The Ombudsman for Short-Term Insurance examines a case where someone submitted a claim following an accident – admitting they had been drinking earlier that day.
South African insurers can reject a claim for driving under the influence of alcohol—but they still have an obligation to prove their case when making that decision.
Although the driver admitted that he had four beers at his girlfriend’s party between 09h00 and 15h00, the accident took place at 19h48 after he avoided a pedestrian on the road, veered into an embankment and hit a tree.he said that he was sober and that the alcohol did not have any influence on his driving abilityAlcohol is mainly broken down by the liver, which can metabolise roughly one standard drink per hour, but this also depends on age, weight, gender and food eaten.
Although the insurer correctly submitted that circumstiaonal evidence must be taken into account, it failed to provide any circumstantial evidence to support its submission that the insured had been influenced by the consumption of alcohol on the evening in question. It was unclear whether the statements regarding alcohol were factual, and even if they were, there was no evidence to suggest that the insured was under the influence of alcohol.
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