insurance

One of the continual problems under motor cover is the loss of no claims discount when a company pays out in circumstances in which one driver considers himself/herself to be innocent. Policyholders are obliged by their policies to notify insurers of an accident. They are not obliged, however, to make a claim. It is important that insurers make it absolutely clear to policy holders that they have this option when no damage to the other party has occurred. The ombudsman declared his intentions in 1982 to explore the feasibility of seeing if insurers could make it clear to policy holders that the option was theirs. Once the insured has put the claim into the insurer's hand, he cannot then dictate how the third party claim should be handled.

Another area of concern involves third parties who agree to pay the damages themselves but renege when presented with the bill. The ombudsman suggests that a partial cure would be to adopt what exists in some countries, namely, a register of insurance cover that would assist the claimant in locating the other parties' insurers. To date, no such central register exists in the UK.

Where two drivers are insured with the same company, the apportionment of blame and the resulting effect on no claims discount is often an area of contention. The claims manager may decide that both are to blame and thus both parties may lose their discounts. The problem was described by the ombudsman as an undesirable state of affairs. It is difficult to see a solution. In one particular case, counsel's opinion was sought which had the effect of contradicting the claims manager's assessment of liability. It would clearly become a drain in the Bureau's resources if counsel's opinion was sought on too many occasions. What is important is that insurers are aware of the conflict in such cases, and give the matter special consideration rather than treat it as purely an internal claim matter.

‘Knock for Knock' agreements are the clause of numerous complaints by motorists. These are intended largely as accounting procedures between insurers in an effort to keep down administrative costs. Unfortunately, it would appear that such companies will often accept at face value the counter accusations of blame made by each policyholder, and thus deduct from the no claims discount. The Ombudsman accepted that this often happened, and called upon insurance companies to guard against the unfair implementation of these arrangements in cases where one party could show that he was blameless. Insurers should remember that they should defend the insured's rights, not simply accepting blame because it might be administratively easier for them to do so. There is little point in asking witnesses if their views are not to be taken seriously. In recent years, knock for knock agreements between insurers have been abolished on the grounds that they did not lead to administrative cost savings as they once did.

Car insurance policies, indeed all motor insurance policies usually require that vehicles be kept in roadworthy condition. A problem may then arise when the insured chooses to do his own repairs. If a subsequent crash can be traced to faulty home servicing, then insurers are right to reject the claim. The ombudsman suggested that where an expensive or special car is insured, it might be worth considering a ‘special' policy endorsement calling for professional servicing to be undertaken.

The value of a ‘write-off' is often another area of contention. The Ombudsman appreciated that offers, rejections and new offers might occur when the claim was against a third party insurer because, as he explained, this is the realm of contentious business. Where, however, it was a claim of one's own insurer, the offer should not be one intended for further negotiation. It should be a genuine offer based on the best evidence available. That evidence has now been declared by the Ombudsman to be the cost to the insured of purchasing a car of similar quality on the open market.

An area of great misunderstanding in motor insurance is the scope of the cover to drive. Two specific problems arise. When other named drivers appear on the certificate of insurance, this does not give them cover to drive other vehicles, unless that other vehicle is insured for that driver. The misunderstanding arises because the certificate does give the policyholder, but not the other driver, the cover to drive another vehicle. But that leads to the second problem. The extension to drive another vehicle does not usually give comprehensive cover to the second vehicle, but only the basic requirements of the Road Traffic Act 1988, namely, cover against third party liability. The Ombudsman makes no criticism against insurers for this, it is merely apart of motor insurance law. He does suggest, however, that it might be worthwhile for certificates to reflect this all important point in clearly expressed language.