Insurance

Konstantin Astafiev

Konstantin Astafiev

Partner
Attorney at law

Consulting services:

  • Legal examination of terms and conditions of insurance contracts at the stage of conclusion thereof (analysis of the insurance coverage, obvious and hidden  exclusions from the insurance coverage)
  • Regulation of the mechanism of actions of the parties in respect of claim’s settlement, possible Insurer’s reasons to deny the coverage or reject the claims, counselling of clients (including Russian insurance companies) on issues of provision of the reinsurance coverage under insurance contracts concluded on foreign markets
  • Legal support to clients (insured persons) at the stage of claim’s settlement

Insurance audit:

  • Legal examination of actual insurance contracts in order of optimization of their conditions for further period

Dispute settlement:

  • Representing interests of principals in judicial disputes according the claims of insurance indemnity

Insurance forensic:

  • Attorney and expert investigation of insurance cases
  • Investigation of insurance fraud with further support in criminal proceedings

Legal adjusting:

  • Immediate Legal support to clients directly on the place of the incident (insurance case)
Dispute settlement:

  • Representation of the interests of the largest Russian insurance company in a dispute related to thirty foreign reinsurers, including the members of the Lloyd's insurance cartel, which rejected the claims to pay reinsurance money in the amount of more than 40 million dollars in connection with the crash of a Sukhoi Superjet aircraft in Indonesia in 2012. Based on the results of different-level courts considering the disputes, the claims were upheld in full and are currently being enforced on the territory of foreign countries.
  • Representing the interests of Insurers and Insuring Parties in major judicial disputes concerning trade (commercial) loan insurance, in particular:
    • in favor of the Insurer, in a dispute against the Insuring Party under the latter’s claim in connection with the refusal to pay insurance compensation due to the Insuring Party's inequitable conduct in the course of the insurance contract performance;
    • in favor of the Insuring Party, in a dispute against the Insurer under the latter’s claim for insurance contract invalidation due to the provision by the Insuring Party of false information when concluding the insurance contract. The Insurer's claims were dismissed;
    • in favor of the Insuring Party, in a dispute against the Insurer under the claim for contesting the amount of the insurance compensation paid.
  • Consulting the Insuring Party on legal issues under a judicial dispute with the Insurers to the amount of more than EUR 1 billion under insurance contracts for power-generating machinery and builder's risks.
  • Support for major judicial disputes with the amount of claims up to USD 30 million related to insurance of electrical energy risks, aviation risks, transport (including marine) insurance, agricultural insurance, insurance of property of legal entities (real estate, inventory holdings, etc.), insurance of different types of liability and reinsurance, for example:
    • Representation of interests of the defendant in dispute with ASKO Interregional Insurance Company LLC in the case on recognition as concluded of the reinsurance contract for the sum of USD 15 million. By virtue of a complex approach to the substantive law it was proved in the court that the parties of the case failed to comply with the statutory requirement on the form of the reinsurance contract which in its turn served as a reason for refusal to satisfy the claim.
    • Defense of interests of the insurer in the case against a reinsurer on recovery of the insurance compensation for the sum of approximately USD 10 million under the property insurance contract. The court refused to satisfy the stated claims. Based on the results of the judicial dispute the representatives proved that the presence of the insured property at the warehouse during the fire in the amount stated by the plaintiff was not confirmed.
    • Defense of interests of the insurance company in the dispute on recovery of the insurance indemnity for the sum of approximately USD 3 million in favour of Chelyabinsk Pipe-Rolling Plant OJSC. The stated claims were not satisfied.
    • Representation of interests of the insurer in the case against the agri-industrial company that filed a claim for more than USD 2 million. In the course of the proceedings the defendant’s representative proved that the plaintiff missed the limitation period and that no evidence of occurrence of the insured event was present.
    • Effective defense of the insurance company in the arbitration court under the claim on recovery from the defendant of the insurance indemnity for the sum of more than USD 1 million under the cargo insurance contract. As a result it was proved that the limitation period was missed, and also the fact that the defendant is improper was proved.
    • Representation of interests of a major insurer in the case against a major agro-industrial complex that filed a claim on payment of indemnity  under the crop insurance contract and interests for the use of borrowed funds for the total sum of approximately USD 1 million. The stated claims were dismissed due to a successful mechanism of the representatives’ defense.  
  • Representing insurance company Allianz in a dispute with a foreign reinsurer on a reinsurance recovery in the total amount of more than USD 35 million arising out of the accident at the Sayano-Shushenskaya hydropower plant (total damage over USD 200 million). The result – the client’s claim was satisfied in full, afterwards the decision was enforced in the territory of Switzerland.

