1. Presented by: Holger Backu, CEO
AIIF 2015 –Baku, Azerbaijan
Differences in MTPL claims in Europe and consequences for claims management of MTPL insurers
Presented by:
Holger Backu, CEO

2. Agenda
I. Introduction II. Legal Framework for MTPL Claims in Europe III. National MTPL Claims and Cross Border Claims IV. Trends in Claims Management in Europe V. Conclusions
AIIF Azerbaijan International Insurance Forum

3. InterEurope: Trusted Leader in Claims & Consultancy
Centralized structure to ensure optimal steering of an international network
Own presence in 11 countries and cooperation partner in the remaining countries of the Green Card System
AIIF Azerbaijan International Insurance Forum

4. Institute of European Traffic Law: an European claims think thank
AIIF Azerbaijan International Insurance Forum

5. Agenda
I. Introduction II. Legal Framework for MTPL Claims in Europe III. National MTPL Claims and Cross Border Claims IV. Trends in Claims Management in Europe V. Conclusions
AIIF Azerbaijan International Insurance Forum

6. One system, different realities
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7. Precedence of European and international law over national law
Treaties; charter of Fundamental Rights, general legal principles
international agreements entered into by the EU
Regulations, Directives, Decisions
National Law
AIIF Azerbaijan International Insurance Forum

8. MTPL- and Indemnity Law
Harmonization through MTPL Directives
Directive 2009/103/EC of the European Parliament and of the Council of 16 September 2009 („6th MID“)
Minimum insurance amounts (art. 9)
Personal: 1 mio EUR per victim, 5 mio per claim
Property: per claim
Direct right of action (art. 18)
Compensation procedure for international claims (art. 20 ff., ex 4th MID)
Reasoned offer, reasoned reply within 3 months, sanctions (ex 4th and 5th MID)
National Indemnity Law
National diversity regarding determination of liability and quantification auf damage
AIIF Azerbaijan International Insurance Forum

9. Legal framework in indemnity law: Proof of causality and liability systems
Germany
Italy
France
Spain UK
Poland
Romania
Czech Republic
Strict liability
§ 7 Road Traffic Act
Art Civil Code
Art. 4 Badinter Law
Art. 1.1 LRCSVM
(-)
Art. 436 Civil Code
Art Civil Code
(-) not for driver
Fault-based liability
§ 823 Civil Code
Art Civil Code
Art Civil Code
Art. 1.2, 1.3 LRCSVM, Art Civil Code
Each case decided on individual merit
Art. 415 Civil Code
Art Civil Code
§ 420 Civil Code
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10. Calculation of amount of compensation for non material damage
Germany
Italy
France
Spain UK
Poland
Romania
Czech Republic
By Discretion of the courts X
Guideline: „Hacks/Wellner/Häcker Table“
Guideline: „Judicial Studies Board“ x
By Law with Table System
„Baremo“
By mixed system
National table for minor bodily injuries and judicial tables for serious personal injuries
Dintilhac Terminology
Discretion of the courts:
Discriptive medical assessments
Evaluation of a whole range of single aspects such as duration of disability, intensity of pain etc. compensatory function, release function
Case law decisive also for out of court settlement, no role of doctors in establishing amount of the indemnity
Problems: regional differencies, role of the courts in creating harminized case law
Table systems: basis for determination of the indemnity amount shifts from legal to medical specialist
AIIF Azerbaijan International Insurance Forum

11. Different heads of material damage for bodily injury
Germany
Italy
France
Spain UK
Loss of income/service x
Medical treatment costs
Costs for household assistance
Increased requirements
Loss of alimentation
Funeral costs
Social insurance recourse
but restricted
Although the various heads of medical
AIIF Azerbaijan International Insurance Forum

12. Timeframes for claims handling
Germany
Italy
France
Spain UK
International MTPL-claims
3 months to send a reasoned offer or reasoned reply
3 months to send a motivated offer or a reasoned reply
8 months from the date of accident or 3 months from the presentation of the claim to send a reasoned offer; final offer within 5 months from knowledge about stabilisation of injuries
3 months to send a motivated offer
Pre-action protocol:
21 days to respond to letter of claim;
3 months investigation period to make a commitment in respect of liability
National MTPL-claims
No official time frames but 4 – 6 weeks according to jurisprudence
90 days for personal injuries
Same as before
Ministry of Justice Portal:
15 days investigation period (for BI claims up to GBP)
Speed required to give a motivated negative reply or to handle claims
AIIF Azerbaijan International Insurance Forum

13. IVASS Sanctions (Ivass Regulation n. 24/2008)
Days in delay for bodily injuries
Min
Max
Delay up to 30 days € €
Delay up to 60 days €
Delay up to 90 days €
Delay up to 120 days €
Delay over 120 days € €
AIIF Azerbaijan International Insurance Forum

14. Agenda
I. Introduction II. Legal Framework for MTPL Claims in Europe III. National MTPL Claims and Cross Border Claims IV. Trends in Claims Management in Europe V. Conclusions
AIIF Azerbaijan International Insurance Forum

15. Different claims settlement systems in Europe
Without direct compensation systems
Voluntary direct settlement
Mandatory direct compensation systems
AIIF Azerbaijan International Insurance Forum

