Third-party Claim

What is third-party insurance & what is covered? 

Third-party car insurance is the minimum level of insurance that one can obtain. A third party is defined as a person or group apart from two others, who are primarily involved in a legal transaction, such as an individual and her insurer.

This insurance is designed to provide compensation to a third party, should you cause damage to their person, vehicle or property. In the case of a car accident, where a person has driven blindly into an intersection and into the side of another car, third party insurance would cover damage to the other person’s vehicle, that person and any passengers involved.

Third party insurance does not cover the costs of repairs or treatment for your own damages, the insurance only covers the cost involved in compensating the victim.

Do you need to claim as a third party?

If you have been involved in a vehicle accident or accident involving another’s property, where you were not at fault, you may want to claim back for damages from the insured party. In order to do this, you must attempt to prove the extent of loss you suffered, as a result of the incident.

If you are involved in a car accident, or accident involving property in which you are a third party, the onus is in you, the claimant to prove the extent of your losses.

Also, it is important to note that as a third party, you are not necessarily eligible to claim directly from the responsible party’s insurer. Instead, you should make a direct claim from the responsible party, who will in turn hand over any correspondence and legal documents to her insurer.

The duty of the insurer to the responsible party is to ensure that she is cleared of legal liability regarding damages to the third party. The rights of the insurer regarding the claim will be stipulated in the insurance policy with the insured party.

Essentially, the purpose of the insurer in third-party insurance is to take over the responsibility of the insured party, should she be the cause of damages to another person or her property.

In order to claim from the responsible party:

• You, as the claimant, must first prove that the damages suffered by you and your property are a direct result of the incident.
• You must prove negligence or recklessness on the part of the insured party, such as driving while on the phone or at unlawful speeds
• You must prove that the repairs and compensation will return the vehicle to the state it would have been in if the accident had not occurred.
• You may need to repair your wall due to a drunk driver swerving into it. You can claim back from the insured after conducting the repairs.

If the responsible party does not have insurance, you were the victim of an accident while on a public vehicle, like a bus, or you would prefer to pursue your claim through the government, you should contact the Road Accident Fund.

The RAF is particularly useful to both parties injured in the accident.

It will mediate the process of apportioning just and equitable compensation to the parties involved. If the responsible party has caused damages due to criminal conduct, you should lay a charge at the closest police station, and if possible, call the police to the scene.

Any witness to the incident should be requested to testify in defence of your case and should you be pursuing criminal charges, any police investigation should be included in your claim.

To summarise

1. A third party may only claim against the responsible party and not directly against the insurer.
2. If the insurer agrees to discharge the responsible party of liability and takes over the defence, then the insurer and third party will interact
3. The insured may not induce the insurer to become prejudiced towards the third party or compromise their policy
4. Cooperation of the insured party is required
5. The insurer is only obligated to settle the claim to the extent that the policyholder is legally responsible

What can you claim for?

• Medical expenses such as hospital stays, surgery, doctors consultations and any follow-up procedures with a medical professional to treat injuries.
• Losses resulting from the inability to work because the damages incurred impeded your ability to work, either by means of personal damage or damage to property resulting in the inability to earn. For example, if you work from home and your work studio has been damaged due to another’s' negligence.
• Compensation for pain, loss, trauma related to the damages incurred. For example, you may suffer psychological difficulties when recovering from the incident, in light of this the Judge may grant you compensation
• Loss of support, if the person injured or killed in a third-party accident was legally bound to support you, and also the bread-winner of your family and financial support, you can claim for loss of support, which would entail proving your dependence.

In the case of a successful claim of loss of support, you will be granted a monthly compensatory fee in order to maintain your livelihood. The Judge will consider a variety of factors when determining the amount to be paid and often past cases are used as evidence you rationale for a ruling.

Preparing to see your lawyer

Before seeing your lawyer, it may help things run smoothly if you are prepared. Try to have as many of the following relevant documents at your appointment:

• Identity document
• Documentation of the accident and damage caused
• Registration number of the car that caused the accident
• Police case number
• Personal details of the driver or the owner of the car
• Personal details of any witnesses to the accident
• A hospital patient number (if you have one)

If claiming for loss of support, a death certificate, a legal document proving your dependence and a copy of the victim's latest payslip will be required.

Consequential loss

Say your car is crashed into from behind by another car in traffic. You have gone through the rigmarole of claiming and getting a panel beater approved by the insurer to fix your car. However, just after you pick your car up you notice a rattling noise while driving. It transpires that while at the panel beaters, your car sustained some damage. Depending on the insurance policy, such ‘consequential loss’ may or may not be covered. These losses are difficult to prove and often insurance companies will exclude these costs in the contractual agreement.

Rounding it up

As a victim of a third-party accident, you are entitled to compensation from the responsible parties, especially if they have acted criminally. In South Africa, very few citizens have comprehensive insurance, if at all. Unfortunately, the claiming process often goes before the Small Claims Court, which involves a trial, but not always legal representation.

Due to the small nature of these claims, it is entirely possible to present your case to the Judge without a lawyer representing you, in which case you need to familiarise yourself with the necessary procedures as well as collate all the evidence into a coherent and detailed story.

You may also wish to source your own expert witnesses, such as your attending doctor, mechanic or any party able to provide evidence in support of your claim.