Insurance Lawyer in Mersin | Unpaid Insurance Claims

As an insurance lawyer in Mersin, I handle the claims of policyholders and injured parties where the insurance company does not pay a loss, pays less than it should, or argues that the policy does not cover the event. In disputes over compulsory traffic insurance, comprehensive motor insurance (kasko), home and compulsory earthquake insurance, life and credit life insurance, personal accident and health insurance, three factors decide the outcome: documenting the application to the insurance company fully, assessing the policy terms and the grounds for rejection correctly, and choosing the right route among arbitration, the consumer arbitration committee and the courts in time.

On this page you can find when the insurance company must pay, the most common grounds for rejection, the difference between the Insurance Arbitration Commission and the courts, what happens when the insurer seeks recourse against you, limitation periods and how the process works in Mersin.

Which Insurance Disputes Do I Handle?

Compulsory traffic insurance: Claims of people injured in an accident against the other vehicle’s insurer. For all aspects of the accident, see the traffic accident compensation and vehicle depreciation pages.
Comprehensive motor insurance (kasko): Non-payment of the loss, undervaluation of the vehicle, disputes in total loss (pert) procedures.
Home, workplace and compulsory earthquake insurance (DASK): Payment of fire, flood, theft and earthquake damage.
Life and credit life insurance: Non-payment of the loan debt or the sum insured after the death or disability of the insured person.
Personal accident and health insurance: Non-payment of treatment costs, daily allowance or disability benefit.
Recourse cases: The insurance company claiming back from the policyholder the payment it made to the injured party.

You can find my work for insurance companies, agencies and insured businesses on contracts, regulatory compliance and risk management on the insurance sector page.

When Must the Insurance Company Pay?

The insurance indemnity or sum becomes due after the risk occurs and the related documents are submitted to the insurer, once the insurer’s investigations are completed, and in any event forty-five days after the occurrence of the risk is notified to the insurer; for life insurance this period is fifteen days (Turkish Commercial Code, TTK Art. 1427). Once the debt is due, the insurer is in default without the need for a formal notice, and default interest accrues.

If the insurer’s investigations cannot be completed within three months of the notification, the insurer pays as an advance, to be set off against the amount due, at least fifty percent of the loss amount determined by the parties’ agreement or by a preliminary expert examination ordered by the court (TTK Art. 1427/3).

Once the occurrence of the risk is learned of, the insurer must be notified without delay. Failure to notify or late notification does not by itself remove the right to compensation; however, if the delay caused the compensation to increase, a reduction may be made according to the degree of fault (TTK Art. 1446).

Common Grounds for Rejection Used by Insurance Companies

The claim that the risk is not covered: The burden of proving that one of the risks in the contract falls outside the insurance coverage lies with the insurer (TTK Art. 1409/2). The ground in the rejection letter must be compared with the policy and the general conditions.
Incomplete or incorrect disclosure: Reasons such as an illness or the way the vehicle is used not having been disclosed when the contract was made. The effect of the disclosure on the occurrence of the risk and whether the insurer knew about it are assessed separately.
Driving under the influence of alcohol or without a licence: In kasko, payment may be refused depending on the policy terms; in compulsory traffic insurance, this cannot be raised against the injured party.
Low expert valuation: The loss or the vehicle’s value being set below market value.
Missing documents: Payment being held back on the grounds that documents are incomplete. It matters whether the documents requested by the insurer are actually necessary to determine the scope of the risk.

Application to the Insurance Company and Pre-Litigation Routes

Written application to the insurance company: This is the first step in every route. In compulsory traffic insurance, a written application to the insurance company is required before filing a case; if the company does not reply within 15 days or the reply does not meet the claim, a case can be filed or arbitration can be used (Highway Traffic Law, KTK Art. 97).
Insurance Arbitration Commission: To apply to the Commission, you must have applied to the insurance company and show that your request was wholly or partly rejected; the company not replying in writing within fifteen working days of the application is also sufficient (Insurance Law, Art. 30/13). In compulsory insurance, this route can be used even if the insurance company is not a member of the system. Arbitral decisions below a certain amount are final; decisions above it can be objected to once within ten days of notification.
Consumer arbitration committee and consumer court: These can be used for disputes arising from insurance contracts made as a consumer. If the dispute has been taken to court or to the consumer arbitration committee, an application to the Insurance Arbitration Commission cannot be made on the same subject (Insurance Law, Art. 30/14).
Mediation and court: In commercial cases against an insurance company concerning a sum of money, applying to a mediator before filing the case is a precondition for bringing the case (TTK Art. 5/A). If no agreement is reached in mediation, a case is filed.

The route is chosen according to the amount claimed, the need for speed, the evidence and whether there are other liable persons besides the insurance company. Arbitration is faster than court in most cases; claims for non-material damages or against other persons such as the driver and the vehicle operator can be brought together in court.

