Insurance Law and Insurance Disputes
Insurance is intended to provide reassurance when it is needed most, but in practice disputes often arise over whether and how much the insurer will indemnify. A refusal to pay compensation or an offer that is too low is not always final, and the insurer’s decision can be challenged.
Insurance disputes arise in many different situations, for example after a traffic accident, fire, theft, water damage, personal injury or the realisation of a business risk. A dispute often concerns whether the insured event is covered by insurance, whether the indemnity has been assessed in the right amount and how the terms of the insurance contract should be interpreted. The interpretation and precise wording of the terms are often decisive in insurance matters.
The insurer may refuse to indemnify or reduce the indemnity, for example by referring to the terms of the contract, exclusions or the policyholder’s breach of an obligation. Such reasons are not always correct or final. It is important to document the loss event carefully and review the reasons for refusal. In many cases the decision can be challenged and fair indemnity can be achieved.
Law Firm Namm helps to assess whether the insurer’s decision is justified, interpret the terms of the insurance contract, file and challenge claims for insurance indemnity and represent clients in negotiations and court. We represent policyholders and injured parties, and also clients against whom a recourse claim or another claim has been filed. We work in Estonian, Russian and English.
How we help in insurance law and insurance disputes
- Claims for insurance indemnity and filing such claims
- Challenging a refusal to indemnify or another decision of the insurer
- Motor third-party liability insurance disputes
- Comprehensive motor insurance disputes
- Property insurance disputes (home, property, business)
- Matters related to liability insurance
- Personal injury and accident insurance disputes
- Cargo and transport insurance disputes
- Interpretation of the terms of the insurance contract
- Disputes related to claims handling and the amount of indemnity
- Recourse claims and defence against them
- Matters related to the Estonian Motor Insurance Bureau
- Defence in the event of a suspicion of insurance fraud
- Representation in insurance disputes in court
Frequently Asked Questions
The insurer refused to pay compensation. Can I challenge the decision?
Yes. The insurer’s refusal is not always final and can be challenged. First, the reasons for refusal, the terms of the insurance contract, exclusions and evidence of the loss event must be reviewed. The outcome often depends on whether the insurer has interpreted the terms correctly.
The indemnity seems too low. What should I do?
The indemnity offered by the insurer may not reflect the actual damage. In that situation, objections, additional evidence and, if necessary, an independent assessment of the amount of damage can be submitted. In disputes about the amount of indemnity, it is important to show what damage actually occurred and how it is proven.
Why may an insurer refuse to indemnify?
Common reasons include exclusions in the insurance contract, late notification, insufficient evidence or the argument that the event is not covered by insurance. Some of these reasons may be valid, but others depend on the interpretation of the contract and the specific circumstances. For this reason, the reasons for refusal should be reviewed carefully.
What is a recourse claim and how can you defend against it?
A recourse claim means that the insurer seeks to recover the indemnity paid from a person who, in the insurer’s view, is responsible for the damage. A recourse claim can be challenged if the basis of liability, the amount of the claim or the causal link is questionable. It is important to check whether the insurer had the right to bring the recourse claim and whether the claim is proven.