Prejudicial legal support for loss settlement process:

  • Consulting the Insuring Party, a major apparel manufacturer, at all the loss settlement stages for a loss incurred due to a fire which occurred in production premises, resulting in significant damages caused to the equipment insured. As a result of the proper drafting and preparation of a package of the necessary documentation as well as participation in negotiations with the Insurer, the insurance compensation was paid within a reasonable time and in the amount provided for in the insurance contract.
  • Written consultation of the Insuring Party, a major office furniture manufacturer, on the issue of determining the amount of the insurance compensation in connection with a fire resulting in significant damages caused to the real estate insured. As a result of negotiations with the Insurer conducted on the basis of a legal opinion drawn up, the insurance compensation was paid in the amount provided for in the insurance contract and totaling over 100 million rubles.
  • Written consultation of the Insuring Party, a major climate equipment manufacturer, on the issue of determining the amount of the insurance compensation under an insurance contract for trade (commercial) loans in connection with the failure to pay the insurance compensation in full. As a result of negotiations with the Insurer conducted on the basis of a legal opinion drawn up, there was paid an additional insurance compensation to make the total amount paid up equal to the amount provided for in the insurance contract.
  • Written consultation of the Client on the legitimacy of claims presented to the Client by the Insurer by way of subrogation. As a result of the analysis of the facts in the case and the documents submitted, a response to the claim was prepared for the Insurer resulting in the Insurer's claim to the amount of over 50 million rubles having been revoked.

Insurance audit: 

  • A large-scale legal audit of the loss settlement and claim-related work system of a major Russian Insurer, as a result of which there were recommendations issued on the optimization of the existing business processes.
  • Drafting a standard package insurance contract (real estate insurance, insurance against equipment failures, insurance against disruption of production losses) for the Insuring Party, a major Russian production holding.
  • The sum insured was indicated in the property insurance policy, but the insurance value was not disclosed. It is permissible, but in practice allows Insurer to seek to manipulate amount of insurable value at loss adjustment in order to minimize insurance  indemnity under article 949 of the Civil Code of the Russian Federation (proportional compensation of damages for incomplete property insurance). Client–Insured was advised on the modification of the contract in the precise definition and indication in the contract insurance value of the property covered.
  • The terms of the insurance contract provided the possibility of its early termination by the Insured with return of a part of the insurance premium. The amount of the insurance premium that need to be returned to Insured would be determined in proportion to the unexpired period of insurance net of expenses of the Insurer to handle the case. The terms of the contract did specify neither the exact amount of these expenses or the determination of them. Client – Insured was advised on the clarifying the terms of the contract in the specification of expenses of the Insurer to handle the case.
  • While loss adjustment  under policies in goods in trade, Insurer requested from Insured an information on the average value of similar goods at other participants of the market. The terms of the insurance contract contained the list of the documents that the Insurer has the right to request for making a decision on the insurance payment, among which this document was missing. Client – Insured consulted on the matter of to comply the request of the Insurer. The client was advised not to provide information is not expressly provided for by the contract, since the handling this request could be the reason for the claimed nullity of the insurance contract in the excess insurance amount over average market value of goods (if price of similar goods at other participants of the market would be lower than insurance value under the insurance contract).