Denied Car Insurance Claims Explained

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kingr
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Denied Car Insurance Claims Explained

Post by kingr »

It’s one of those niggly aspects of life most people think they’ll either charm or bulldoze their way through, as needs be, if ever it happens. The prospect of having car insurance claims declined make most of us tingle in the back of the neck. It can be devastating, especially if you have honestly misreported your car’s specifications or use, or otherwise not known of some definite exclusions.

Although the insurance ombudsman has been a great aid in clearing up the previously untenable situation, where some insurers were making a habit of at best half-payments, most of us still wouldn’t be able to recite the key points of our insurance policies in a pinch. Even before looking at those details, there are some common inputs that may well jeopardise your chances of a successful insurance claim in the event of an accident.

Related: Car Insurance Explained

Denied insurance claim reason # 1: Alcohol

Drinking and driving has become less acceptable, although it remains widespread, and might soon become wholly illegal. If you have any toxicology report implicating you in illegal amounts of alcohol consumption at the time you were driving and had an accident, expect your insurance claim to go out the window. The law will never defend an illegality, and so too will insurers not support your ability to wrap a car around the lamppost on your way home because you’re merrily sloshed!

You can submit the claim, but don’t be surprised if it’s partially or completely denied if your insurer has legitimate intel on the fact that you were, technically or raucously, drunk at the time of an accident.

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Denied insurance claim reason # 2: Speeding

By the very same simple principle, your insurer is likely to hide behind the law if they have legitimate evidence of you speeding at the time of an accident. This can be a stationary camera’s records, police actively speed-trapping at the time and in the locale of the accident, and even something as tenuous as having been “reported speeding” by a policeman or other accepted witness. This last intel typically only surfaces if you’ve really been whacking it, driving visibly reckless on the road, but it can happen.

Don’t forget that if it goes as far as an investigation, accident-scene analysers can nowadays also pinpoint speeds and of course trajectories of the cars involved. The nutshell? You’re unlikely to make a successful claim after doing 160kph in a 60kph zone. And if you were reported or spotted speeding on camera immediately prior to or during an accident, your claim is toast.

Denied insurance claim reason # 3: Cellphones

Although Orwellian, the reality of your service provider being able to determine if you were on a call and whether or not you were on a hands-free kit or not, is here. Welcome to the technological age. Comments on the Volkswagen Club forum and elsewhere point to innumerable instances where either witness testimony that saw the driver on their phone, or technical analysis of the instrument’s use have been employed to deny claims. You might feel assured that talking on your phone had nothing to do with an accident, but it’s one of those defeating “technicalities” that can erase all hopes of a successful claim, leaving you to foot the bills.

Denied insurance claim reason # 4: False info or claim history

It might seem trivial, but you had better make sure that every line item is not only correctly entered when you initially sign up for insurance, but also that you don’t fib in the least when answering questions. While it might seem inane years down the line, if some time back you lodged a claim with any insurer that proved to be false and didn’t acknowledge this when signing for your current insurance, and they find out when they start looking - and they will - that’s a compelling reason for any insurer to deny your claim. They can, if they can show that you were dishonest with information, from where the car is typically parked and how many locks you have on your gates, through to previous illicit claims or other embellishments that aren’t true.

Hot tip: Call your insurer up and ask them to read their understanding of your policy to you, such as “This policy covers a such-and-such car owned by so-and-so, driven by and stored at…” - you name it. If anything pops up that doesn’t tally with what you know to be true, correct it right there and then, so that all parties have exactly the same picture and there’s no room for misunderstanding.

Denied insurance claim reason # 5: Incorrect tyres or unroadworthy

While you might think or even know absolutely that your cracked windshield or faulty wipers had zero to do with an accident, if your car was demonstrably unroadworthy at the time of an accident, you could have your claim denied too. Also, when fitting non-run-flat tyres to a run-flat spec car, you’d better call up your insurer first and get them to formally accept that you remain covered and that the fitment of such tyres will not be grounds that constitute “unroadworthiness” at any point in the future. If you ever swap them back again, be sure and notify your insurer too.

In short, any modification on your car should always be cleared with your insurer, no matter how much of a pain it seems. It’s only in your best interests. And note very bene that smooth tyres can also constitute grounds for denied insurance claims. If you could have avoided an accident but slid along a wet road like a boogie board on worn tyres, your insurance can deny your claim.

Related: 5 things you must know about run-flat tyres on cars

Denied insurance claim reason # 6: Insurance premiums not up to date!

