the employee of the tenant, if the insured (insured) is the landlord;
- 10. Actions and / or inaction of the insured (insured) and / or its employee committed or admitted as a result of drinking alcohol, narcotic drugs or other foaming substances;
- 11. non-fulfillment by the insured (insured) within the established period of requirements (prescriptions) issued by the supervisory authority;
- 12. Violations of the rules of fire safety admitted by the insured (insured person) or his employee, which was obliged to comply with their observance;
- 13. Implementation by the insured (insured) work and / or provision of services in the absence of permission of the supervisory authority (in the case when the presence of such permission is required), illegal redevelopment of residential / non-residential premises;
- 14. Implementation of the operation of the technical device by an employee of the insured (insured), which did not have a document indicating the presence of the right to operate the technical device (in the case when the presence of such a document is required);
- 15. Damage, destruction or damage to the property, which the insured (insured) leased, hiring, rental, leasing or deposited, or accepted for storage under the contract;
- 16. Permanent, regular and / or long-term thermal influence or exposure to gases, vapors, rays, liquids, moisture or any, including non-vitrors (soot, soot, smoke, dust, etc.). However, the damage is subject to refund, if one of the above actions will be sudden and unforeseen;
- 17. Unemption by the insured (insured) or victims of reasonable and accessible measures to reduce possible losses;
- 18. Caution of moral damage, missed benefits, harm, dignity, business reputation, as well as imposing a responsibility on the insured in the amount exceeding the current legislation.
Events are not recognized as insurance cases and the insurance indemnity is not paid if during the term of the insurance contract occurred:
- 1. The provision by the insured and / or beneficiary of documents decorated improperly. Documents are considered properly due to the case when they are registered in accordance with the established procedure for registration (according to current regulatory acts), contain appropriate details (printing, signature of the corresponding official, etc.), contain full information provided for this the form of the document (according to the current regulatory acts), unless otherwise provided by the insurance contract;
- 2. Message by the insured (insured) and / or beneficiary of obviously false information about the insurance case and the amount of the loss.
