An Evaluatıon on Whether Temporary Incapacity Damages are Covered by Compulsory Traffic Insurance
Kübra Yetiş ŞamlıMotorway Motor Vehicles Compulsory Financial Liability Insurance (Traffic Insurance) is the most common compulsory insurance and the most common liability insurance in Turkey. In recent years, both the legislation and the general insurance terms, which are essential parts of the insurance contract, have been radically amended. These amendments affected the scope of the liability of the insurer against the injured party. Lastly, the Motorway Traffic Act (Act Number: 2918, Acceptance Date: 13.10.1983, OG 18.10.1983/18195) has been amended by Act Nr 6704 (Act Number: 6704, Acceptance Date: 14.4.2016, OG 26.4.2016/29695). Concordantly in 2016, the General Terms of Motorway Motor Vehicles Compulsory Financial Liability Insurance have also been amended. After these amendments, it becomes unclear whether the insurer is liable to indemnify the damages due to temporary incapacity. In fact, insurance companies are able to claim that temporary incapacity damages are not covered by the compulsory traffic insurance contract. Our study has discussed this issue. First of all, the concept of temporary incapacity damage has been examined in light of the Supreme Court decisions. Afterwards, the provision of the General Terms, which leads to uncertainty, is addressed. The subject has been discussed with reference to a recent decision of the Arbitral Committee of Appeal assessing this issue. In the case of compulsory insurance regulated under a special statute, only the circumstances may be excluded from the scope of the insurance coverage, which are stated as such as per the law provided that they are explicitly excluded in the General Terms. Furthermore, exemption clauses must be definite, clear, and certain. In addition, in terms of legal policy, it is indefensible that these damages could be excluded from the scope of the insurance coverage. Therefore, it has to be considered that the damages due to temporary incapacity will fall within the scope of the insurance coverage.
Geçici İşgöremezlik Zararlarının Zorunlu Trafik Sigortası Teminatı Kapsamında Olup Olmadığının Değerlendirilmesi
Kübra Yetiş ŞamlıÜlkemizdeki en yaygın zorunlu sigorta ve aynı zamanda en yaygın sorumluluk sigortası olan trafik sigortası bakımından, son yıllarda gerek mevzuat hükümlerinde gerekse sigorta sözleşmesinin bir parçası olan sigorta genel şartlarında yapılan önemli değişiklikler, sigortacının zarar görene karşı olan edim yükümlülüğünün kapsamını da etkilemiştir. Son olarak, 65 Yaşını Doldurmuş Muhtaç, Güçsüz Ve Kimsesiz Türk Vatandaşlarına Aylık Bağlanması Hakkında Kanun İle Bazı Kanun Ve Kanun Hükmünde Kararnamelerde Değişiklik Yapılmasına Dair Kanun (Kanun Numarası: 6704, Kabul Tarihi: 14.4.2016, RG 26.4.2016/29695) ile Karayolları Trafik Kanunu’nun (Kanun Numarası: 2918, Kabul Tarihi: 13.10.1983, RG 18.10.1983/18195) (KTK) bazı maddeleri değiştirilmiş ve buna paralel olarak 2016 yılında Karayolları Motorlu Araçlar Zorunlu Mali Sorumluluk Sigortası Genel Şartları’nda da değişiklik yapılmıştır. Bu değişiklikten sonra, geçici işgöremezlik nedeniyle uğranılan malvarlığı zararlarından sigortacının sorumlu olup olmadığı hususu belirsiz hâle gelmiştir. Zira Trafik Sigortası Genel Şartları’nın (TSGŞ) sigortanın kapsamına giren teminat türlerinin sayıldığı A.5.b. bendinden, geçici işgöremezlik zararlarının sigorta teminatının kapsamında olup olmadığı hususu net olarak anlaşılamamaktadır. Öyle ki, sigorta şirketleri, geçici işgöremezlik zararlarının teminat kapsamında bulunmadığını ileri sürebilmişlerdir. Çalışmamızda, bu sorun incelenmiştir. Öncelikle geçici işgöremezlik kavramı, Yargıtay kararları ışığında ortaya konulmaya çalışılmıştır. Daha sonra geçici işgöremezlik zararlarının teminat kapsamında olup olmadığına ilişkin belirsizlik yaratan genel şart hükmü ele alınmıştır. Bu meselenin değerlendirildiği yakın tarihli bir İtiraz Hakem Heyeti Kararı’na da değinilerek, geçici işgöremezlik zararlarının teminatın kapsamına dahil olup olmadığı tartışılmıştır. Özel kanunla düzenlenen zorunlu sigortalarda, ancak kanunda teminat kapsamı dışında bırakılabileceği belirtilen hâller, Genel Şartlar’da açıkça istisna edilmeleri kaydıyla, sigortacının edim yükümlülüğünün kapsamı dışına çıkarılabilir. Ayrıca muafiyet klozlarının kesin, açık ve belli olması gerekir. Kaldı ki, hukuk politikası bakımından bu zararların sigorta teminatının kapsamı dışına çıkarılması da savunulamaz. Zira zorunlu trafik sigortası teminatını kalıcı sakatlık hâlleri ile sınırlamanın haklı bir gerekçesi bulunmamaktadır. Bütün bu hususlar dikkate alındığında, geçici işgöremezlik zararlarının zorunlu trafik sigortası teminatı kapsamında sigortacının sorumluluğunda bulunduğu sonucuna varılmalıdır.
