Maître Lauréline ROUSSEAU

Avocat au barreau de Nantes

Compétences : Droit des assurances, Droit du crédit et de la consommation, Droit bancaire et financier

Barreau : Nantes

Adresse : 12 rue Boileau 44000 NANTES

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Publié le 12/04/2022

Mon assureur refuse de m'indemniser: que puis-je faire? comment réagir?

Article juridique - Droit des assurances

Par Me Lauréline ROUSSEAU

Mon assureur refuse de m'indemniser: que puis-je faire? comment réagir?

Assurance habitation, assurance automobile, assurance emprunteur, assurance prévoyance... tout le monde (ou presque) est lié par un contrat d'assurance.

Mais quand il s'agit de se faire indemniser, parfois ça coince.

Tous les refus de prise en charge ne sont pas infondés - et heureusement !

Mais, quelque fois, l'absence d'indemnisation de l'assureur ne repose sur rien ou pire, est faite en toute mauvaise foi.

Me Laureline ROUSSEAU, Avocat en droit des assurances à Nantes, vous aide à y voir plus clair.

Avant toute chose, il convient de comprendre correctement ce que vous oppose votre assureur pour ne pas intervenir en garantie.

Les motifs de refus sont nombreux, et il est impossible d'en faire un inventaire exhaustif.

Les plus fréquents sont:

- l'exclusion de garantie: l'assureur considère qu'une clause de son contrat exclut expressément le sinistre déclaré

- le défaut d'une condition de garantie: l'assureur considère que l'assuré n'a pas respecté certaines obligations de prévention ou certaines conditions

- la déchéance de garantie pour déclaration tardive: ici l'assureur considère que l'assuré a trop tardé pour déclaré son sinistre

- la déchéance de garantie pour fausse déclaration : dans ce cas, la garantie est due mais l'assureur prive l'assuré de son indemnité considérant que ce dernier a menti lors de sa déclaration de sinistre

Quels que soient les motifs invoqués par votre assureur, il est utile de souligner qu'un refus d'indemnisation n'est pas irrémédiable.

En effet, et c'est heureux, vous pouvez contester cette décision.

Pour ce faire, une étude précise de votre contrat d'assurance s'impose.

Cette analyse passe obligatoirement par la lecture de vos conditions particulières (ou conditions d'adhésion) et conditions générales.

Si vous ne les avez pas, le premier reflexe sera de les demander à votre assureur.

Le deuxième reflexe est de mettre en demeure votre assureur d'avoir à indemniser votre sinistre sous un certain délai: cette mise en demeure doit impérativement être adressée par LRAR afin d'interrompre la prescription de deux ans.

Enfin, troisième reflexe, confiez votre dossier à votre Avocat afin qu'il puisse vous donner un avis juridique sur votre situation et débloquer votre situation.

Maître Laureline ROUSSEAU, Avocat en droit des assurances à Nantes, met ses compétences à la disposition des assurés qui souhaitent se voir indemniser de leur sinistre.