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What general rules, requirements and procedures govern the filing of insurance claims?
The Insurance Contract Act requires that an insurance claim be notified to the insurer within eight days of the date when the policyholder becomes aware of the occurrence of the risk. In the event of delayed notification, the insurer cannot deny cover, but is entitled to any damage it has suffered due to the delay. Following the occurrence of an insured event, the policyholder must take all appropriate measures to avoid or mitigate the insured loss and to comply with the insurer’s instructions.
What is the time bar for filing claims?
Claims arising out of an insurance contract are prescribed after the lapse of four years in the case of non-life insurance and five years in the case of personal insurance, starting from the end of the calendar year within which the claim arose. Third-party motor liability claims prescribe within five years of the date of the accident.
Denial of claim
On what grounds can the (re)insurer deny coverage?
The insurer is entitled to refuse to pay insurance money:
- if the policyholder intentionally violated its obligation to inform the insurer of any information or circumstance objectively material for the assessment of risk;
- if the policyholder intentionally caused a significant aggravation of the insured risk;
- if the insured event occurred due to an intentional act or omission or gross negligence of the policyholder, the insured, the persons dwelling with them, their legal or other representatives or third parties entrusted professionally to safeguard the insured interest in case of indemnity insurance; or, in case of personal insurance, if the insured event occurred due to an intentional act or omission of the above listed persons; or
- in case of exemptions from the insurance cover agreed in the insurance contract.
What rules and procedures govern the insured’s challenge of the denial of a claim?
Greek law does not provide for special procedures regulating the resolution of insurance-related disputes. The ordinary procedure for the judicial resolution of commercial disputes should be followed, as provided by the Code of Civil Procedure. A special division of the substantive courts deals with road accidents and third-party motor liability claims, aimed at the quicker resolution of the disputes.
On what grounds can a third party file a claim directly with the (re)insurer?
(Re)insurers cannot be sued directly, neither can insurers, unless this is expressly provided by law, as in the case of third-party motor liability claims with respect to insurers. Where no direct action is available, insurers are called to participate in the trial by way of joinders or by the “deviated” action of the Code of Civil Procedure, under which the insurer is called to pay the third party’s creditor.
Are punitive damages insurable?
Greek law does not recognise the concept of punitive damages in the sense of paying a penalty to the damaged party. Penalties are provided only by criminal law provisions and are payable exclusively to the state. Hence, punitive damages are not included in insurable risks in Greece. However, if the indemnity is defined according to a foreign law which recognises punitive damages, these could be included in the insurance indemnity or adequate provision to the contrary must be made in the policy.
What regime governs (re)insurers’ subrogation rights?
In cases of non-life insurance where the insurer performs its contract and satisfies the insured, while the insured also is entitled to indemnification by a third party which caused the damage, the rights of the insured against the third party are automatically transferred to the insurer, which can initiate proceedings to be satisfied by the third party to the extent of the indemnity paid to the insured.
The insurer cannot be subrogated in the insured’s rights against its ascendants, descendants, spouse or persons who live with the insured, or its legal representatives, unless they have acted maliciously. The insured or the policyholder must preserve rights against third parties in favour of the insurer. Violation of this obligation entitles the insurer to claim damages. If the policy is concluded for business purposes, the parties may agree that the insurer will be released from any obligation should its subrogation right be called off.
The reason for the subrogation is that in non-life insurance, the insured cannot be made richer after the insured risk has occurred (ie, it cannot use the damage as a cause for enrichment). Hence, it can be indemnified only once for the same damage. Subrogation is an assignment of rights provided by the law. It is also usual to agree contractually that the payment of the insurance indemnity confers on the insurer all material and procedural rights of the insured.
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