Some experts perceive “ insurance event" and "insured event" as synonyms. Others understand by “events” possible misfortunes covered by the contract; and by “incident” - a nuisance that has already occurred, financial responsibility, compensation for the consequences of which falls on the shoulders of the insurance company.

An insured event is an unfortunate set of circumstances in which the insurance company’s obligations to the client come into force. Definition insured event specified in each specific insurance contract.

An insured event is a potential damage to the insurance object for which an insurance contract has been concluded. An insured event differs from an insured event in that an insured event means a realized possibility of causing damage to the insurance object.

The insured event thus appears to be the decisive event, the occurrence of which entails the liability of the insurer. Insurance payment is made only under a certain condition, namely upon the occurrence of an event specified in the contract - an insured event. If the insured event does not occur, the insurer does not make a payment. Moreover, he has no right to produce it.

Insurance risk in the meaning of an event is always compared with the insured event. With this comparison, however, significant differences are revealed, which are manifested, first of all, in the fact that an insured event is an event that has already occurred, completed, while insurance risk is the possibility or probability of the occurrence of a certain event, which excludes any of them. identification, and even more so considering them as coinciding concepts. Insurance risk and insured event are correlated not as general and specific, but as a generalization of categories.

Let us consider in Table 1 insured events and insured cases according to different types insurance.

Table 1

Comparison of insurance claims and insured events
for different types of insurance

Each insured event and insured event requires confirmation or proof of the occurrence, infliction or damage to the insured object.

By voluntary health insurance, insurance for people traveling abroad and other types that involve the provision of services by a third party at the expense of the insurance company, confirmation is the client’s very request to a third party (to an assistance company, clinic, etc.). In this case, the insurance company receives a notification from a third legal entity (usually its partner) that such and such a client has contacted it with an agreement of this number. The client receives the service, the insurance company pays its cost to a third party.

In other situations, the client must justify to the company's expert why a fire in the country or car theft is an insured event. The client is required a large number of confirming certificates from all kinds of competent authorities, and the insurance company, to the extent of its own integrity or dishonesty, can accept these certificates for consideration or begin to find fault with every comma and ask the client to wait until the insurance company employees check everything.

A possible way out of this situation could be this option - you can hire insurance broker, who will “conduct a conversation” with the insurer on behalf of the client. While protecting his nerves, the citizen will have to pay for brokerage services from 0.5% to 5% of the insured amount, but in an amount of at least $100-200 - for an insured incident of minor or moderate severity.

When determining an insured event, most insurance companies “catch” clients whom they want to refuse payment. A typical excuse from company employees may be: “your event is not insurable.” In order not to become a participant in the discussion on the topic “who is right - the client or the insurer?”, in which the arbiter is usually, and unfortunately, the judge, you should clarify what your insurer understands by an insured event. Moreover, do this at the stage of signing the contract. To do this, the client should make sure that the contract:

¾ risks are specified. So, if the policy contains a clause “natural disasters”, but there is no definition of what kind of natural disasters the insurer covers, it is better not to risk it and ask for clarification in the policy;

¾ exceptions to insured events are specified. The list of reasons exempting financiers from paying compensation should not contain ambiguous, inaccurate or incomprehensible wording. After all, when an event occurs, insurance company lawyers will certainly try to fit each exception to the client’s case, and interpret each clause of the contract in favor of the employer.

Insurance event-Potentially possible damage to the insurance object. An insured event differs from an insured event in that the latter means a realized hypothetical possibility of causing damage to the insurance object. An insured event must be taken into account when registering a risk. An insured event is studied by insurance statistics.

Insurance case– an actually occurring event that is provided for by law or an insurance contract and entails the insurer’s obligation to make insurance payment(Clause 2 of Article 9 of the Law of the Russian Federation “On the organization of insurance business in Russian Federation"). An insured event is recognized only as an event that, at the time the insurance legal relationship arose, either had not yet occurred, or had occurred, but the policyholder was not aware of it and could not have known about it; this is the case with personal insurance in the event of death. The concept of an insured event is closely related to the concept insurance risk. Insurance risk is a risk that is supposedly foreseeable, but has not yet occurred, and in some cases, if provided for in the contract, has already occurred, but is not known to the policyholder. An insured event is an actually realized, realized insurance risk.

