How vehicle maintenance affects your insurance claims

The law requires all vehicles on public roads to be roadworthy, and insurers are within their rights to reject a claim when a vehicle’s unroadworthiness causes an incident.

Every time a vehicle hits the road, it enters into an unspoken contract, not just with the driver, but with the insurer. That contract hinges on one critical condition: the vehicle must be safe, legal, and roadworthy. When it isn’t, the risks multiply, not only for the driver, but for everyone else on the road.

This is according to the Non-life Insurance Division of the National Financial Ombud Scheme (NFO), who has cautioned that insurers may deny claims or limit payouts if they determine that poor vehicle maintenance contributed to an incident. 

This means vehicle owners bear significant responsibility for maintaining their vehicles in a roadworthy condition. South Africa records thousands of road fatalities annually, with many linked to vehicle defects that could have been addressed.

Making roadworthiness a condition for insurance is not just about reducing insurers’ exposure to unwanted risks; it’s also about protecting lives, the NFO said.

Tyres and brake systems that do not meet the minimum requirements of roadworthiness may result in an insurer repudiating a claim. Maintaining the vehicle’s brakes and ensuring that the tyres comply with the National Road Traffic Act are among the minimum roadworthiness requirements.

“Generally, insurance companies provide cover on the condition that the insured party takes reasonable steps to prevent harm. Most policies explicitly state that claims may be denied if the insured fails to comply with the Act and the vehicle is not roadworthy at the time of the incident," Edite Teixeira-Mckinon, lead Ombud of the NFO said.

According to her, faulty brakes and unroadworthy tyres are the most common reasons relied on by insurers to reject accident claims on the ground that the vehicle was not roadworthy. In respect of vehicle unroadworthiness, expert evidence is often relied on by insurers to demonstrate that the vehicle did not comply with the Act.

Teixeira-Mckinon cited a case-study where the complainant claimed for accident damage when he lost control of his vehicle and collided with a pavement while driving through a puddle of water.

The insurer’s expert found that the left rear tyre was unroadworthy as the two inner tread wear indicators on the tyre were level with the remaining tread pattern of the tyre. The expert concluded that the worn left rear tyre could not disperse the amount of water which the front tyres were channeling towards the rear tyres. The driver subsequently lost his claim and his complaint was also dismissed by the NFO.

Teixeira-Mckinon added that it is, however, not enough for the insurer to demonstrate that the vehicle is unroadworthy. The NFO does not only make decisions based on the strict letter of the law. In terms of its equity jurisdiction, the NFO will consider whether the unroadworthy condition of the vehicle was material to how the loss took place.

In a second case-study, she said the insurer rejected a claim on the basis that the brake shoes on the vehicle and the right rear brake disc were worn. In this case the driver swerved to avoid a pothole when the vehicle fell to its side.

In this case the insurer’s rejection of the claim was overturned by the NFO as the insurer had not demonstrated that the condition of the brakes was material to the way the accident had happened.

“To avoid the financial burden of a claim being rejected due to a vehicle being unroadworthy, insureds are advised to carry out regular checks to key areas of their vehicles,” the NFO advised.

zelda.venter@inl.co.za