Admiral Insurance Drink and Drugs policy

[CPWP]

It was a year and a half ago. In October 2019. And during all this time, since my husband signed the indemnity form, they haven’t tried to talk to us to discuss the case at all, just came up one day telling us we should pay them 22k. Is it possible to challenge they haven’t act on my husbands best interest as they said they would?

How did they breakdown to 22K? How much was the other car vs whiplash and hire car? Seems an awful lot!

 

[Depressed Dad]

It was a year and a half ago. In October 2019. And during all this time, since my husband signed the indemnity form, they haven’t tried to talk to us to discuss the case at all, just came up one day telling us we should pay them 22k. Is it possible to challenge they haven’t act on my husbands best interest as they said they would?

Firstly, let me caveat all my comments in this post and the whole thread. I am not legally qualified. I cannot give legal advice. This is purely my personal opinion having been through the mill with my son's offence over 10 years ago. You should seek professional advice.

Anyway, here is my two penneth:

Insurance companies generally outsource claims to a Claims Management company because it's easier. They used to make a lot of money in commission for passing it on. Often individuals in the insurance company, police or other services would make money from passing details to ambulance chasers. I think they've stopped all that but the claims process still stinks.

Find out if there is a claims management company involved. Ask who they are and get copies of all the bills. Make it clear you are not prepared to line the pockets of third parties.

Ask for Admiral's damage report and their medial report. There won't be any. They'll say it keeps the costs lower. Fine if they are paying out because it's a reciprocal benefit between insurance companies.

Ask them if they made a pre-medical offer for the injury - They'll often pay up without any medical evidence.
Soft tissue injuries are notoriously difficult if not impossible to prove. The claims management company use sympathetic medics who will obviously report soft tissue damage. The medic gets repeat business and the claims co cream off a portion of the claim. It's corrupt.

If your other half has signed the indemnity form they shouldn't (in my opinion) be coming after the policyholder. If they still threaten to come after the policyholder I would class that as unfair intimidation. Ask them outright (in writing) if they will still hold you liable. The answer will lead to other questions and challenges.

Ask them if the written off vehicle has been scrapped or sold on - you could do your own HPI check. I did and found the £1500 old banger my son wrote off had be written of twice before. It devalues the vehicle. Admiral hadn't bothered to check. If it has been sold that amount (in my opinion) should be taken off the claim.

Consider putting in an official complaint and follow that up by raising a case with the FOS if Admiral don't satisfy your complaint.

As policyholder you should make sure no claim is logged against you. Make it clear that they have not covered the claim with the policy and therefore they should not impact your claims history - I won this point through the FOS - I can send you the case number if you need it.

Having signed the indemnity form ask what they have done to reduce the value of the claim. Nothing is the most likely answer.

Effing Bar Steward Pirates.

Think about contacting national newspapers and radio phones ins where they offer legal advice - LBC have a weekly one I think.

 

[Depressed Dad]

Depressed Dad,
I was just saying what Admirals position is, whilst in no way agreeing with it!
The law says that whey yow enter in to a contract, you are agreeing with the terms of that contract and it is up to you to be certain that you understand the contract before you sign it. Fast forward to the real world and if it was an offer of a mortgage, or setting up a Limited Company, of course everyone would read it thoroughly.
If it is a key fact in the contract, then I agree that it should not be buried in sub paragraph xx sub clause you. Some terms in an insurance contract are universal and can be taken as read, but The Admiral group are almost alone in having this clawback clause that can ruin a person financially and it should be in a prominent place at the top of the contract so that people thinking of taking out insurance with Admiral will be aware of it.
Having said that, even if it was the first item in the terms and conditions, if people only go on price, will they even be aware then?
In Civil law, if you make a company lose money through negligence, they could sue you to get their money back, so in theory any insurance company could decide to sue a drink drive for negligently costing them money. If admiral win a few case it might make the rest of the insurance industry jump on the bandwagon even without the exclusion in their policy.

I know you're being the voice of reason John and I'm being emotive .

Some companies had the clause and took it out - Zurich I think.

There has to be something not quite right with it or they'd all have it. I'd love to know what the thinking is.

EUI (Admiral) lost a case EUI v Bristol Alliance where they tried not to pay out for damage caused by a deliberate act.
The Bernaldez case is cited where the European Court ruled that the insurer could pursue the drunk driver for the costs.

I've forgotten most of this stuff and can't claim to have ever completely understood it.

Reading some of it again a lot of it refers to deliberate acts by the driver - usually trying to kill themselves by driving into a building and then the property insurer arguing with the motor insurer who should pay up.

