Table of Contents
- Intro
- What is the motivated offer
- Time limits: the previous claim and the three months of the insurer
- What the offer should include
- The reasoned answer: when the insurer offers nothing
- What to do if you don't agree
- Appropriation and interest on delay
- Summary of the procedure
- Frequently asked questions
- Conclusion
1. Introduction
After a traffic accident with injuries, a key moment comes: the insurance officer reports how much he is willing to pay. This communication, the motivated offer, is regulated by law and has specific requirements. Knowing what it should contain and when it should be rejected can make a difference of thousands of euros in the final compensation.
2. What is the motivated offer
The reasoned offer is the proposal for compensation to be submitted by the insurer to the injured person due to a traffic accident, in accordance with the Article 7 of the Law on Civil Liability and Insurance in the Movement of Motor Vehicles. It aims to facilitate an agreement without the need for a trial, forcing the insurer to justify the amount it proposes.
It applies to both drivers and occupants of vehicles and to pedestrians, cyclists or public transport passengers. You can see a real example in our article about the bus braking injuries.
3. Time limits: the previous claim and the three months of the insurer
Before going to court, the injured person must submit a complaint to the insurance company of the vehicle responsible. This claim is mandatory to be able to sue later and to interrupt the time limit for claims.
Since the receipt of the claim, the insurer has 3 months to submit a reasoned offer or, if it rejects its responsibility, a reasoned response. If it does not respond within that time, it is exposed to interest on delay and administrative sanctions.
4. What the offer should include
The offer must be justified, not enough to indicate a figure. It should include:
- The breakdown of concepts compensation: days of healing, sequelae, financial damage and other damage.
- The medical reports on which the valuation is based.
- The criteria of the of Law 35 / 2015 applied to calculate the quantity.
If the offer does not explain where the figure comes from or is based on an incomplete medical assessment, it is a clear sign that it should be reviewed with a lawyer.
5. The reasoned answer: when the insurer offers nothing
If the insurer considers that her insured person is not liable or that the damage is not credited, she must provide a reasoned response explaining why she rejects the claim. This refusal does not close the door: the injured person can go to court to make it a judge who decides. Even when it is not clear who caused the accident, case law can favour those who claim, as explained in our article on the motorcycle accident we won on appeal.
6. What to do if you don't agree
To accept or reject the offer is the decision of the injured person. If the amount seems insufficient, there are several ways:
- Report of a trusted expert doctorwhich values all lesions and sequelae from the clinical history.
- Report of the Institute of Legal Medicinewhich the law allows to apply in the event of non-conformity with the offer.
- Mediationas a way to try an agreement without trial.
- Judicial demand, claiming the appropriate amount according to the scale.
The important thing is not to accept the offer before the injuries have stabilized and have a complete medical assessment.
7. Appropriation and interest on delay
The insurer can pay or record in court the amount it offers. This avoids interest on the amount of delay. These interests are regulated in the Article 20 of the Insurance Contract Actare particularly high: the legal interest increased by 50% and, from the second year since the accident, at least 20% per year.
The appropriation does not require the injured person to comply with that amount. If he considers it more appropriate, he can continue to claim the difference.
8. Summary of the procedure
| Phase | What's going on? | Legal basis |
|---|---|---|
| Prior claim | The injured person claims the insurer before suing | Article 7 of the Law on Civil Liability and Security in Movement |
| Response time | Three months for the reasoned offer or response | Article 7 of the same Act |
| Content of the offer | Breakdown, medical reports and barem criteria | Article 7 and Law 35 / 2015 |
| Disconformity | Self-study, Institute of Legal Medicine, mediation or demand | Civil Liability and Security in Movement Act |
| Delay in payment | Legal interest + 50%; minimum 20% per year after two years | Article 20 Insurance Contract Act |
9. Frequently asked questions
How long does it take for the insurance company to make the motivated offer?
It has a period of three months since it receives the claim from the injured person.
Am I obliged to accept the reasoned offer?
No. You can reject it and claim a higher amount, preferably with the support of an expert medical report.
What if the insurance company doesn't respond in three months?
He is liable to pay interest on delay and administrative sanctions, and the injured person can go directly to the courts.
When is the best time to accept an offer?
When the injuries have stabilized and you have a complete medical assessment that confirms that the amount covers all your damage.
10. Conclusion
Reasoned offer is a mandatory step for the insurer, but it is not the last word. To review its content, to compare it with an independent medical report and to know the means of complaint allows the injured to obtain the compensation that is actually due to him.
In Leynver Lawyers We review insurance offers and accompany you from the previous claim to the trial.
