Non-material damages

RULES consistent with the legal practice, concerning the procedure for settlement of claims for damages arising from death or bodily injury, according to Article 290, paragraph 2, item 9 of the Insurance Code and Article 7, paragraph 1, item 9 of the Rules of Organization and Operation of the Guarantee Fund.

1. Making Claims Procedure

1.1. For payment of compensation for non-material damages by the Guarantee Fund under obligatory Third Party Liability Insurance of Motorists and Accident Insurance for the passengers, the person injured as provided in Art. 265 of the Insurance Code shall file a written application (notice) to raise his/her claims.

1.1.1 Application /notice/ under Article 288, paragraph 9 of the Insurance Code shall be accompanied by documentary evidence of:

1.1.1.1. Traffic accident, injured person’s right to get compensation for such event and the amount of the damages caused;

1.1.1.2. Verifying the identity of the injured person /copy of the front and back of ID card or driving license or a copy of the green passport; for foreign nationals residing at the Republic of Bulgaria – a copy of a document under Article 14 of the Bulgarian Identity Documents Act; for foreign nationals – a copy of the document with which they entered the Republic of Bulgaria at the time of the traffic accident; personal data are processed in accordance with the provisions of the Personal Data Protection Act solely on the damage opened with the Guarantee Fund./;

1.1.1.3. IBAN and BIC of the bank account and the full name of the injured person as in the identity document under item 1.1.1.2.;

1.1.2. Application /notice/ may be submitted in person or via a proxy:

1.1.2.1. Directly to the Guarantee Fund - at the Fund office or may be send with a registered letter with a receipt acknowledgement.

The Guarantee Fund address is: city of Sofia 1000, 2, Graf Ignatiev street, floor 4

1.1.2.2. Or to any of the insurers licensed and offering obligatory Third Party Liability Insurance of Motorists, obligatory Accident Insurance for the passengers, respectively.

1.1.3. Where the application (notice) is filed by a proxy, an original power-of-attorney shall be enclosed, with a notarized certification of signature, if such proxy is a person other than a person, association or a company under the Bar Act. Where the application is filed by a lawyer, person, association or a company the provisions of Article 25 of the Bar Act shall be obligatorily applied. The power-of-attorney shall state the powers given by the injured person to the proxy to raise any claims for payment of any non-material damages to the Guarantee Fund.

1.2. Application /notice/ along with a list of the evidences enclosed shall be entered into a registry under Article 31, paragraph 2 of the Rules of Organization and Operation of the Guarantee Fund. Each filed claim shall be certified by the Secretary Office of the Guarantee Fund by placing an entry number on the application /notice / and a Damage File (Liquidation Dossier) shall be opened under an individual number in the damage registry kept, relating to the application /notice/ entry number.

 

2. Evidences relating to the Traffic Accident, injured person's right to be paid compensation in relation to the event and the amount of damages in connection with the obligatory Third Party Liability Insurance of Motorists, regarding:

2.1. Traffic Accident:

2.1.1. A protocol of findings, a traffic accident protocol or a certificate issued by the authorities of the Ministry of Internal Affairs certifying the traffic accident occurrence - original or certified copy. Presentation of other evidence to certify the accident is not obligatory.

2.2. Injured person's right to be paid compensation from the Guarantee Fund in relation to the event:

2.2.1. Evidences accompanying the application /notice/ under 1.1.1., complying with the obligatory provisions of the Insurance Code, concerning the right to be paid compensation in relation to the event, according to Article 288, paragraph 9, first sentence of the Insurance Code, associated with one of the grounds for it, provided in Article 288, paragraph 1, items 1 and 2 of the Insurance Code and the requirements of the Bulgarian legislation to establish the guilty driver who caused the traffic accident, according to Article 288, paragraph 1, item 2, b.”a”, b.”b” and b.”c” of the Insurance Code, as cumulative grounds for payment of compensation claimed;

2.2.2. Original of a Certificate of Legal Heirs - current at the date of the claim, in cases in which the application /notice/ is made by an heir /heirs/, accompanying the application /notice/ under 1.1.1.;

2.2.3. A certified copy of: Death Certificate and/or Birth Certificate and/or Certificate of Kinship with the victim, accompanying the application /notice/ under 1.1.1.;