I wonder if it hinges on being over the DD limit as a deliberate act?
I don't know.

 

[price1367]

I think it would come under reckless behaviour rather than deliberate.
I was just trying to explain what the insurance company reasoning is. If you understand their thought process then you are better placed to fight it!

 

[Depressed Dad]

I think it would come under reckless behaviour rather than deliberate.
I was just trying to explain what the insurance company reasoning is. If you understand their thought process then you are better placed to fight it!

I certainly don’t understand their strategy or reasoning on this. They are outliers with this particular clause in their policy. It’s borderline vindictive and I wonder how much it actually adds to their P&L

 

[Paul W]

I certainly don’t understand their strategy or reasoning on this. They are outliers with this particular clause in their policy. It’s borderline vindictive and I wonder how much it actually adds to their P&L

As much as I don't like posting this, I feel i must to give you a full picture. This does NOT mean that your or anyone else's circumstances are such that their decision cannot be challenged. I simply explain the general insurance rules....

Under law, ..... "Under the Road Traffic Act, insurers must meet the costs of any claim by a third party for injury or damage."

However most insurance policies will have a drink and drug driving clause. Make sure you check your policy documents to find out what you're covered for.

This means Insures are responsible for meeting third party claims but gives them the option of recovering costs and expenses against the at fault party

I know most people may think this only applies to a few insurers but this is not true. Drink and drug clauses apply for the majority of insurers and where they do not, that is the exception rather than the rule, they may use the term over the legal limit or impaired but it all applies. If someone is on anti-hay fever tablets and is sleepy they can be stopped and prosecuted and the insurer may decide to reclaim any costs for any damage or injury.

You will and are covered under the road traffic act for the purposes of "driving with insurance" according to the law, but that does not mean your insurer will not pursue you for costs and expenses incurred.

Because many of these companies are PLC's and many pension funds invest in them they have a duty to pursue a recovery for both their shareholders, other policyholders and pension funds.

Doesn't mean i agree or disagree with them. Just stating the position

 

[CPWP]

As much as I don't like posting this, I feel i must to give you a full picture. This does NOT mean that your or anyone else's circumstances are such that their decision cannot be challenged. I simply explain the general insurance rules....

Under law, ..... "Under the Road Traffic Act, insurers must meet the costs of any claim by a third party for injury or damage."

However most insurance policies will have a drink and drug driving clause. Make sure you check your policy documents to find out what you're covered for.

This means Insures are responsible for meeting third party claims but gives them the option of recovering costs and expenses against the at fault party

I know most people may think this only applies to a few insurers but this is not true. Drink and drug clauses apply for the majority of insurers and where they do not, that is the exception rather than the rule, they may use the term over the legal limit or impaired but it all applies. If someone is on anti-hay fever tablets and is sleepy they can be stopped and prosecuted and the insurer may decide to reclaim any costs for any damage or injury.

You will and are covered under the road traffic act for the purposes of "driving with insurance" according to the law, but that does not mean your insurer will not pursue you for costs and expenses incurred.

Because many of these companies are PLC's and many pension funds invest in them they have a duty to pursue a recovery for both their shareholders, other policyholders and pension funds.

Doesn't mean i agree or disagree with them. Just stating the position

Hi Paul - any idea why they then require you to sign a document to enable them to process the 3rd party claim? If it's simply in their terms and conditions then why do they even need you to sign such a document?

 

[Paul W]

Hi Paul - any idea why they then require you to sign a document to enable them to process the 3rd party claim? If it's simply in their terms and conditions then why do they even need you to sign such a document?

Hi CPWP,

I can't answer that question i am afraid. When you purchase insurance you automatically give the insurer the power to handle any claim as part of the claim process. That includes third party claims as that is why the government insists on insurance to protect "innocent" third parties. ( i am not going to cover uninsured drivers hitting you as that is a different process).

They do not need your permission to proceed - that is key here - they do not need your permission.

In the event an insurer deals with a claim under the RTA act (e.g. third party cover) they can issue a notification to advise you immediately or at some further point down the line once they are aware of their liability and costs. I am not legally trained (just 20 plus years at an insurer) so i don't know about any statute of limitations on advising you but i would assume there would be a legal cut off date (can anyone advise?) between the incident occurring and that legal cut off date. Different insurers will follow different procedures and timescales.