Motorway Motor Vehicles Compulsory Financial Liability Insurance (Traffic Insurance) is the most common compulsory insurance and also the most common liability insurance in Turkey. In recent years, both the legislation and the general insurance terms, which are essential parts of the insurance contract, have been radically amended. These amendments affected the scope of the liability of the insurer against the injured party. Lastly, the Motorway Traffic Act (Act Number: 2918, Acceptance Date: 13.10.1983, OG 18.10.1983/18195) has been amended by Act Nr. 6704 (Act Number: 6704, Acceptance Date: 14.4.2016, OG 26.4.2016/29695). Concordantly in 2016, the General Terms of Motorway Motor Vehicles Compulsory Financial Liability Insurance have also been amended. After these amendments, it becomes unclear whether the insurer is liable to indemnify the damages because of temporary incapacity. In fact, insurance companies are able to claim that temporary incapacity damages are not covered by the compulsory traffic insurance contract. Temporary incapacity is the incapacity for work continuing during the treatment and recovery period because of loss of bodily integrity. Its result is existing damage that materializes by the date of the verdict. The calculation of the amount of the damage is concrete. On the other hand, if the effects arrive after the date of the verdict, it is a future damage, of which the amount has to be calculated using the abstract method.
Temporary incapacity may occur as the first step of permanent incapacity. For example, a person may lose 30% of his capacity to work because of a traffic accident. During the six-month recovery period, he is 100% incapable of working. In such a case, this person shall be deemed completely but temporarily incapable of working during his recovery period. After the completion of the recovery period, he shall be deemed permanently but partially incapable of working. The Turkish Supreme Court has opined that the recovery period should be taken as a basis for calculating the compensation of the temporary incapacity damages. The injured party may use his right of direct action against the liability insurer. In that case, the insurer shall pay as if it were the substitute of the insured. Therefore, as to the recoverable damage, the calculation of the damage, incapacity, duration of the incapacity, etc, it is irrelevant who pays the compensation. The general principles of tort law and practice shaped by the Supreme Court decisions must apply in exactly the same way. However, the insurer is not the tort feasor. Since the insurer’s liability has been limited in some aspects by the terms of the insurance contract or by law, the amount of the compensation payable by the insurer is not exactly the same as the amount of the compensation payable by the insured party. On the other hand, it must be highlighted that this situation only affects the amount of compensation claimed from the insurer, not the total amount of compensation.
As mentioned previously, after the latest amendments of the General Terms of Traffic Insurance in 2016, it becomes unclear whether the insurer is liable to indemnify the damages because of temporary incapacity. Within this scope, if there is no permanent incapacity, the damages caused by temporary incapacity are not covered explicitly by any of the provisions of the General Terms of Traffic Insurance. Despite that uncertainty, the damages because of temporary incapacity must be considered to be within the scope of the insurance coverage. This is because, in the case of a compulsory insurance regulated under a special statute, only those circumstances may be excluded from the scope of the insurance coverage that are stated as such as per the law, provided that they are explicitly excluded in the General Terms. Furthermore, exemption clauses must be definite, clear, and certain. In addition, in terms of legal policy, it is indefensible that these damages could be excluded from the scope of the insurance coverage. Hence, a recent decision of the Arbitral Committee of Appeal assessing this issue determined that the damages because of temporary incapacity would fall within the scope of the insurance coverage.