Insurance loss is the cost of a completely lost or depreciated part of the damaged property according to the insurance estimate. Based on the calculated amount insurance loss determine the value insurance compensation to be paid. In this case, the conditions under which the insurance contract was concluded are taken into account. The amount of insured damage is equal to the amount of insurance compensation. The procedure for determining insured damage is carried out by the insurer or a trusted expert (adjuster) appointed on his behalf. In this case, the conditions under which the insurance contract was concluded are taken into account. Is being studied sum insured, on the basis of which insurance compensation is calculated.

Insurance compensation-Payment amount from insurance fund to cover damages in property insurance and insurance civil liability the insured for material damage to third parties. Insurance compensation may be equal to or less than the insured amount, based on the specific circumstances of the insured event and the terms of the insurance contract (for example, the presence of a franchise). The basis for payment of Insurance compensation by the insurer is the adjuster’s conclusion on the fact and circumstances of the insured event. IN foreign practice The insurance compensation paid is called the settled claim of the policyholder (made in connection with the insured event). The insurer that has paid the Insurance Indemnity acquires the right of recourse against the causer of harm (causing the damage).

The concept of “insurance event” means the potential ability of an insured event to occur, in the event of which the insurance company becomes obligated to compensate the insured or beneficiary for the losses (damages) specified in the contract or the obligation to pay compensation amounts.

The difference between an insured event and an insured event

As you can see, the concepts of “insured event” and “insured event” are not identical. The first concept includes the actual, and not the potential (possible in the future), occurrence of the need for insurance payments. The insured event must be confirmed and recognized in order to transfer it to the category of “insured event”. If an agreement is reached on the possible occurrence of an insurance event, the contract necessary for you is concluded. To avoid misunderstandings in the future, do not be afraid to ask questions, clarify, and make suggestions.

IMPORTANT!!! The insurance contract itself must always contain a list of insured events, upon the occurrence of which the compensation specified in the contract is made.

The most common insurance events under the contract personal insurance- this is n accident, illness and death.

Necessary actions in the event of an insured event

Such actions are:

Contact the 24-hour service of your company where you provided insurance, specify the address and operating hours of the loss settlement department. Take all available documents with you, preferably with a copy of each document for yourself. Ask that each photocopy of the document be marked with a mark indicating acceptance of the original from you (signature, transcript of the signature of the employee who accepted the documents from you, and a prerequisite - affixing the date);

Behave as correctly as possible in the company, with the employee. Try to address him by his first and patronymic. Almost always, such organizations conduct both video and audio recordings, but we also don’t need proceedings regarding insults and slander. Specify the time frame within which your application will be considered; what actions the employee will take to review your insurance event, and what your further actions should be.

If you have been refused, and in your opinion, unreasonably, do not despair!

You can contact:

Every serious insurance company has its own quality service (they were created for this purpose, and as practice shows, they resolve most controversial issues without going beyond the company).

in case of conflicts with car insurance - Russian Union Auto insurers, You can also officially contact Federal service insurance supervision of the Russian Federation. And no one canceled the trial!

Also remember! If it turns out that you intentionally committed actions that led to the occurrence of an insured event, you will not only be deprived compensation payments, but they can also be held accountable (administrative, civil or even criminal)!

“ON THE ORGANIZATION OF INSURANCE BUSINESS IN THE RUSSIAN FEDERATION” and in article No. 9, the concepts of insurance risk, insured event, and insurance payment are defined.

• 1. Insurance risk is an expected event in case of occurrence of which insurance is carried out. An event considered as an insurance risk must have signs of probability and randomness of its occurrence.
• 2. An insured event is an event that has occurred, stipulated by the contract insurance or law, upon the occurrence of which the insurer becomes obligated to make an insurance payment to the policyholder, insured person, beneficiary or other third parties.
• 3. In case of an insured event involving property, the insurance payment is made in the form of insurance compensation, in case of an insured event involving the person of the policyholder or a third party - in the form of insurance coverage.

Risk is understood as a situation when, knowing the probability of each possible outcome, it is still impossible to accurately predict the final result. Insurance is based on insurance risk.

