Insurer's 'drunk driving' denial of own-damage cover fails twice

Background

Our client had an accident while driving their own car. Citing a policy clause excluding own-damage cover for accidents while driving under the influence, the insurer sued for a declaration that it owed our client nothing.

The issue

Whether our client was over the legal drunk-driving limit under the Road Traffic Act at the time of the accident. The insurer bears the burden of proving an exclusion.

Our approach

Our client rebutted the insurer by submitting the blood test taken after being taken to hospital, and records showing that investigators had dropped the drunk-driving case because it could not be established that the legal limit was exceeded at the time of driving.

The court's reasoning

The court accepted that our client had drunk alcohol before the accident, but held that, given the blood test and the investigation outcome, the fact of drinking alone did not prove driving over the limit. On appeal, the court found the first-instance ruling correct even taking into account the new emergency-room treatment records the insurer submitted.

Outcome

The first-instance court dismissed the insurer's claim, and the appeal court dismissed its appeal. The insurer was ordered to bear all litigation costs.

What this case means

To rely on an exclusion clause, an insurer must prove the excluded circumstance. Having had a drink does not automatically justify denying a claim.

This is the outcome of an individual case and does not guarantee the same result in similar matters. Some facts have been generalized to protect the parties involved.