2.2.4. After filing the claim and opening a Damage File /Liquidation Dossier/ under 1.2., the Guarantee Fund shall notify the applicant of the evidences, which do not accompany his/her application /notice/ under 1.1.1., submitted pursuant to 1.1.2.1., and in case submitted pursuant to 1.1.2.2. the necessary evidence that the insurer has not collected and forwarded to the Guarantee Fund with the entire file of the claim in accordance with the obligation under 288, paragraph 9, third sentence of the Insurance Code, which shall be provided for the establishment of grounds and amount of the claim, not allowing further evidences under Article 105, paragraph 5 of the Insurance Code and without the obligation to prove whether the guilty driver cannot or refuses to pay compensation in accordance with Article 31, paragraph 3 of the Rules of Organization and Operation of the Guarantee Fund;

2.2.5. In cases where the injured person and/or his/her representative cannot obtain all or part of the evidence under 2.2.1. due to existing regulatory encumbrances or lack of legal opportunity for their provision, and after exercising his/her right provided in the obligatory provision of Article 106, paragraph 1, first sentence, second proposal of the Insurance Code, the Guarantee Fund collects the necessary evidence, if applicable, under Article 106, paragraph 1, first sentence, third proposal of the Insurance Code;

2.2.6. Additional evidences may be required in writing by the injured person or his/her agent only if the their need could not be foreseen at the time of filing the claim and within 45 days at the latest from the date of presentation of evidences required upon filing the claim under Article 31, paragraph 6, first sentence of the Rules of Organization and Operation of the Guarantee Fund;

2.3. Amount of damages caused:

2.3.1. Medical and other documents - expert reports, medical notes, certificates, medical history, records of MCC or TEMP, sick leave, etc., proving the occurrence of injuries due to the traffic accident;

2.3.2. Writ of Execution – in original where such writ has been issued in favour of the injured person.

3. Evidences relating to the Traffic Accident, injured person's right to be paid compensation in relation to the event and the amount of damages in connection with the obligatory Accident Insurance of Passengers, regarding:

3.1. Traffic Accident:

3.1.1. A protocol of findings, a traffic accident protocol or a certificate issued by the authorities of the Ministry of Internal Affairs certifying the traffic accident occurrence - original or certified copy. Presentation of other evidence to certify the accident is not obligatory.

3.2. Injured person's right to be paid compensation from the Guarantee Fund in relation to the event:

3.2.1. Evidences accompanying the application /notice/ under 1.1.1., complying with the obligatory provisions of the Insurance Code, concerning the right to be paid compensation in relation to the event, according to Article 288, paragraph 9, first sentence of the Insurance Code, associated with the grounds for it, provided in Article 288, paragraph 4 of the Insurance Code for payment of compensation claimed;

3.2.2. After filing the claim and opening a Damage File /Liquidation Dossier/ under 1.2., the Guarantee Fund shall notify the applicant of the evidences, which do not accompany his/her application /notice/ under 1.1.1., submitted pursuant to 1.1.2.1., and in case submitted pursuant to 1.1.2.2. the necessary evidence that the insurer has not collected and forwarded to the Guarantee Fund with the entire file of the claim in accordance with the obligation under 288, paragraph 9, third sentence of the Insurance Code, which shall be provided for the establishment of grounds and amount of the claim, not allowing further evidences under Article 105, paragraph 5 of the Insurance Code and without the obligation to prove whether the guilty driver cannot or refuses to pay compensation in accordance with Article 31, paragraph 3 of the Rules of Organization and Operation of the Guarantee Fund;

3.2.3. In cases where the injured person and/or his/her representative cannot obtain all or part of the evidence under 3.2.1. due to existing regulatory encumbrances or lack of legal opportunity for their provision, and after exercising his/her right provided in the obligatory provision of Article 106, paragraph 1, first sentence, second proposal of the Insurance Code, the Guarantee Fund collects the necessary evidence, if applicable, under Article 106, paragraph 1, first sentence, third proposal of the Insurance Code;

3.3. Injured person's right to be paid compensation in relation to the event:

3.3.1. Deed of Traffic Accident of injured passenger with a detailed description of the case, drawn up by the carrier or a certified copy of a deed drawn up by a competent authority for control of the respective transport type, accompanying application /notice/ under 1.1.1.;

3.3.2. Ticket, card or other document in original, proving that the injured person was a passenger accompanying application /notice/ under 1.1.1.;

3.3.3. Medical and other documents - expert reports, medical notes, certificates, medical history, etc., proving the occurrence of injuries due to traffic accident accompanying application /notice/ under 1.1.1.;

