AR
Anisha R

1 reviews | Active since Dec 2018

07 Dec 2018, 20:05

Refuting of third party claim

I had an accident with an outsurance client on the 30/11/18 on the highway wherein their client drove into the back of my vehicle more than once on the highway before coming to a stop. Traffic officers were on the scene and after the vehicles came to a stop the other party alighted her vehicle and walked across the highway to the side. After a few minutes of shock and after seeing the traffic officers stopping other traffic i got out of my vehicle and went to where the other driver was. Before approaching her a female traffic officer said the lady said she had shortness of breath and panicked and lost control and the traffic officer mentioned asthma. When i approached her she explained she was experiencing short breath and panicked and lost control of her vehicle . She explained to me in the traffic officers presence. When i spoke to her she was speaking and breathing normal . In fact she called outsurance right at the scene and explained what happened and even handed me her phone to speak to them and took full liability for the accident. The traffic officers asked if we can drive and she indicated she is fine and will drive. Unfortunately her car was not drivable. I interjected and said i don't think she should drive and suggested an ambulance be called to access her medically. She rep**** she does not need an ambulance and she is fine. Before i left the scene she informed me i will hear from her insurance. I found her to be a very pleasant person not hiding from liability. She was well in her senses at all times. She called me the following day and told me she informed her insurance the accident was her fault. She panicked and caused the accident. She went to the dr as her body was in pain. She informed me it was her priority to sort my vehicle even before hers and was very sorry she was responsible for the accident. I submitted a 3rd party claim together with all the many documents and photos requested. On 7 December 2018 i get a reply from outsurance legal dept refuting the claim on grounds that their client was not legally liable as she couldnt breathe and her eyes went blurry and the doctrine of sudden emergency app****. A section from a law book was quoted explaining the doctrine of sudden emergency. The person from outsurance legal dept claimed that was the citation of the case law he is relying on. I rep**** a section copied from a law book is not case law. Outsurance is pathetic because they will do anything to avoid a claim even if their client admits liability. There is no medical evidence to confirm what happened to their client. She was walking and breathing perfectly fine right after the accident...she even called outsurance at the scene and spoke with them with no breathing issues. Never once did she complain about her eyes going blurry. The accident report also confirms only shortness of breath. How does outsurance come to the conclusion that any other reasonable person who has short breath will lose control of a vehicle and panic...which by the way is the test for the doctrine of sudden emergency. They indicate it was the first time it happened to their client and she is not on medication and could not forsee it could happen to her. Where is the evidence that it happened in the first place? Do we just take her word without any other supporting evidence? As i stressed the lady was breathing normal right after accident and speaking to them on the phone. She didn't want an ambulance, said she was fine and even said she will be able to drive. Who investigated when she realized she actually was getting short breathe? What happened to the short breathe after the accident? I saw her in my rear view as she rammed me more than once and she didnt seem to be struggling at that point with breathing. She just raised her hand and placed it on her head. I cannot comment on what happened to her medically before the accident but what places outsurance in the position to decide she had a sudden emergency which in this case is a totally subjective question as it involved her directly. Could she have safely pulled off the side off the road before the accident when she realised she was not well? Did she make an unsafe decision to continue driving because her home was nearby? Was she negligent by panicking for and losing control of the vehicle when she apparently had a very short session of short breath? Where does blurred eyesight come from in the refuting letter.. its not even on the accident report or mentioned to anyone on the scene. All the case law on doctrine of sudden emergency refers to situations different from this where a party reacts to a situation to avoid something or reacts in an emergency situation only to cause an accident. With the little information outsurance has at their disposal how do they conclude its applicable here? I sent an email requesting the relevant case law and also pointing out my dissatisfaction at their decision and still awaiting feedback.

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Replies (2)
AR
Anisha R's update11 Dec 2018, 11:33
Reviewer Update
Dear Kevin Please confirm you have received the claim number as requested. I have not received any response from you acknowledging you received it. Thank you. Anisha
OUTsurance
OUTsurance's reply13 Dec 2018, 14:22
Official
Good day anisha-ramshai,

Thank you for bringing the matter to our attention.

Elizna our Legal Manager has contacted you regarding the matter. She discussed the merits of the claim in detail with you. You informed her that you will send your assessment through for us to review.

Thank you,
Kelvin