Beware the Financial Fallout of Drinking and Driving

If you drink and drive, you not only risk being apprehended by the police for being over the blood alcohol concentration limit of 0.05g per 100ml, but if you are in an accident you may not be covered by your insurance policy.

This warning comes from the National Financial Ombud Scheme (NFO) in the run-up to the festive period, when the incidence of drinking and driving skyrockets.

The Non-life Insurance Division of the NFO has seen a surge in complaints where motor vehicle accident claims have been rejected because the driver was found to be under the influence of alcohol or other intoxicating substance.

Edite Teixeira-Mckinon, Lead Ombud of the Non-life Insurance Division, says a common misconception among complainants is that the insurance company must rely on the outcome of blood or breathalyzer test to reject a claim.

She explains that a claim against an insurer is a civil claim, meaning that, unlike in a criminal case, the insurer need only demonstrate on a balance of probabilities that the driver was intoxicated. “The insurer has a lighter burden of proof than the State in criminal matters and may rely on other evidence to reject a claim,” Teixeira-Mckinon says.

She says this evidence may include:

• Evidence from witnesses at the accident scene describing the driver’s appearance and conduct. 

• The driver’s whereabouts prior to the accident – for example, at a shebeen, pub, party or braai where alcohol was consumed.

• The vehicle’s tracking data and the driver’s cellphone records.

• Bank statements confirming that the driver had purchased alcohol prior to the accident.

• Evidence from paramedics and doctors who attended to the driver after the accident.

• How the accident occurred.

“The financial implications of a rejected accident claim are not limited to the policyholder’s own vehicle damage but extend to the damage caused to a third party,” Teixeira-Mckinon says. She urges consumers to “think before you drink, before you drive”.

Case study

In a recent matter to come before the ombud, Mr A’s insurer rejected a claim for damage to his vehicle on the grounds that Mr A’s son, the incident driver, was under the influence of alcohol. Mr A contested the rejection of the claim.

The driver’s version of the accident was that it took place shortly after 1am when, while trying to overtake a vehicle, the vehicle had moved into his lane causing him to collide with the vehicle and lose control of his own vehicle. He said that on the day of the accident he had met a friend at a shooting range. After their shooting practice, they had each consumed a draught beer. He had then fetched his girlfriend from work, and they had gone to a café where they had a pizza and a milkshake.

In rejecting the claim, the insurer relied on the tow truck driver’s evidence, which stated that the driver was severely under the influence of alcohol. In addition, the insurer obtained the son’s medical reports, which included notes compiled by the doctor who first treated Mr A’s son when he arrived at the hospital in an ambulance. The doctor noted that he was clinically intoxicated and reeked of alcohol.

Mr A disputed the doctor’s evidence, stating that his son had used hand sanitizer and had consumed brandy after the accident, which would have explained the smell of alcohol noted by the doctor. 

Taking into account the son’s whereabouts prior to the accident, the way the accident took place and the attending doctor’s notes, the ombud upheld the insurer’s rejection of the claim on a balance of probabilities.