3.3.4. Original of a Certificate of Legal Heirs - current at the date of the claim, in cases in which the application /notice/ is made by an heir /heirs/, accompanying the application /notice/ under 1.1.1.;

3.3.5. A certified copy of: Death Certificate and/or Birth Certificate and/or Certificate of Kinship with the victim, accompanying the application /notice/ under 1.1.1.;

3.4. Amount of damages caused:

3.4.1. Medical and other documents - expert reports, medical notes, certificates, medical history, records of MCC or TEMP, sick leave, etc., proving the occurrence of injuries due to the traffic accident;

3.4.2. Writ of Execution – in original where such writ has been issued in favour of the injured person.

 

4. Assessment of the damages caused and determination of the compensation amount

4.1. In case of death or bodily injury, the claim and the evidences presented are discussed by an Expert Insurance and Medical Committee to the Guarantee Fund, appointed by order of the Executive Director.

4.2. The Committee shall make a written proposal to the Board of the GF on the grounds and the amount of compensation to be paid to the injured person in accordance with the evidence presented and in compliance with the following criteria:

4.2.1. Persons who are entitled to compensation for non-material damage as a result of death or bodily injury, established by an interpretative decision of the Supreme Court of Cassation.

4.2.2. The severity and gravity of the pain and suffering endured.

4.2.3. In case of death - the circumstances which led to death, the age of the deceased, the relationship between the deceased and his/her heir, who brought the claim for non-material and material damages, as well as persons who are entitled to support money from the deceased.

4.2.4. In case of bodily injuries - the circumstances which led to the occurrence of the event, the age of the victim, the nature of the disability, the functional consequences depending on the degree of injury, under the provisions of the Criminal Code.

4.2.5. Contribution to the damaging result by acts or omissions of the victim.

4.2.6. Factual circumstances upon occurrence of the event in case the circumstances contributed to the occurrence of death or injury were known to the victim.

4.2.7. Additional criteria - age of the injured person, if different from the victim, profession and other medical and social factors.

4.2.8. Material damages in the cases under Article 288, paragraph 2 of the Insurance Code, in conjunction with Article 28, paragraph 2 of the Rules of Organization and Operation of the Guarantee Fund are determined according to the documents submitted for the costs incurred.

4.3. Compensation for non-material damages and material damages as a result of death or bodily injury is determined by the Management Board on the basis of the claim and all the evidence relating to the establishment of the event and the amount of damages.

4.4. The amount of compensation for non-material damages shall be determined:

4.4.1. For the obligatory Third Party Liability Insurance of Motorists – by equity, based on the evidence presented in compliance with the criteria set out in item 2.

4.4.2. For the obligatory Accident Insurance for passengers in public transport - based on the evidence presented; the minimum amount of insurance is paid in case of death, and in case of permanent disability - the percentage of the sum insured, as is the percentage of permanent disability.

4.5. The amount of compensation paid by the Fund may not exceed the minimum insured sum under the obligatory insurance in the year in which the traffic accident has occurred.

4.6. The deadline for ruling of the Management Board of the GF is 3 /three/ months from the date on which the claim was filed in the registry under Article 31, paragraph 2 of the Rules of Organization and Operation of the Guarantee Fund.

 

5. Compensation payment.

5.1. The Management Board of the Guarantee Fund, within a period which may not be longer than three months from the date of filing the claim under 1.2., shall make a decision and pay compensation to the bank account of the injured person or refuse payment when there is no ground for payment or where the evidence was not sufficient to establish the grounds or the amount of compensation pursuant to Article 288, paragraph 7, in conjunction with paragraph 9, first sentence of the Insurance Code, in conjunction with Article 31, paragraph 8 of the Rules of Organization and Operation of the Guarantee Fund;

5.2. The injured person /or the person authorized/ shall be notified in writing by the Guarantee Fund for the decision and the grounds of the Management Board on the claim. Rules consistent with legal practice, concerning the procedure for settlement of claims for damages arising from death or bodily injury, according to Article 290, paragraph 2, item 9 of the Insurance Code and Article 7, paragraph 1, item 9 of the Rules of Organization and Operation of the Guarantee Fund, were adopted by the Council of the Fund by Decision no. 1-4/27.07.2007, as amended and supplemented by Decision no. 2-3/27.06.2008, and Decision no. 2-4/27.06.2008 of the Board of the Fund.