The basic form of the emergence of legal relations in the field of insurance is an insurance contract, which is concluded between the insurer (insurance company) and the insured, in order to protect the property interests of the latter by making an insurance payment by the insurer upon the occurrence of an insured event.
The fact of concluding an insurance contract can be certified by an insurance certificate (policy, certificate), which is a form of an insurance contract.
Insurance can be voluntary or compulsory, and the subject of the insurance contract can be property interests related to life, health, work ability and pension provision (personal insurance), with the possession, use and disposal of property (property insurance), with compensation by the insured for the harm caused to a person or his property, as well as damage caused to a legal entity (liability insurance). Which event is recognized as an insured event must be specified in detail in the insurance contract.
Participants in insurance legal relations often identify the concepts of “insurance payment” and “insurance compensation”, but the law separates them. The insurance claim is the amount of money that is paid by the insurer in accordance with the terms of the insurance contract upon the occurrence of an insured event. And insurance compensation is an insurance payment, which is carried out by the insurer within the insured amount under property insurance and liability insurance contracts in the event of an insured event.
As a rule, upon the occurrence of an insured event, insurance companies declare that the event is not insured, the policyholder has incorrectly drawn up certain documents, untimely reported the occurrence of an insured event, or created obstacles in determining the circumstances, nature and amount of losses.For this reason, most insurance disputes arise from the refusal of the insurer to make insurance payments. Such a refusal is accepted by the insurer within a period not exceeding that provided for by the contract and insurance rules, and is communicated to the policyholder in writing with justification of the reasons for the refusal and may be appealed in court.
Also, the courts consider disputes on the appeal of insurance contracts, compensation for damage in the order of recourse and subrogation, disputes in the field of reinsurance and others.
Since insurance disputes fall under the category of civil cases, they are considered by courts in the order of civil proceedings.