Boy, if you want to imagine time travel as real as you can desperately hope it to be possible, just rear-end someone in traffic a week after you thought you’d juuuust delay paying this month’s premium a little. You’ll live out being able to go back and reverse that decision at least a million times in your imagination! The short version is: if you’re behind on your premiums, it’s very, very likely that your insurer will deny claims in that window period. Note that if you have either spoken or written comms where they have given you a date by which to catch up on premiums, be sure and ask if you are still covered until then, under the circumstances. Assuming that you can’t settle right away, make sure a payment arrangement doesn’t include a loss of cover in the interim.

The moral of the story is that while insurance premiums and a few other fiscal details in this life seem to be persistent yet vacuous drains on your cash flow, they sadly become an immediately top priority when you have a claim denied because you’re behind. Rather ensure that you’re always up to date. Download a bank statement and confirm your monthly debits are successfully processed each month. That kind of sure.

Denied insurance claim reason # 7: Inspection was never done

It’s common for an insurer to ask that you submit your car for inspection when initiating an insurance contract and, for a variety of reasons, this sometimes gets omitted. Neglect it at your peril, however, as it’s fundamental grounds for either shrinking or denying a claim outright. To be fair, the insurer has nothing but your word that the car was in a pristine condition when you took out the insurance policy, and the only way they can proceed from a clean slate is by visually inspecting the car.

If they inconvenience you and ask that you submit the car for an inspection, be zen and just get it done. It’s not a “luck” when you manage to wheedle out of it. You’re just a denied claim waiting to happen, paying money for nothing if you fail to complete a mandated initial inspection.

Denied insurance claim reason # 8: No Tracker fitted

So what, you might ask. Millions of people don’t fit a tracking device to their cars in South Africa. That’s absolutely true, except that they are not driving your car, and your car might well be insured under a policy that stipulates the fitment of a tracking device. It’s a quick phone call to your insurer if you’re not sure whether you’re obliged to have such a device - or gealocks, alarms or immobilisers by the same token - fitted to your car. Find out and straighten it out, as that’s a biggie that most insurers won’t overlook, even if you have.

Hot tip: Remember too, with many modern cars, installed telematics can also record driver error, pinpointing your liability in the event of an accident. Factor in your car’s ability to monitor you when driving, and play it safe.

Denied insurance claim reason # 9: Wrong licensing

While you and hubby or you and the kids regularly take whichever car is in the driveway when you need to roll, that might not agree with the terms in your personal policy. Insurance doesn’t automatically cover someone else driving your car just because you married them, for example, so be absolutely sure at the time of policy uptake who is allowed to drive which vehicles and under what circumstances.

Also, crash scene photos showing you and the carpentry team standing next to the smashed bakkie holding tools are not going to charm your insurer, not when your car was insured for private and not business use. Most policies will accommodate “occasional business use” as reasonable, but it it’s a work vehicle, be honest about it before it catches up with you. Even if your longest-standing, favourite and most responsible employee was behind the wheel, tough cheese if he wasn’t listed as an authorised driver on your policy. The claim will be denied, so iron those details right out, crystal clearly.

Denied insurance claim reason # 10: No write-off cover

“Write-off cover” is something we’ve all come to assume from insurers. It means that when a car is badly damaged, an insurer will typically write-off (scrap or throw away) and usually replace your car, rather than repair it, as it’s more cost-effective for them. That said, it’s not necessarily a given, so make sure that you discuss this at the time of signing for the insurance. Make sure you have write-off cover, preferably write-off cover that won’t merely settle any car finance, but will also enable you to be driving a replacement car in as short a time as possible.

Conclusion

All in all, the insurance ombudsman’s office makes it easier for consumers to contest issues, but few of us have the time, will and legal savvy to argue legal battles for car insurance. And insurers know it. Just play ball! Feel free to haggle, shop around and check your insurance premiums frequently, as that’s just good practice. It’s not all on the insurer’s side, as the marketplace is competitive and you are also entitled to full disclosure from insurers as legislated by consumer law in this country. But for the rest, make sure that you’ve been scrupulously honest and that you comply with the laws of the road. That way there are no grounds for denying your insurance claim, and you get the peace of mind you’re paying for in the first place.

If you have been scrupulously honest at signing up for the policy, conducted your affairs legally and in a roadworthy vehicle suitably licensed, there should be no issues with any claim of yours. If you’ve done your part and if you ever do have a contested claim, enjoy your day in court, because you’re going to win!
Kurt #3337

Current:
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- 2020 Mini Cooper S Clubman (swambo)
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Ex: 07" G5 GTi, 13" ST180, 03" Mk4 2 door 1.8T Stage 2, 07" Velo 1.6, 83" Mk1 GT 2.0 8v MP9, 87" Mk1 1.6 CitiSport, 88" Mk2 2.0 16v, 83" Mk1 GT 1.6 + 40 webers
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