The transmission of the mutual report takes the place of a declaration of loss, including for bodily injury. It should therefore be drafted when possible. The accident must in all cases be declared to the insurer within 5 working days.
The insured victim of bodily injury must also inform:
- His employer if he is an employee, to whom he must transmit any work stoppage prescribed by a doctor.
- His primary health insurance fund, to whom he must send any care sheets and the work stoppage within the legal deadlines. He may then receive the daily allowances or even invalidity pensions provided for by law or the collective agreement.
- The insurers with whom he has taken out bodily guarantees. Some contracts provide for flat-rate services, which can therefore be combined. Others benefits of a compensatory nature. The insurer then somehow pays an advance on the compensation that the accident victim will have to collect.
Which insurer
The bodily injury suffered by the victims of a traffic accident must be compensated (without any deductible) by the civil liability insurer of the person responsible for the accident.
But when the damage does not exceed 5% of partial incapacity, and to simplify the procedure, it is the civil liability insurer of the victim who directly takes care of the compensation for the driver and possible passengers. Taking the help of the personal injury lawyer happens to be essential here in this case.
The compensation proposal
The offer of compensation made by the insurer must cover all the consequences of bodily injury suffered by the victim. And especially:
- All healthcare costs incurred (after deduction of benefits paid by social security organizations)
- All income and remuneration that the victim would have received if he had not been injured (net of benefits paid by the employer or social organizations)
The compensation procedure
In principle, the victim of the accident receives from the insurer an information file and a medical questionnaire, which he must complete and return within six weeks with the supporting documents (work stoppage, certificate medical, etc.). He is then summoned for an examination by a doctor appointed by the insurer. The conclusions of the medical expertise are sent to him within 20 days of the date of the examination.
However, the victim can also send a direct claim to the insurer, naturally accompanied by all the supporting documents. The insurer can then:
- either formulate an offer of compensation within three months of receiving the request, which may be reviewed if the victim’s state of health is not stabilized,
- or postpone the offer of compensation if:
- responsibility for the accident is not yet clearly established
- or if the victim’s state of health has not yet stabilized.
In the event of a late claim by the victim or his dependents or if the insurer concerned requests additional time for the above reasons, the latter is still required to make an offer of compensation within eight months of the date of the accident.
If the victim accepts the offer of the insurer, the latter must pay the compensation provided for within 45 days of acceptance of the offer. The payment can take the form of a capital or a life annuity. The victim has a withdrawal period of fifteen days after acceptance of the offer.In the event of disagreement, the dispute will be settled by the courts, which will be required to fix the amount of compensation.