The Injured Party’s Right to Claim Directly from the Insurer

In liability insurance, the injured party can claim the part of the loss up to the sum insured directly from the insurer, provided this is within the limitation period applicable to the insurance contract (TTK Art. 1478). So even if the person who caused the damage cannot be reached or cannot pay, compensation can be claimed from their insurer if they are insured.

If the Insurance Company Seeks Recourse Against You

In compulsory traffic insurance, the insurer cannot raise against the injured party the circumstances arising from the policy or the law that remove or reduce compensation; it pays the injured party. However, after paying, it can claim from the policyholder to the extent that it could have removed or reduced the compensation under the contract and the law (KTK Art. 95). In practice, this arises most often in cases such as driving under the influence of alcohol or without a licence, the driver causing the accident deliberately, and use of the vehicle contrary to its registration.

In a recourse case, it must be examined separately whether the ground for recourse actually exists, whether there is a causal link between this ground and the accident, whether the payment the insurer made to the injured party matched the actual loss, and limitation. The full amount claimed by the insurer is not always justified.

Limitation Periods in Insurance Disputes

Claims arising from the insurance contract: Two years from the date the receivable became due; claims for the insurance indemnity and sum insured in any event six years from the date the risk occurred (TTK Art. 1420). Special periods in other laws are reserved.
Claims arising from traffic accidents: Two years from the date the damage and the person liable were learned of, and in any event ten years from the date of the accident; if the accident constitutes a crime subject to a longer limitation period, that period applies. Limitation interrupted against the person liable is also interrupted against the insurer (KTK Art. 109).

Which Documents Are Needed?

The policy and any special conditions, and the general conditions of insurance
The loss notification made to the insurance company, the company’s replies and the rejection letter
The accident report, police or fire brigade report, photographs of the scene
The expert report, repair invoices and quotes
For life and health insurance, hospital records, discharge summary, death certificate and certificate of inheritance
For credit life insurance, the loan agreement and correspondence with the bank

Care should be taken with releases signed when accepting a payment offered by the insurance company; wording that accepts an incomplete payment as “full and final” may make it difficult to claim the remaining amount.

Where Is an Insurance Case Filed in Mersin?

In cases arising from the transactions of a branch, the court where that branch is located also has jurisdiction (Code of Civil Procedure, HMK Art. 14). Liability cases arising from motor vehicle accidents can be filed at the courts where the insurer’s branch or the agency that made the insurance contract is located, or at the court of the place where the accident occurred (KTK Art. 110). For this reason, where the policy was made with an agency in Mersin or the accident occurred in Mersin, the case can in most cases be filed in Mersin. Commercial cases against an insurance company are heard by the commercial court of first instance, and cases arising from insurance contracts made as a consumer by the consumer court.

For clients living outside Mersin, meetings can be held online; documents can be sent electronically and the case can be followed through UYAP, the national judicial network. If the insurance dispute arises from an accident or bodily harm, see also the material and non-material damages page for all heads of claim.

Frequently Asked Questions

Within how many days must the insurance company pay a claim?

The insurance indemnity becomes due after the documents are submitted and the insurer’s investigations are completed, and in any event forty-five days after notification of the risk, or fifteen days for life insurance (TTK Art. 1427). If the investigation exceeds three months, the insurer pays at least fifty percent of the determined loss as an advance.

Where can I complain if the insurance company does not pay?

First, a written application is made to the insurance company. If the request is rejected or not answered within fifteen working days, an application can be made to the Insurance Arbitration Commission. For contracts made as a consumer there is the consumer arbitration committee or consumer court, and for commercial disputes mediation and the commercial court of first instance.

Can I object to a decision of the Insurance Arbitration Commission?

Arbitral decisions in disputes below a certain amount are final. Decisions above this amount can be objected to once before the Commission within ten days of notification of the decision (Insurance Law, Art. 30/12).

Does insurance pay in an accident involving alcohol?

Compulsory traffic insurance pays the loss of third parties injured in the accident; the alcohol situation cannot be raised against the injured party. After paying, the insurer may seek recourse against the policyholder if the conditions are met. In kasko, payment may be refused depending on the policy terms; the ground for rejection and the effect of alcohol on the accident must be assessed separately.

What is the limitation period in an insurance case?

Claims arising from an insurance contract become time-barred two years from the date the receivable became due and in any event six years from the date the risk occurred (TTK Art. 1420). For traffic accidents, the periods in the Highway Traffic Law apply.

How are an insurance lawyer’s fees determined?

Fees are determined according to the type of dispute, the amount claimed and whether arbitration, the consumer arbitration committee or court will be used, and cannot be lower than the Minimum Attorney Fee Tariff. Application fees, court fees and expert costs are assessed separately.

Get an Assessment of Your Insurance Dispute

When the insurance company’s rejection letter, the policy and the loss documents are examined together, it becomes clear which route to take and how long to wait. To have your situation assessed, you can contact me through the contact page.