An increasing number of motor vehicle accident insurance claims are being rejected and disputed on the strength of a clause in insurance policies, namely the reasonable precautions clause, according to the Ombudsman for Short-Term Insurance (OSTI).
Ayanda Mazwi, senior assistant ombudsman, said that a report of complaint trends conducted by OSTI in November 2021 showed an increasing number of motor vehicle accident claims rejected by insurers based on the insured’s breach of a contractual duty of care.to prevent or minimise loss, damage, death, injury or liability. A breach of the clause by the insured may warrant the rejection of a claim.
It may rely on evidence such as data downloaded from the vehicle’s onboard computer, vehicle tracking reports, and experts in accident reconstruction. “If it is established that the insured was speeding, OSTI will then consider the legal principles applicable to the reasonable precautions clause.” Alternatively, the driver simply did not care that the measures were inadequate and therefore recklessly reconciled himself/herself with the danger. It is unlikely that a driver will admit recklessness. Therefore, it may be determined by inferential reasoning based on the facts of the case.
The insured stated that he had not seen the intersection ahead. When another vehicle suddenly approached from his left-hand side, he had to take evasive action which caused him to lose control and collide with a tree, the ombudsman said.
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