IF YOU are planning to see in the new year
with a glass or four of bubbly‚ or something stronger‚ best you make
plans to ensure that you won’t be getting behind the wheel afterwards.
You
have a good chance of killing or injuring yourself and others‚ of
course. But even if you’re involved in a relatively minor‚ no-injury car
crash‚ you could be left to foot a hefty repair bill yourself‚ because
your insurer won’t pay out a motor accident damage claim if they find
out you were over the legal limit at the time of the crash.
Here’s the thing — you don’t have to have been convicted in court of driving over the legal limit; insurers can‚ and mostly do‚ conduct their own investigations‚ and may rely on circumstantial evidence in repudiating your claim.
Outsurance customer "Leroy" wrote to me recently‚ not at all happy about a request the insurer made after he submitted a car accident claim.
"They’ve requested permission from me to do a cellphone billing and beacon check‚ to track my movements and see my phone calls‚" he wrote.
"They also want me to send them a bank statement to see if I made any purchases of booze on the night of the accident.
"Is that not digging too far into my private and personal information?"
Well‚ clearly if an insurer suspects that a vehicle accident happened when the driver was under the influence of alcohol — grounds for repudiation — they’re entitled to investigate the circumstances as part of deciding whether to approve or repudiate the claim.
But buying alcohol does not prove that the person consumed it‚ nor how much. So proof of purchase is a very far cry from proof of inebriation at the time of the accident.
Asked to respond‚ Outsurance’s head of client relations‚ Natasha Kawulesar‚ said the insurer relied on both circumstantial and objective evidence in order to paint a picture of "the most probable scenario at the time of the incident and leading up to the incident".
"In doing this‚ we take note of the reasonableness and relevance of the request as well as the effort required from our clients in obtaining the information‚" she said.
"Requesting a client’s bank statement and cellphone beacon and billing is part of this process and it is only on the rare occasion that we require these documents.
"We fully agree with you that a bank statement showing alcohol was purchased is by no means conclusive proof that the alcohol was consumed and that the client was under the influence of alcohol when the collision occurred.
"Should we have only a bank statement showing the purchase of alcohol and no other information to confirm the consumption of alcohol by the client‚ we would settle the claim.
"The bank statement may show if alcohol was purchased‚ where the client may have been on the evening‚ for example‚ payment at a restaurant. This can be very valuable in then confirming the client’s events leading to the incident.
"There is certainly no intention to breach a client’s privacy in requesting the information but rather to validate and finalise the claim."
So if you believe‚ as many do‚ that your insurer can only repudiate your claim on the grounds of driving over the legal alcohol limit if you’re criminally convicted‚ you’re mistaken.
The Ombudsman for Short-Term Insurance has in several cases sided with insurers that rejected claims if the company was able to prove‚ on a balance of probabilities‚ that the driver in question was "drunk" at the time of the accident.
Insurers obtain such "proof" from a variety of sources‚ including police and paramedics who were at the accident scene‚ hospital records and restaurant bills.
And you can be sure that if your accident happens in the early hours of New Year’s Day‚ your insurer will launch a very thorough investigation of whether you were drunk at the time.
TMG Digital
Here’s the thing — you don’t have to have been convicted in court of driving over the legal limit; insurers can‚ and mostly do‚ conduct their own investigations‚ and may rely on circumstantial evidence in repudiating your claim.
Outsurance customer "Leroy" wrote to me recently‚ not at all happy about a request the insurer made after he submitted a car accident claim.
"They’ve requested permission from me to do a cellphone billing and beacon check‚ to track my movements and see my phone calls‚" he wrote.
"They also want me to send them a bank statement to see if I made any purchases of booze on the night of the accident.
"Is that not digging too far into my private and personal information?"
Well‚ clearly if an insurer suspects that a vehicle accident happened when the driver was under the influence of alcohol — grounds for repudiation — they’re entitled to investigate the circumstances as part of deciding whether to approve or repudiate the claim.
But buying alcohol does not prove that the person consumed it‚ nor how much. So proof of purchase is a very far cry from proof of inebriation at the time of the accident.
Asked to respond‚ Outsurance’s head of client relations‚ Natasha Kawulesar‚ said the insurer relied on both circumstantial and objective evidence in order to paint a picture of "the most probable scenario at the time of the incident and leading up to the incident".
"In doing this‚ we take note of the reasonableness and relevance of the request as well as the effort required from our clients in obtaining the information‚" she said.
"Requesting a client’s bank statement and cellphone beacon and billing is part of this process and it is only on the rare occasion that we require these documents.
"We fully agree with you that a bank statement showing alcohol was purchased is by no means conclusive proof that the alcohol was consumed and that the client was under the influence of alcohol when the collision occurred.
"Should we have only a bank statement showing the purchase of alcohol and no other information to confirm the consumption of alcohol by the client‚ we would settle the claim.
"The bank statement may show if alcohol was purchased‚ where the client may have been on the evening‚ for example‚ payment at a restaurant. This can be very valuable in then confirming the client’s events leading to the incident.
"There is certainly no intention to breach a client’s privacy in requesting the information but rather to validate and finalise the claim."
So if you believe‚ as many do‚ that your insurer can only repudiate your claim on the grounds of driving over the legal alcohol limit if you’re criminally convicted‚ you’re mistaken.
The Ombudsman for Short-Term Insurance has in several cases sided with insurers that rejected claims if the company was able to prove‚ on a balance of probabilities‚ that the driver in question was "drunk" at the time of the accident.
Insurers obtain such "proof" from a variety of sources‚ including police and paramedics who were at the accident scene‚ hospital records and restaurant bills.
And you can be sure that if your accident happens in the early hours of New Year’s Day‚ your insurer will launch a very thorough investigation of whether you were drunk at the time.
TMG Digital
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