However, practice shows that the system often does not function as citizens expect. While some try to abuse insurance through false or exaggerated claims, others claim that insurance companies make it difficult or avoid paying compensation. Where is the line between a justified claim and fraud, and how can citizens protect their rights?
Montenegro is not immune to insurance fraud. Although the law clearly defines what constitutes fraud, in practice such cases are often difficult to prove, but they are increasingly being discovered.
"This is regulated by the criminal offense of insurance fraud from the Criminal Code of Montenegro. For this offense, according to paragraph one, a prison sentence of three months to three years is provided," lawyer Nemanja Stamatović told RTV Podgorica.
Court expert in traffic engineering, Igor Radojević, said that in earlier periods, traffic accidents that never happened were often faked, while today, fraud attempts are increasingly common in which injured parties seek to increase material damage.
Photo: RTV PG
Although abuses are most often related to material damage, the interviewees state that cases of faking physical injuries are rare, but they warn about the transfer of fraud models from the region.
"A case was recorded from Slovenia, where a woman amputated her hand. Suspicion was raised because she arrived at the hospital very quickly, with her hand on ice, and the cut was extremely precise, which is why doctors suspected that it was not an accident," said Radojević.
Citizens are often not sufficiently aware of their rights, and signing documents without reading them carefully can further complicate the situation.
"There is often a fine line between attempted fraud and an actual accident, so it happens that the insurance company denies the damage, after which the case ends up in court, where it is determined whether the damage actually occurred," Radojević pointed out.
Stamatović adds that there is a procedure in which the insured can challenge the insurance decision - first through a complaint to the commission, then peacefully before the competent center, and finally before the court, where experts of the appropriate profession are involved.
Experts advise that the most important thing is to act properly immediately after an accident – document all the facts and avoid hasty decisions.
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