Compensation, insurance and settlement

The strength of the claim is the key to fair compensation. Our creativity in this area goes beyond the usual boundaries, treating each claim as a unique challenge. We combine legal expertise with innovative approaches to achieve optimal results in the resolution of compensation claims, insurance claims and settlements.

Where possible, we seek out-of-court settlements with liable parties to secure compensation for our clients. Alternatively, we pursue compensation or insurance premiums from the insurance company. Where appropriate, we represent the client and negotiate an out-of-court or court settlement to achieve the quickest possible resolution.

Claiming compensation from the liable party 

We issue a demand for compensation to the liable party. We send a reasoned demand to the liable party, explaining the legal and financial consequences of failure to pay our client. If the liable party does not fulfil its obligations to our client, we represent the client and take legal action against the liable party in the competent court.

If the liable party has sufficient insurance coverage, the claim is also submitted to the insurance company. 

Compensation and insurance claims against insurance companies

We work with our clients throughout the process of pursuing out-of-court or judicial claims against the insurance company in the event of a claim:

  • Compensation and insurance claims with insurance companies: We actively pursue compensation and insurance claims with insurance companies through carefully prepared documentation and active collaboration with external experts to assess the damage. We seek compensation for material and non-material damage, in particular for personal injury, traffic accidents, accidents at work, medical malpractice and payment of accident and property insurance premiums.
  • Complaints to the insurance company’s complaints board: If an insurance company fails to meet its legal or contractual obligations to policyholders, we take firm action by lodging a complaint with the relevant complaints board. We aim to ensure that the client receives the full insurance benefit to which they are entitled.
  • Legal action against the insurance company: Where the insurance company wrongly refuses to pay or underpays, we take legal action against the insurance company on behalf of the client and play an active role in enforcing the client’s rights. Our role includes providing legal representation, obtaining relevant evidence and taking other legal action.

The two main forms of legally recognised damage are:

  • Material damage: Includes any interference with another’s property and is expressed as ordinary damage, which is the difference between the property before and after the loss event, and as lost profit, which is the reduction in the injured party’s property due to the prevention of its increase.
  • Non-material damage: Consists of physical distress, mental distress suffered owing to a reduction in life activities, disfigurement, the defamation of good name or reputation, the curtailment of freedom or a personal right, the death of a close family member, and fear.

Typical examples of loss events:

  • Traffic accidents: A traffic accident is an event that gives rise to several claims for compensation. These include compensation for material damage resulting from damage to the vehicle, reimbursement of the cost of temporary replacement or hire of another vehicle and compensation for loss resulting from a reduction in the market value of the vehicle. In many cases, the consequences of a traffic accident include physical and mental distress, fear, reduction in life activities and disfigurement, which entitle the parties involved to compensation.
  • Accidents at work: In most cases, the employer is liable for damages caused to the employee in the course of their work, simply because the employer is engaged in a dangerous activity. We represent clients in disputes with employers.
  • Damage to property (house, apartment, appliances, etc.): By filing a property insurance claim, we enable the client to obtain adequate financial compensation or reimbursement of financial losses in the event of material damage, loss or another harmful event.
  • Bodily injury: Personal accident insurance provides greater financial and social security for the client in the event of an accident or for their family members in the event of their death.
  • Medical malpractice: If a doctor’s conduct does not conform to the requirements of medical doctrine and the deterioration of a patient’s health is the result of the doctor’s malpractice or failure to exercise due care, the patient is entitled to compensation.

In the context of such claims, which are addressed by the parties directly to the entities responsible for the damage caused or to the insurance companies, we observe an increasing trend towards denial of liability and limitation of payments, as well as denial of adequate compensation and insurance benefits. The complexity of legal proceedings and the need for legal analysis make our intervention increasingly important, ensuring correct legal interpretation, effective legal representation and a focus on fair compensation in accordance with the legal framework and case law.

Review of insurance policy terms and conditions 

We ensure that our clients are familiar with the contents of insurance policy terms and conditions. We advise our clients to carefully review and analyse the policy terms and conditions (the “small print”) before entering into an insurance contract, as a full understanding of their contents is key to knowing when the insurance coverage is excluded or limited, which is critical to the payment and amount of the insurance benefit in the event of a claim. We also carry out a thorough analysis of the policy terms and conditions after an insured event has occurred in order to gain a full understanding and assessment of the actual payment of compensation or insurance benefit.

Settlement

A settlement is a legally regulated agreement by which a mutual understanding is reached to resolve a disputed or uncertain legal relationship. Our law firm’s approach to both court and out-of-court settlements is entirely focused on the interests of our clients. Settlements are only reached after the client’s objectives and interests have been clearly defined. In order to achieve our goal of obtaining the highest possible payout for our clients, we offer the following services:

  • legal advice on the settlement option, its benefits and potential risks,
  • analysis of the optimal terms for the client in the event of a court or out-of-court settlement,
  • drafting of settlement proposals,
  • negotiating with the other party or its representatives to reach a compromise solution,
  • representation in court in the event of a court settlement,
  • monitoring the implementation of settlement agreements, including all conditions and obligations.

By applying innovative claiming strategies, we seek to optimise claims payments and take a leading role in the process with the aim of maximising the payout for the client.

Krištof & Brečko Advokatura