16. MTPL Claims – Traditional System
TPL Insurer
Direct Right of Action
Insurance Contract
Injured Person
Indemnity - Civil Code
Responsible Person
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17. MTPL Claims - Direct compensation
Legal Rules + Conventions between Insurers
TPL Insurer / Claimant - Injured
TPL Insurer / Responsible Person
Cover, Liability, Lump Sum acc. to law and convention
Indemnity & liability acc. to law
Insurance Contract
Insurance Contract
Injured Person
Responsible Person
AIIF Azerbaijan International Insurance Forum

18. Positive and negative aspects
Claimant:
Liability and Quantification of Damage according to Indemnity Law (= civil law + MTPL insurance law)
Claims settlement through his own MTPL insurer
Experts, Lawyers, Legal Protection Insurers, other organisations on his side?
Court proceedings?
MTPL Insurer
Claimant => Own Insured => long term relationship => Customer relationship management
Service and active claims management towards own insured
Containment of Indemnity and Processing costs vs. Quality?
Containment of fraud and speculation
Responsible Person / Insured
Stability of Insurance Premium
Information + Assistance
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19. Green Card vs. 4th Motor Insurance Directive Claims
Green Card Claims
4th MID Claims
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20. Applicable law: Rome II Regulation (864/2007)
General rule (Article 4)
Principle: application of the law of the country in which the damage occurs irrespective of the country in which the event giving rise to the damage occurred …”
Exception: application of the law of the habitual residence of the persons involved in the accident if the person claimed to be liable and the person sustaining damage both have their habitual residence in the same country at the time when the damage occurs, the law of that country shall apply”
Exception for 1 and 2: if the tort is…manifestly more closely connected to a third country
AIIF Azerbaijan International Insurance Forum

21. Applicable law: Hague Convention (1971)
Rules
Hague Convention prevails over Rome II in the signatory States of the Convention(*) - (art 28 (2) Rome II art. 4)
Principle: application of the law of the country in which the accident occurred
Exception: application of the internal law of the State of registration in specific cases
Example:
where only one vehicle is involved in the accident and it is registered in a State other than that where the accident occurred towards a victim who is a passenger and whose habitual residence is in a State other than that where the accident occurred …
(*) signatory States: Austria, Belgium, Bosnia-Hercegovina, Croatia, Czech Republic, France, Latvia, Lithuania Luxembourg, Montenegro, Morocco, Netherlands, Poland, Serbia, Slovakia, Slovenia, Spain, Switzerland, Macedonia and Ukraine
AIIF Azerbaijan International Insurance Forum

22. Agenda
I. Introduction II. Legal Framework for MTPL Claims in Europe III. National MTPL Claims and Cross Border Claims IV. Trends in Claims Management in Europe V. Conclusions
AIIF Azerbaijan International Insurance Forum

23. Challanges in claims management: claims as „the moment of truth“
Interdisciplinary management
Network management
Active Claims Management
Integration of claims service and Assistance Services
Digitalisation
Fraud detection and prevention
Data Protection
Solvency II
Service to the Client: the positive claims experience
AIIF Azerbaijan International Insurance Forum

24. InterEurope’s legal management expertise
Experts
Networks
Processes
Legal know-how
of processes
of experts
of networks
Focus on interdisciplinary legal management
Key factor in claims handling
Allows for fast and advantageous out of court settlements
Legal know-how
through short handling periods
automated processes
Efficiency gains
through superior legal competence
through professional fraud detection
Average indemnities below market average
AIIF Azerbaijan International Insurance Forum

25. An example of proactive claims management in Germany
Technological progress requires advanced technical, legal and management know-how
InterEurope:
Separates claims into automated standard procedures and complex know-how driven claims
Manages the claimant
Manages expert networks
applies legal know-how to clarify (product) liability and protect the interests of its client
Increasing complexity of cars splits the claims market into automated standard processes and complex claims, with the potential of significant savings.
AIIF Azerbaijan International Insurance Forum

26. IT driven processes require State-the-of-Art technology
in-house claims management software
IT interfaces with client systems
Integrated document management system
mandatory constitution and revision of reserves
Payment Autorisation levels
Checks of payments against financial sanctions lists
automatic statistical tool for various queries
diary management
all access is protocoled
multilingual
multicurrency
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27. Agenda
I. Introduction II. Legal Framework for MTPL Claims in Europe III. National MTPL Claims and Cross Border Claims IV. Trends in Claims Management in Europe V. Conclusions
AIIF Azerbaijan International Insurance Forum

28. Interdisciplinary management
Insurance Company
International qualification
Expertise in International Private Law
Proactive claims management
Repairshop networks
Automation of processes
Networks of external experts
Claim steering, controlling
Monitoring of the external service providers
Repair-shops
Rental Companies
Experts
Insurers
Medical experts
Hospitals
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29. Interdisciplinary management – internationality in claims
Integration of advanced professional know-how and constant improvement and change
Legal
Process Management
Technology
Medicine
Anti-fraud …
AIIF Azerbaijan International Insurance Forum

30. Interdisciplinary management – internationality in claims
AIIF Azerbaijan International Insurance Forum

31. Interdisciplinary management – internationality in claims
AIIF Azerbaijan International Insurance Forum

32. Thank you for your attention