# 8. Claims handling, evidence and payment due dates

URL: https://insurancelawestonia.ee/insurance-law-cpd/claims-handling-evidence-and-payment/
Author: Dr Olavi-Jüri Luik, Partner, Head of Insurance Law, attorney at law (Advokaadibüroo WIDEN OÜ)
Last updated: 2026-11-11

> CPD module 8: steps after a loss, burden of proof, when the benefit falls due and the right to claim the minimum amount (VÕS § 450).

Module 8 of 20 · Theme: Claims and disputes · Level: Specialist · Suggested study time: 90 minutes 

**In short.** This module covers the steps after a loss, evidence and when the insurance benefit falls due.

## Learning outcomes

After completing this module you will be able to:

- prepare a notification and evidence plan;
- distinguish proof of the insured event, the amount of loss, an exclusion and a breach of duty;
- explain the conditions for claiming a minimum amount.

## Key points

### First steps

The insured event must be notified to the insurer without delay (VÕS § 448(1)). At the same time the loss must be prevented and reduced (§ 488(1)), and the damaged property must not be altered before the loss is established in a way that makes it harder to determine the cause or extent, unless the change is necessary to reduce the loss or in the public interest (§ 488(2)). Unavoidable intervention should be documented.

### Who proves what

Each party must prove the facts on which its claims and objections are based (TsMS § 230(1)). As a rule the policyholder proves the insured event and the amount of loss, and the insurer proves the conditions of an exclusion or a breach of duty. An evidence plan links each disputed issue to an item of evidence and to who holds it.

### When the benefit falls due

The insurer's obligation falls due when the steps needed to establish the insured event and the extent of performance have been completed (VÕS § 450(1)). If, two months after notification, the policyholder asks for an explanation and the insurer does not reply within one month, the obligation falls due (§ 450(2)). If the steps have not been completed within one month of notification, the policyholder may, once the insured event is established, claim the amount the insurer should at least pay in the circumstances (§ 450(3)).

### In court

In court proceedings the insurer may, as a measure securing the action, be ordered to pay during the proceedings the amounts that are clearly payable at a minimum (TsMS § 378(1)(8)). According to Supreme Court case law the threshold for this measure is high.

## Read before the quiz

Articles on this site:

- [Notification and post-loss duties under Estonian insurance law](https://insurancelawestonia.ee/estonian-insurance-contract-law/notification-and-post-loss-duties)
- [Claims handling practice in Estonia: a guide for TPAs](https://insurancelawestonia.ee/guides/claims-handling-practice-estonia)
- [Presenting a cyber, crime or D&O claim: documents and evidence](https://insurancelawestonia.ee/specialty-lines/handbook/claim-documentation-and-evidence)

Legal sources:

- [VÕS §§ 448–450, 488–489](https://www.riigiteataja.ee/akt/V%C3%95S)
- [TsMS §§ 230, 378](https://www.riigiteataja.ee/akt/TsMS)

## Practical case

*Write down your own answer before opening the suggested approach.*

There was a fire at a company's warehouse. Property damage of EUR 30,000 has been established by an expert; the amount of business interruption loss is disputed. Five weeks have passed since notification. When and on what basis can the company claim a partial payment?

Suggested approach

As the steps were not completed within one month of notification and the insured event (the fire) has been established, the company may claim under VÕS § 450(3) the amount the insurer should at least pay in the circumstances; the undisputed property damage is the natural basis. The request should be made in writing with the expert report and the loss calculation. If completion of the steps was hindered by circumstances attributable to the policyholder, the period is suspended (§ 450(3), second sentence). Proof of the business interruption loss must continue; two months after notification the company may ask under § 450(2) for the reasons for the delay.

## Self-check quiz

Answer the three questions and press "Check answers". An explanation is shown for each question.

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