You are probably aware that if you crash your car while driving under the influence of alcohol or other drugs, your insurance company has the right to repudiate your claim, leaving you liable not only for the damage to your vehicle, but also for any other damage caused by the accident.
What you may not know, and what the new Ombudsman for Short-term Insurance, Deanne Wood, points out in a media release, is that your insurer does not have to prove beyond reasonable doubt that you were driving under the influence for it to repudiate your claim. It simply has to come to that conclusion “on a balance of probabilities”.
The outcomes of criminal and civil cases are determined by different criteria.
“In criminal cases, in order to secure a conviction of drunk driving or driving under the influence, the State is required to demonstrate beyond reasonable doubt that a driver was indeed driving in such a state.
“In civil cases, however, such as a claim under an insurance policy, the insurer need only show that the insured was, on a balance of probabilities, driving under the influence,”Wood says.
This means the insurer does not have to rely on the results of a blood or breath test to confirm that you were over the legal limit at the time of the accident; all it needs is sufficient circumstantial evidence.
“Examples of circumstantial evidence on which insurers often rely are statements by:
police or emergency service personnel at the scene of the accident,
doctors or nurses who attended to a driver who was admitted to hospital,
eyewitnesses who were able to observe the driver’s demeanour,
witnesses who can account for the driver’s whereabouts prior to the collision and who can attest to whether he or she consumed alcohol,
and video footage from restaurants or bars,” Wood says.
LEAVING THE SCENE OF AN ACCIDENT
Another common condition found in motor vehicle insurance policies, the ombudsman says, is that the driver may not unlawfully leave the scene of an accident.
If you are in an accident in which a person or an animal is killed or injured, or any property (including another vehicle) is damaged, the National Road Traffic Act requires that:
You stop your vehicle and report the accident to the police;
You ascertain whether a third party sustained any injuries, and if so, render whatever assistance you can;
You ascertain the nature and extent of any damage sustained;
Where reasonable grounds exist for a person to ask for your name, address and other personal details, you provide such information;
If no report is lodged at the scene of the accident, you report the accident to the police within 24 hours of the accident (unless you are prevented by injury from doing so) and produce your driver’s licence and further details; and
Except on the instructions of a medical practitioner, you not consume any alcohol or drugs until you have reported the accident to the police and, if so ordered by a traffic officer, you have been examined by a medical practitioner.
Your failure to comply with any one of these provisions entitles your insurer to reject your claim, and if you complain about it to the ombudsman’s office, your complaint is likely to be rejected.