Insurance risk is an ambiguous concept, but most often it refers to the probability of damage occurring. Risk is an objective prerequisite for the emergence of insurance relations: if there is no risk, there is no need for insurance. However, not every risk can form the basis of an insurance relationship. Only that risk can be insured for which it is possible to assess the likelihood of an insured event occurring, determine the amount of possible damage and calculate the equivalent insurance premium.

An insured event is an event provided for by an insurance contract or legislation that has occurred and upon the occurrence of which the insurer becomes obligated to pay the insured amount (insurance compensation) to the policyholder, the insured or another third party. The definition of an insured event is given in Art. 9 of the Law on insurance business, which defines an insured event as an accomplished event provided for by an insurance contract or law, upon the occurrence of which the insurer becomes obligated to make an insurance payment to the policyholder, the insured person, the beneficiary and other third parties.

In fact, any sphere of life in human society is associated with the possibility of risk or the threat of losses, both material and physical. It is known how serious damage natural disasters cause to both the national economy and the population. Suffice it to recall the earthquake in Armenia, when not only industrial enterprises were destroyed, but also shops, warehouses, infrastructure, residential buildings, people were hurt. Meanwhile, on average, more than 18 earthquakes occur on the globe annually.

Even much smaller-scale natural disasters - fires, explosions, mudflows, tsunamis, typhoons, dust storms, etc. - can cause significant destruction and permanently disable one or another link in social reproduction.

With the development of productive forces, society encountered a new, very significant source of danger: the so-called technical risks.

Technical risks are associated with the implementation of the reproduction process. They grow with the growth of production capacity, the complication of technology, the use of new types of energy, etc. The density of industrial facilities in a particular territory has a great influence on the amount of technical risk, since when high density an accident at one facility can provoke an accident at another, etc. according to the so-called “domino principle”.

There are also sectors of the national economy that are most at risk, for example Agriculture, sea and air transportation, chemical industry, energy, etc. Every entrepreneur who invests in these industries exposes his capital to significant risk. The very concept of “entrepreneurship” is always associated with greater or lesser risk. Risk almost always accompanies a purchase. valuable papers, certificates of deposit and other transactions on money market. IN banking exists complete system insurance (hedging) of financial risks.

Under the influence of various factors: social, political, environmental, certain risks arise. Let's look at them.

Pure and speculative risk.

Risk is the threat of loss. Their compensation is fixed by a certain monetary compensation, which the court awards to the plaintiff who wins the case. But not all damage is compensated. Insurance deals primarily with pure risk. Pure risk is risk that involves only the possibility of loss. Thus, an avalanche represents a type of risk that no physical or entity unable to predict or avoid. In other words, any disaster, like an earthquake or fire, is costly to the people affected by it, but its absence does not lead to increased profits. Pure risk contains only the danger of damage, without any possibility of gain.

On the other hand, speculative risk opens up the prospect of making a profit, which, above all, pushes people to do business. Any business implies that while making money you can lose it. Speculative risk is a risk that involves the possibility of both profits and losses.

The uncertainty inherent market economy, makes possible the existence and development of speculative risk. Speculation is especially developed on stock exchanges. There are 3 methods of speculative activity on stock exchanges:

• 1. Purchase of goods, their storage for a certain period and subsequent sale. When buying a product, a speculator expects prices to rise. If prices go down instead of up, the speculator will suffer losses.
• 2. Concluding derivatives (futures) contracts, when, after a certain period, the investor undertakes to buy or sell a certain amount of a commodity at a price determined today. But if the price will fall, he will lose.
• 3. Conclusion of an option contract. An option is a contract under which an investor buys the right to buy or sell in the future a quantity of a commodity at a price determined today. The specificity of this method is that the investor may or may not exercise his right depending on his desire, which is determined by the circumstances. If selling price decreases contrary to expectations, the investor will not exercise his right. In this case, however, he will lose the part that he paid in the form of a fee to the broker when concluding a contract with him. An options contract is a safer (less risky) way of speculating compared to a forward contract, because the loss can only be equal to the broker's fee. Both futures contracts and options are used in hedging - insurance of production and trade of industrial and trading firms using the exchange. Hedging helps reduce the risk of an unfavorable price change, but does not provide the opportunity to take advantage of a favorable price change. During hedging operations, the risk does not disappear, but it changes its bearer: the producer transfers the risk to the stock speculator, since he has an aversion to risk. The speculator takes on the risk because he is essentially a risk taker.

