Most repudiations of motor insurance claims are driven not by administrative or technical factors, but by preventable driver behaviour and non-compliance with traffic regulations and responsible driving practices, says the South African Insurance Association (SAIA).
In an article posted on the association’s website, Ms Lebohang Tsotetsi, Insurance Risk Manager at the association, said that an analysis of sampled data from the Insurance Data System (IDS) and case trends from the National Financial Ombud Scheme (NFO) highlights several recurring causes for rejected motor insurance claims. The IDS is a centralised repository of personal lines claims and policy information managed by the SAIA.
Key behavioural factors behind rejected motor claims
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Driving under the influence
Driving while intoxicated remains one of the most common reasons for claim repudiation and a leading contributor to fatal crashes. If a driver is found to be over the legal alcohol limit at the time of an accident, insurers may reject the claim because the driver violated both the law and the policy conditions.
This exposes motorists to significant financial risk, as they may be held personally liable for damage to their own vehicle as well as any third-party losses.
Excessive speed and reckless driving
Speeding, racing, ignoring traffic signals and aggressive driving behaviour are among the most common forms of reckless driving.
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Where evidence indicates that excessive speed – “gross negligence” – contributed to the accident, claims may be repudiated under the “reasonable precautions” clause in that the driver failed to take reasonable care.
From a road safety perspective, this aligns with national traffic enforcement priorities, where speeding remains a leading cause of accidents.
Unroadworthy vehicles
Vehicle condition is another recurring factor. Claims may be rejected where the vehicle involved in the accident is found to be unroadworthy or if the accident was caused by poor vehicle maintenance; for example, worn tyres below the legal limit or defective brakes.
Such cases highlight the intersection between vehicle maintenance and accident prevention. Pre-trip vehicle checks are essential, especially for long-distance Easter travel.
Unlicensed or unspecified drivers
Insurance policies typically require that drivers be licensed and correctly disclosed at underwriting stage, that is, when the policy is first taken out. Claims may be declined if the vehicle is driven by an unlicensed or undisclosed driver at the time of the accident.
This issue is particularly relevant during holiday travel periods, when vehicles are frequently shared among family or friends.
Misrepresentation or non-disclosure
Insurance policies rely on accurate information. Claims may be rejected if:
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The driver misrepresents the circumstances of the accident;
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Damage occurred before the reported incident; or
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There is evidence of insurance fraud.
In 2023, motor vehicle accident (MVA) volumes stood at 215,204, with repudiations at 1%. In 2024, while total MVA claims reduced to 191,398, the rejection rate increased to 2%.