KN
Khayelihle N

1 reviews | Active since May 2015

27 Mar 2019, 09:17

My Claim was unfairly rejected.

My claim was rejected for the following reasons as per the Discovery Insurance rejection letter: a) For leaving the scene of the accident; and b) Taking reasonable measures to prevent loss, damage, death, injury and accidents.

My responses were as follows: a) For leaving the scene of the accident It should be noted that the accident happened around 2 am (19 March 2016). My car hit the corner of a concrete wall. Shocked as I was, I did immediately stopped the vehicle and stepped out. At the time I could only see the damages to the left front door of the vehicle, that the airbags were visibly out and that the concrete wall suffered minor damages. Since I was alone (the area is not muted from possible victimisation by strangers), shocked, no other person was in danger as a result of the accident, not knowing the extent of injuries I might have suffered and my house being not far from the accident scene (less that 1 km), I found it reasonable to drive to my house where a family member could assist me in case of any injuries and/or abnormal re-action by my body. I recall very well that my phone battery was already dead at that time, which was also a limiting factor in requesting assistance. In the morning I felt strong pains in my body especially my left back and a severe head ache which made it difficult for me to even get out of bed. Upon getting out of bed, I immediately consulted a doctor. The 1st doctor who examined me could not conclusively confirm the extent of injury; the doctor accordingly requested a second opinion from another practitioner. Thereafter on the same day (within 24 hours or 1st working day after an accident) I managed to report the accident to the nearest police station (Elexandra road police station). Based on the above I would like to state the following: a) At the scene of the accident it could not have been possible to confirm/determine if I did not suffer severe injuries and that I was not in any imminent danger. b) I managed to report the accident within 24 hours or 1st working day after an accident which is in compliance with Section 61(1)(f) of the National Road Traffic Act. Section 61(1)(f) of the National Road Traffic Act 93 of 1996 reads “if he or she has not already reported the accident to a police or traffic officer at the scene of the accident, and unless he or she is incapable of doing so by reason of injuries sustained by him or her in the accident, as soon as is reasonably practicable, and in the case where a person is ****ed or injured, within 24 hours after the occurrence of such accident, or in any other case on the first working day after the occurrence of such accident, report the accident to any police officer at a police station or at any office set aside by a competent authority for use by a traffic officer, and there produce his or her driving licence and furnish his or her identity number and such information as is referred to in paragraph (e).”

The rejection letter states the reads “It is worth pointing out that according to Section 61(1) of the National Road Traffic Act 96 of 96 obliges the driver of a vehicle involved in an accident where property is damaged to remain at the scene of the accident”. I have noted the act hereby referred to, which I would assume is the act which is presumed to have been contravened. The following contra with my understanding of the said act. • It is worth to mention that the act referred is not correct and my understanding is that the act that is applicable is National road traffic act 93 of 1996 (National Road Traffic Act) not act number 96 of 96. • It is concerning that this act was not fully quoted which may be interpreted as being selective and misinterpretation of the fact. Subsection 61(1)(f) of National Road Traffic Act the has been overlooked.

b) Taking reasonable measures to prevent loss, damage, death, injury and accidents. I am not sure of this statement due to:- i) Since I was alone at about 2 am at the area is not muted from possible victimisation by strangers, shocked, no other person was in danger as a result of the accident, not knowing the extent of injuries I might have suffered and my house being not far from the accident scene (less that 1 km), I found it reasonable to drive to my house where a family member could assist me in case of any injuries and/or abnormal re-action by my body. ii) I recall very well that my phone battery was already dead by that time, which was also a limiting factor in requesting other assistance. iii) I am not s****ed in examining if the car is roadworthy and due to my state of mind at that time (as stated above) at the scene of the accident, it was impractical for me to even examine the roadworthiness of the car. iv) Considering the above, I would not have been able at the scene of the accident to determine if the car was un-roadworthy and if driving the car to the nearest safe place (My home) would be considered to be forcefully driving a car. v) Consideration of impending damages or driving an un-roadworthy vehicle should be weighted with the consideration of my personal safety and wellness. I therefore submit that my priority was my safety and my health. vi) The statements and conclusion provided that rejects my claim suggests that I should have prioritised the impending damages to the car and ignored my personal safety and impending injuries. vii) Reference is made to paragraph 7.10 of 2016 Discovery Insure Plan Guide which states that “Further damage after an accident If your vehicle is in an accident and is used or driven before the repairs have been done, you will be responsible for the cost of repairs for any further damage to the vehicle related to the accident”. Based on this it is clear that causing further damages to a car does not make a claim to be rejected by rather a policy holder to be liable for further damages. viii) Reference is made to paragraph 5.25 or (5.24 as quoted in the rejection claim) of 2016 Discovery Insure Plan Guide which states that “You must take all reasonable precautions for the maintenance and safety of the insured property. This means that you must take reasonable steps to prevent and/or minimise loss, damage, death, injury, liability and accidents. You may carry out emergency repairs to prevent further damage with our consent”. My claim has been rejected for not taking reasonable measures to prevent loss, damage, death, injury and accidents. In my case the insured property was my vehicle. I have not been provided with reasonable measures that I should have taken to prevent loss, damage, death, injury and accidents. It should be noted that attempts were made to stabilise the car to avoid accident, however were unsuccessful. It is therefore unclear as to how it was concluded that I did not taking reasonable measures to prevent loss, damage, death, injury and accidents. It is the actual incident that resulted in a loss. Activities or actions after incident had occurred would more probably be a reduction of loss than a prevention of loss, thus section 5.25 or (5.24 as quoted in the rejection claim) is not applicable.

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