Presentation to the Motor Insurance Bureau of
the Republic of Macedonia.
Direct Motor Claims’ settlement
Jean-Pierre Daniel
Skopje Nov.22. 2010.
What are the objectives ?
• From a commercial perspective.
– To speed up the claims’ settlement.
– To give a better service to the customer as
he/she will be treated by his/her own
insurance company.
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What are the objectives ?
• From a technical perspective.
– To control the claims costs.
• Thanks to the virtuous influence of the lump sum.
• In decreasing the administrative expenses due to
claims management.
• In removing legal expenses originated by court
claims settlement.
• In impeding the implementation of “no win, no
fees” offices.
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Some facts.
• Material damages car accidents
– Are so numerous that it is impossible to deal
with them in courts.
– It is often impossible to know who is really
guilty.
– Are not ( will not be ? ) such a big deal for
drivers.
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Some figures.
• Number of MTPL accidents.
– France : 1 704 000 37 million vehicles.
– Italy : 3 370 000 42 million vehicles.
– Germany : 3 801 000( including bodily injuries ) 55,5 million
vehicles
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Direct indemnification of the
insured.
• Established in 1968.
• Agreement between insurance companies.
• So deeply implemented in the market that
it seems compulsory.
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Direct indemnification of the
insured.
• Company of the driver • Company of the driver
at fault.
not at fault.
– Receives the amicable
statement.
– Pays the lump sum to
the opposite company.
– Receives the amicable
statement.
– Assesses the claim.
– Pays the body shop.
– Claims for a lump sum
the opposite company.
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Direct indemnification of the
insured.
• Applies to any motor claim.
• Settles only material damages.
• Applies in this simple way if the damages
do not exceed 6500 €.
• The lump sum : 1204 € = average cost of
material damages claims below 6500 €.
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Direct indemnification of the
insured.
• If the damages exceed 6500 €,
– The company of the driver not at fault has to
invite the opposite company to assess the
damages.
– The company not at fault claims for the total
amount of the damages.
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Direct indemnification of the
insured.
• Claiming for a lump sum is the key factor
of success.
– On one hand, as the company settles the
claim of its customers, it treats him well.
– One the other hand, as the company which
settles the claim receives only a lump sum, it
has no interest in exaggerating the cost of the
repairs.
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Why does the system work ?
• Each company receives a copy of the
amicable statement.
• Thanks to a table part of the agreement,
each company immediately knows which
driver is at fault.
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How does the system work ?
• 13 cases depending on the position of the
cars.
• Assessment based on objective elements.
– 100% at fault,
– 50%/50%
– Not at fault.
• 92% of the accidents = 0/100%
• 8% = 50%/50%
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Why does the system work ?
• In case of a disagreement between
companies,
– Each company has an “IDA correspondent”
who will speak with the “IDA correspondent”
of the opposite company.
– Each year only 60 cases are settled by the
arbitration court established by the
agreement.
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Administrative issues.
• A clearing house has been established on a non
for profit basis.
• For the day 25 of each month, each company
sums up all the claims it has paid for each of the
other market participants.
• These amounts are compensated between
insurance companies.
• In case of delay in the payment of the
compensation a rate of interest of 5% per month
applies.
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In other countries.
• In Spain and Italy, exactly identical
agreements.
• In UK and Germany, no market
agreements but agreements between
some companies.
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Settlement of light bodily injuries.
• Since 2002 an similar agreement has been set
up to “light” bodily injuries.
• No disability or disability < 5%.
• A table has been agreed by insurance
companies to assess the compensation of
injuries.
• Allows to settle 85% of bodily injuries claims.
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Settlement of light bodily injuries.
• The company of the
driver at fault.
– Pays back the
company of the driver
not at fault.
• The company of the
driver not at fault.
– Assesses the
damages of the
victims.
– Indemnifies the victim.
• If it pays into the frame
of a table, claims for the
amount paid.
• If it pays over the table,
bears the payment in
excess.
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Thank you for your attention
All questions are welcomed
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