Julius was riding his motorbike when he collided with a car at an intersection. His motorbike was damaged. He blamed the car driver, saying he had passed the car and come to a stop in front of it, but that when the light turned green the car driver had hit him directly from behind. The car driver blamed Julius, saying his motorbike appeared to her left as the light turned green, and crossed in front of her car before she had time to stop. There was a photo of damage to the left hand side of her car’s front bumper.
Julius’s insurer accepted his claim, but concluded that Julius was to blame for the accident. The insurer said Julius put himself in the way of the car and did not allow enough time to pass it safely. The insurer asked that Julius pay a $500 excess. The insurer also said that if Julius wanted to challenge this, he would need to take the car driver to the Disputes Tribunal so that it could determine who was at fault.
Dispute
Julius complained to FSCL. He wanted his insurer to argue his case (that he was not at fault) to the car driver’s insurer. For various reasons he did not want to go to the Disputes Tribunal. Nor did he want it recorded that he was ‘at fault’, as this may have an impact on future insurance applications or claims.
Review
We considered that the insurer had come to a reasonable conclusion, based on the evidence it had, that Julius was at fault. In saying that, we were not making any findings ourselves as to who was at fault, as that is not FSCL’s role. We simply noted that it was a reasonable conclusion for the insurer to reach, weighing the available evidence on the balance of probabilities.
We also noted that Julius’s insurer was not bound to accept what Julius said happened in the accident. The insurer had to objectively assess who was at fault. If Julius disagreed with that assessment, he needed to prove to the Disputes Tribunal that he was not at fault.
Resolution
We formed a preliminary view that Julius’s complaint should be put on hold while the Disputes Tribunal decided who was at fault in the accident. Julius did not take matters further with FSCL, and we discontinued our investigation.
Insights for consumers
An insurer does not have to accept your word for it when trying to assess where fault for an accident lies. The insurer needs to objectively assess who was at fault before paying a claim. If you disagree with the insurer’s assessment, it is open to you to get a finding of fact from the Disputes Tribunal (or a court).