One insurer i worked for issue an "intention notice" as soon as "impairment" was known e.g. drink, drugs, medical condition, My second company issued one impairment was known and value of claim over £XX an my current company waits for the claim to be fully "known" e.g circumstances, convictions, value before writing. I believe this is within 6 years but please verify this as i am insurance not legally trained

 

[Depressed Dad]

Thanks Paul. I understand where you are coming from.

I've made the point numerous times in this thread and other others that people do not read the T&Cs in full.

You mention the Road Traffic Act. How many policyholders have ever read it?

S.148 is the relevant section. I've read it numerous times and I still couldn't explain it in detail - same as any legal document it's hard to understand.

There is a list of exemptions in S.148 that the insurer can recover from the policyholder. i.e. Condition of vehicle
Throw in EUI v Bristol Alliance and the Ruiz Bernaldez case which relates to an Insurers liabilites. Complicated legal arguments about liability for deliberate acts by the driver.

Picking up a mobile phone whilst driving or lighting a cigarette, or setting up your satnav, or turning round to shout at the kids are all deliberate acts that cause a lot of 'accidents'.

BTW - Thornton v Shoe Lane Parking Ltd is a famous contract law case. Albeit relating to the T&Cs of a ticket. Lord Denning said:

'These cases were based on the theory that the customer, on being handed the ticket, could refuse it and decline to enter into a contract on those terms. He could ask for his money back. That theory was, of course, a fiction. No customer in a thousand ever read the conditions. If he had stopped to do so, he would have missed the train or the boat.'

I still don't understand how a named driver is bound by the T&C's of a policy based on a contract between the insurer and the policyholder. How many named drivers read the policy documents?? They don't care about the insurers shareholders either.

Yes, many other insurers have drink and drug clauses of some description but they do seem to vary.

Why do Admiral Group dominate these pages if other insurers have D&D exclusions? Because they have the strictest, most unfair T&Cs

They will pursue the driver or the policyholder.

They will pursue you without a DD conviction, being over the prescribed limit is enough.

So read RTA S.148 everyone and read your policy document cover to cover. Make sure you get your named drivers to read it too. Never drink a drop of alcohol at least 24 hours before driving. Never have an 'accident'.

 

[Depressed Dad]

Hi Paul - any idea why they then require you to sign a document to enable them to process the 3rd party claim? If it's simply in their terms and conditions then why do they even need you to sign such a document?

Because you are not covered by the policy only the Insurers RTA liabilities.
The indemnity form sort of brings them back into play to 'help reduce the costs' and for the driver to promise to pay.
That's my take on it. Could be wrong.

 

[CPWP]

Because you are not covered by the policy only the Insurers RTA liabilities.
The indemnity form sort of brings them back into play to 'help reduce the costs' and for the driver to promise to pay.
That's my take on it. Could be wrong.

HI DD - I am wondering if they need the Indemnity Form signed in order to pursue costs later and without that they have to resolve all 3rd Party costs by law (they will by default drive those costs down anyway as they can never be sure of recovering them all) so if the form isn't signed then although it states in the policy they can come after you that they only do so if a form is signed - there can be no other reason for them to need an Indemnity form signing as their policy states they can come after you anyway - so no need for a form!!

 

[Depressed Dad]

I found this recently - Admiral FOS case
Worth a read for anyone being pursued. A motor insurance legal expert might find something that helps.

Note that FOS investigators and the Ombudsman have always sided with the insurers Drink and Drugs T&Cs. I had a partial success to stop them recording the claim against my insurance record - because there was no claim against the policy.

It mentions Admiral's role as either the MIB Section 75 or RTA insurer. Another complexity I don't fully understand.

This means Admiral wasn’t involved in the third party claims because liability for them was covered by Mr Y’s policy. Instead, Admiral says it was involved in the claims as the RTA insurer, so it was obliged to pay third party claims in the circumstances set out in the Motor Insurance Bureau Articles of Association (‘MIB Article 75’) and the Road Traffic Act (‘RTA’). But I think it’s incorrect for Admiral to suggest it was the RTA insurer, as I understand this can’t be the case if Mr Y’s son was uninsured due to a policy exclusion. I think Admiral would potentially be the MIB Article 75 insurer instead. However, both MIB Article 75 and the RTA only apply if a third party obtained a judgement against either Mr Y’s son as named driver. I’ve seen no evidence of such a judgement, so I don’t think MIB Article 75 or the RTA were triggered here. Therefore, I don’t think either MIB Article 75 or the RTA meant Admiral was legally obliged to settle the third party claims.

