Watch your step if you have an accident late at night

Here’s a sobering thought: if you’re involved in a car accident‚ your insurer can reject your claim on the grounds that you were driving drunk‚ even if there’s no toxicology report to prove it.

Insurers can rely on circumstantial evidence - witnesses saying you smelt of alcohol or acting drunk at the accident scene‚ for example‚ to substantiate rejecting a claim.

Motor vehicle claims made up more than 49% of complaints finalised by the Ombudsman for Short-Term Insurance last year - by far the biggest category of complaints.

Of that 49% of claims‚ most - 74% - was made up of claims relating to accidental damage.

“And that 74% mainly comprised claims rejected on the grounds that the insured was driving under the influence of alcohol‚” said senior assistant Ombudsman Ayanda Mazwi‚ in OSTI’s recently released 2017 annual report.

So you can be sure that if you have an accident‚ especially late at night‚ your insurer is going to pull out all the stops to find out whether or not you were drunk.

And they don’t need hard evidence to reject your claim on that basis.

In the matter of Swart v Mutual & Federal Insurance Co. Ltd of 2009‚ the court held that the demeanour of an insured driver at the time of an accident may constitute sufficient evidence to make a finding that the insured driver was under the influence of alcohol at the time‚ and that this was the cause of the accident.

In other words‚ if no blood or breathalyser tests were conducted‚ an insurer can rely on circumstantial evidence to substantiate rejecting a claim.

Independent witness statements describing a person's demeanour; his or her whereabouts prior to the accident; the amount of alcohol consumed prior to the accident; the way they drove and how the accident happened can all be factored in‚ in coming to that decision.

Old Mutual Insure recently rejected a claim from one of its policyholders on the grounds that he had been driving drunk at the time of his accident.

He claimed he’d swerved to avoid hitting a car which had cut him off‚ causing him to lose control of the car and slam into the wall of a house.

That was at 2am‚ but he claimed to have had his last drink at 8.30pm the previous evening.

A toxicology report backed up his story - his blood alcohol concentration was recorded as 0.033 grams per 100ml at the time of the accident - below the legal limit of 0.05g.

Reporting on the case in its latest “Briefcase” newsletter‚ OSTI said Old Mutual Insure had nevertheless rejected the claim on the grounds that he was under the influence of alcohol‚ despite having no circumstantial evidence to support that contention.

Because of that‚ OSTI recommended that the claim be settled‚ which the insurer agreed to do.

The statistics reveal that driving under the influence is “a very real problem” for the South African insurance industry‚ Mazwi said.

“Some insurance companies have introduced measures such as the ‘take me home’ service to manage the risks associated with drunken driving‚” she said.

• Wendy Knowler is TimesLIVE's consumer champion. You can contact her on email: consumer@knowler.co.za or via Twitter: @wendyknowler