CASCO: insurer refused or is delaying the repair payment: what to do under Georgian law

What to do

1. Deadlines: notify the insurer of the insured event as soon as you learn of it (Civil Code Art. 814); however, the insurer cannot rely on late notice if its interests were not materially prejudiced (Civil Code Art. 814). Lawsuit against the insurer: the limitation period for a contractual claim against the insurer is 3 years (Civil Code Art. 129).
2. Grounds for refusal must be found in the policy: payment is made on the terms of the contract (the policy and the rules) (Civil Code Art. 799). By law, the insurer is released only by the policyholder’s intent or gross negligence (Civil Code Art. 829) — ordinary negligence does not justify a refusal. For a “driver not listed” or “not that service station” — check whether such a condition exists in the rules: unclear standard terms of the policy are interpreted in favour of the policyholder (Civil Code Art. 345); unusual terms that the policyholder could not expect do not become part of the contract (Civil Code Art. 344); an unfairly disadvantageous term is void (Civil Code Art. 346).
3. “Intoxication”: check how it was established (protocol, medical examination) and whether the policy contains such an exclusion. Hail or a fallen tree: force majeure is covered only if it is expressly agreed (Civil Code Art. 831).
4. Delay: payment is made once the event and the amount of damage have been established (Civil Code Art. 814) — submit the documents in writing with a mark of receipt and demand a decision; for property insurance the insurer compensates in money (repair at a “chosen” service station only if the policy expressly says so) (Civil Code Art. 820); reduce the damage and follow the insurer’s instructions (Civil Code Art. 830); if the sum insured is below the car’s value, payment is proportionate (Civil Code Art. 827).
5. If there is an at-fault party: a waiver of claims against that party releases the insurer in that part (Civil Code Art. 832) — do not sign a “no claims” statement with them before the CASCO payment.
6. Procedure: on request, the insurer must provide copies of the contract, policy and annexes free of charge (Supervisory Service Instruction Art. 5); a written claim demanding a reasoned refusal → if the insurer violated your rights, a complaint to the Insurance State Supervision Service (money is recovered through the court) (Law on Insurance Art. 20¹) → lawsuit.
7. Where to apply: insurer (claim) → Insurance State Supervision Service → district (city) court.
8. Evidence: policy and rules, written refusal, date of notice, police documents, photos, service-station estimate.
9. Pitfalls: accepting an oral refusal without written reasons; signing a “no claims” statement with the at-fault party before payment; complaining to the consumer protection authority (for insurance, the Supervisory Service is competent).

Be sure to check

• the grounds for refusal are checked against the policy; the law releases the insurer only for intent or gross negligence
• late notice does not release the insurer unless its interests were materially prejudiced
• unclear, unusual or unfair policy terms are interpreted in favour of the policyholder
• procedure: written claim → Insurance State Supervision Service → court; 3-year limitation