Insurable and uninsurable risks.

Most (but not all) pure risks are insurable; Speculative risks are not insured. An uninsurable risk is a risk that most insurance companies avoid insuring because the likelihood of losses associated with it is almost unpredictable. You can buy insurance from natural disaster such as a flood or earthquake. But Insurance companies always reluctant, consider the possibility of cooperation in cases where the risk is associated with government actions or general economic situation. Uncertainties such as regulatory changes and economic fluctuations are beyond the scope of insurance.

Sometimes uninsurable risks become insurable when enough data is collected to accurately estimate future losses. Insurance companies were initially reluctant to insure airline passengers, but a decade later the risk became predictable.

Uninsurable risks include:

• 1. Market risks - factors that can lead to loss of property or income, such as: seasonal or cyclical changes prices; consumer indifference; fashion changes; a competitor offering a higher quality product.
• 2. Political risks - the danger of such events as:

change of government; war; restrictions on free trade; unreasonable or excessive taxes; restrictions on free currency exchange.

• 3. Production risks - the danger of such factors as: non-economic operation of equipment; lack of raw materials; the need to solve technical problems; strikes, absenteeism, labor conflicts.
• 4. Personal risks - the danger of such factors as: unemployment; poverty due to divorce, lack of education, inability to get a job, or loss of health during military service.

An insured risk is a risk for which the level of acceptable losses is easily determined, and therefore the insurance company is ready to compensate for them. Insured risks include:

• 1. Property risks- the risk of losses from a disaster, which lead to: direct loss of property; indirect loss of property.
• 2. Personal risks - the risk of losses as a result of: premature death; disability; old age.
• 3. Risks associated with legal liability - the risk of losses due to: using a car; stay in the building; occupation; production of goods; professional mistakes.

The insured risk that an insurance company is willing to assume usually meets the following requirements: the insured peril cannot be the result of intentional acts. This means that insurance companies do not pay for damage intentionally caused by the insured company itself or an individual, at her direction or with her knowledge. For example, a fire insurance policy does not cover losses caused by arson of the insured company. However, such a policy provides coverage for losses if the arson is committed by an employee of the company.

An insured event as an element of an insured event should be considered as a danger that can affect the insurance object in such a way that, as a result of this impact, the policyholder, beneficiary or insured person suffers property damage.

The insured event (hazard) must be described in the insurance contract, with a detailed indication of all its essential features that make it possible to establish the fact of the occurrence of the insured event. This rule is defined in paragraph 1 of Art. 942 of the Civil Code of the Russian Federation. It should be noted that an insured event and an insured event are different concepts that have different legal meaning, despite the homogeneity of their perception. The difference between an insured event and an insured event is that an insured event is a potential damage to the insured object, and the realized possibility of causing damage to the insured object will mean an insured event.

In this matter, it can be added that the concept of an insured event, in addition to what is stated above, also means a certain legal fact stating that the condition provided for in the contract (the insured event) has already occurred. From now on this condition from the category of random goes into the category of real and becomes a legal fact, since another concept in an insurance contract is random - an insured event, i.e. danger, the occurrence of which is determined by chance. Therefore, an event is an assumption, and an insured event is an objective reality.

The occurrence of just one event (danger) does not yet indicate that an insured event has occurred, since the occurrence of a danger is only the beginning of the process of the occurrence of an insured event, i.e. the first stage of an insured event. As a rule, the time of occurrence of a danger always precedes the insured event. After the occurrence of danger, the second stage of the insured event process must begin - the impact of the danger on the insurance object, i.e. for insured property or other property interest.

The second stage of the insured event helps to establish the fact of its occurrence. In addition, only at this stage is the moment of the beginning of the impact of danger on the insured object determined, which must occur during the period of validity of the insurance contract, unless a different period is specified in the contract.

It should also be noted that with the beginning of the second stage, the process of harmful effects of a dangerous event on the insurance object simultaneously begins. This stage of the insured event is considered completed when the fact of a person’s property damage is established. This is either a complete loss of property, or partial damage to property, or another event in the life of the insured person.

The insurance contract must be concluded before all stages of the insured event occur. When applying for payment of insurance compensation, the policyholder had to confirm the fact of the occurrence of the insured event and that the lost property was insured by him.