We often hear from those whose cars were damaged in accidents that the claim was the other motorist’s fault, and are outraged that the guilty driver’s insurance company has failed to pay to have their car repaired.
“Not fair, this wasn’t my fault,” they complain, and their sentiments are understandable.
They may have third party insurance or no insurance at all, or they don’t want to claim on their own insurance policy because they would be forced to pay an excess and lose their no-claim bonus, when they’re the “victim” in the story.
The ombudsman for short-term insurance, Brian Martin, says his office gets numerous complaints from such “third party” motorists, but the office cannot deal with them.
“The terms of reference of the ombudsman direct that the ombudsman provides, free of charge, an accessible, informal and speedy dispute resolution process to policyholders who have disputes with their insurers where these disputes fall within the ombudsman’s jurisdiction,” he says.
The key word is “their” insurance company. A complaint against another party’s insurer does not fall within the ombudsman’s jurisdiction.
“In fact, it’s very seldom that a member of the public has a legal right to claim anything from anybody else’s insurer,” Martin says.
“In one sense it may well be that the insurer is obliged to indemnify the other party against the uninsured’s claim, but its legal obligations are entirely towards the person with whom it contracted an agreement of insurance, and it has no legal duty to the other party whatsoever.”
Given that the insurer’s main job is to protect its own policyholder, if it can best protect them by refusing to pay the other party’s claim, it is entitled to adopt that attitude, Martin says.
“A mistake which members of the public often make under these circumstances is to try to deal with the third party’s insurer as if it were their own insurer, giving them full details of the accident, or supplying a full statement and then waiting for the insurer to pay their claim.
“Often this procedure may in fact afford the insurer ammunition not to pay the claim.”
His advice is to not to have anything to do with the third party’s insurer, but to instruct an attorney to make a demand for payment of the full amount, and if it is not received, to sue the other party for his negligence or the negligence of his driver.
If the damage to your vehicle is less than R11 000, you can take your case to the Small Claims Court, which is a free process.
Bottom line – another person’s insurer has no obligations towards you, only to their client.