3rd party insurance advice

[Rudi Pollard]

Hi everyone,

 

Some background first. I was involved in an accident on the 1st of December, where a oncoming car turned in front of me when it was not safe to do so. I hit the car at more than 40kph and was very lucky to walk away from the accident with a cut up arm, bruised hip and sore back. I am very well aware that it could have been a lot worse. In the words of the doctor at the emergency room - "If a car looks like that, a cyclist does not look like you do".

 

Now for the insurance piece. My road bike was not specified on my insurance as it spends 95% of its life on the indoor trainer. It was included in my home contents so it was covered for theft out of the house etc.

The person who hit me, admitted guilt and said I can speak to his insurance and claim under 3rd party directly. He told his insurance that I will be calling them regarding a 3rd party claim as the accident was his fault. The case at the police also reads the same that he turned in front of me when it was not safe to do so.

 

I got a quote for the repairs of the bike which includes a new frame, new carbon handlebars, new front rim, new rear derailleur, the kit I was wearing as well as the helmet which cracked.

 

His insurance asked for the original tax invoices of everything as proof of ownership which I provided.

 

They got back to me yesterday, stating that their client cannot be held fully responsible for the accident, as there is no proof that I took any evasive action. I litteraly had 1-2 seconds to react after he started to turn, where I could basically just hit the brakes and hope for the best. They are offering to pay 60% of the original cost instead of the replacement cost of the items. Surely that cant be right? I am expecting for them to cover the replacement cost of everything that was damaged in the accident.

 

Does anyone have some experience in third party claims who can give me some guidance? The amount the are offering barely covers my helmet and kit. I am considering a lawyer to sue the guy for all damages as well as medical cost which is climbing every week.

[Bateleur1]

Standard insurance procedure.  You could have a word with the insurance Ombudsman but me thinks that you will have to tell the person who drove the car that his insurance is not playing ball and if they stay with their opinion you will have to claim the money directly from him.  He can then deal with the insurance.

[Stoffel76]

Who is the insurer?  There are some who go out of their way to apportion blame to reduce their costs.

 

You are not their client so you can be pretty sure that they are going to try do everything possible to pay you out as little as possible.  Their next step might be to argue they'll give you second hand value on the bike (depending on the age)...

 

Argue your case logically (so tell them you did take evasive action ie brake, assuming you did) and in writing, follow up regularly and threaten to go to the Ombudsman, but at the end of the day you may need to cut your losses and walk away... (Which at least you can do...  And you did some impressive damage to the car!)

 

Good luck with your claim and your recovery!

[Pieter-za]

If you phone your insurance just to get their opinion on the mater?  (Even if the bike wasn't specified, you are still a client of them?)

[Rudi Pollard]

The insurer in question is Telesure. I am awaiting their response after I replied to their ridiculous offer. Ill give my guys a ring as well. I just spoke to a lawyer and his advice is to sue the driver directly. He can then take it up with his insurance company...

[Bateleur1]

The insurer in question is Telesure. I am awaiting their response after I replied to their ridiculous offer. Ill give my guys a ring as well. I just spoke to a lawyer and his advice is to sue the driver directly. He can then take it up with his insurance company...

 

That is basically the way I see it.  While you are not a client of Telesure, they will give you the finger outright.  So sue the driver and the ball is in his court to deal with his insurer to settle quickly.  The fact that he admitted fault and also in the police statement has pretty much secured your case.

[PhilipV]

Time to lawyer up. Sorry.

[Stoffel76]

That is basically the way I see it.  While you are not a client of Telesure, they will give you the finger outright.  So sue the driver and the ball is in his court to deal with his insurer to settle quickly.  The fact that he admitted fault and also in the police statement has pretty much secured your case.

Of course, if the drivers insurer want to be really difficult about this, they can then argue that their client contravened the terms of his policy contract - as the client, you are not allowed to admit liability...

 

From the Auto & General (one of the insurers in the Telesure group, although its fairly standard to all insurers) wording:

 

Your obligations

If you do not fulfil any of the following obligations, your cover may be cancelled.

Your obligations are to:

 

4. not admit any fault, nor make any offer of/or settlement, without written agreement;

 

Hope it doesn't come to that...

[MTBeer]

having exactly the same issue with a vehicle claim. Other party's insurance only paying out 70%. Seems that even though they drove into me from the side it was 30% my fault

[Wet Ears]

Litigation is a long and painful process in which you are not guaranteed a result, you most certainly will not recoup all your legal fees and you will wait 3 years for a court date.

 

And if you win the driver may not have the means to pay a lump sum in which case the court will order that he pay you monthly.

 

A lot to weigh up. What does the shortfall amount to? 

[Pieter-za]

Litigation is a long and painful process in which you are not guaranteed a result, you most certainly will not recoup all your legal fees and you will wait 3 years for a court date.

 

And if you win the driver may not have the means to pay a lump sum in which case the court will order that he pay you monthly.

 

A lot to weigh up. What does the shortfall amount to? 

^^^^  Unfortunately more often than not this is the reality,  + all the soft issues around it.

 

Also - look at the overturn rate at the Ombudsman, it is fairy low?

 http://www.osti.co.za/assets/images/files/Stats%202016.pdf 

 

Perhaps see if you can get a higher %.

 

Also ref http://www.jgs.co.za/index.php/litigation/damages-who-pays-which-portion

[Eugene]

I had a similar issue years back. In my case the insurance company kept delaying payment. At the advice of a friend who is an attorney, I sent the driver a letter giving him 7 days to make payment.

 

 

Within a day I got a letter from his insurance stating they would cover the costs. It took 2 weeks after that and payment was made

[Rudi Pollard]

Their proposal is covering 10-15% of my total costs, depending where the medical bill ends up. So way way below what it will cost me to replace or repair everything

[Patchelicious]

Their proposal is covering 10-15% of my total costs, depending where the medical bill ends up. So way way below what it will cost me to replace or repair everything

It’s not uncommon for direct players to try this. Don’t give in. If he admitted to being at fault you must be compensated.

[kjind]

Some insurers have certain agreements between each other on % settlement based on what happened. This is basically to avoid unnecessary legal cost. They are obviously trying their luck with you on the same basis. Just explain to them that you had no time to react and demand a better settlement.

Also put pressure on the other party directly. Be a nuisance. If he start to argue for a better settlement as well they might budge.

[Stoffel76]

Their proposal is covering 10-15% of my total costs, depending where the medical bill ends up. So way way below what it will cost me to replace or repair everything

Don't forget you can also claim (something) from the Road Accident Fund...