Seems that Admiral settle third party claims as though it was done under the policy. They know it will come to them eventually if the third party obtains a CCJ so better to get in early to try to mitigate the losses. I don't think it makes much difference if you sign the form or not other than a formal agreement for them to act for you and a promise to to pay up.

Again I could be totally wrong. If I ever win Euromillions I'll sponsor a case through the courts with the best legal team I can assemble.

 

[Paul W]

I found this recently - Admiral FOS case
Worth a read for anyone being pursued. A motor insurance legal expert might find something that helps.

Note that FOS investigators and the Ombudsman have always sided with the insurers Drink and Drugs T&Cs. I had a partial success to stop them recording the claim against my insurance record - because there was no claim against the policy.

It mentions Admiral's role as either the MIB Section 75 or RTA insurer. Another complexity I don't fully understand.




Seems that Admiral settle third party claims as though it was done under the policy. They know it will come to them eventually if the third party obtains a CCJ so better to get in early to try to mitigate the losses. I don't think it makes much difference if you sign the form or not other than a formal agreement for them to act for you and a promise to to pay up.

Again I could be totally wrong. If I ever win Euromillions I'll sponsor a case through the courts with the best legal team I can assemble.

ALL insurers will settle claims for which the policy is legally liable. That is why motor insurance is mandatory. In its simplest terms it is a guarantee that someone who has been caused, loss, damage, personal injury or death will be compensated - end of story. Insurer holds sole rights to deal with third party - end of story.
Driving whilst impaired (drink, drugs, etc) will in MOST cases allow insurers to claim back from you if they choose to - end of story.
Driving whilst impaired means you have breached contract, all an insurer is trying to do is reclaim from the driver costs and expenses incurred through this breach of contract event.

As the driver of the vehicle you have a duty to understand your legal obligations and that may mean reading and understanding the contract you have signed up to. If you don't understand you can always ask your insurer. Would it be reasonable to ask a layperson to understand their policy wording? well since the plain english act came in and its regulated by the FOS then i would argue yes. I would also argue that it is reasonable for an individual to assume that driving whilst impaired will affect their insurance policy as it is against the law!

To pick up on other points raised:-
It was mentioned that "only Admiral" seem to do this -that is wrong. Last night i looked at the top 20 motor insurers by volume in the UK as of june 2020. All of them without exception have an impairment clause.

It was mentioned that Admiral keep appearing on this site about impairment - Admiral underwrite 15.4% of the uk private car market. There are approx 32.9 million cars in the UK - that means, give or take, admiral underwrite just over 5million cars every year. There are approx 85,000 convicted drink drivers each year - many of them will be aware of this site especially if they have an issue. I'll let you do the math but given market capacity i would expect Admiral, Axa, direct line then aviva to come up in that order about complaints.

You also mention MIB and article 75 - this is a fund which ALL insurers contribute to and pays for those hit by uninsured drivers including those maimed and killed by uninsured or untraced drivers. It costs you and me about £40 a year on a £400 premium. The MIB collect the cash and some insurers have agreed to process uninsured claims as if they were their own. They do this as a service and not for profit.

Finally concerning your case law, these mainly stem around proof of vicarious liability and so I would not treat them as similar cases to that which have been described on this site, but as i have said before i am insurance trained and not legal trained.

and for the avoidance of any doubt i am not in any way linked to any of the companies mentioned.

Some companies will pursue as a matter of principal others may choose not to. Taking appropriate legal advice is the only advice i can suggest

 

[Depressed Dad]

Thanks Paul. That's useful.

You do know though that the vast majority of people fail in their 'duty to understand their legal obligations'.
Especially the named drivers. There's an enormous gap between 'duty' and what happens in the real world.
Do you read all the T&C's when you buy something online, or just skip to the end and click on Accept. maybe you do but you're in a small minority.

15.4% is a sizable share of the market given the number of insurers. There are other insurers mentioned on here but it is disproportionately Admiral. Same across other forums. The maths (anecdotally) does not stack up. Maybe the demographics of Admiral customers is different.

I've refreshed my list of insurers who have an alcohol clause.

I've quickly searched the policy wording of the top 10 insurers - Searched for Alcohol

Axa, Esure, RSA have similar wording as Admiral

Hastings says no cover but nothing about recovery.

Aviva, Direct Line, LV, NFU, Ageas don't have a specific drink and drugs exclusion that I can see.

Perhaps you can provide links to the wording for the ones I can't find.

I am not qualified to give legal advice either and always suggest to people they seek expert help.

 

[Paul W]

Thanks Paul. That's useful.

You do know though that the vast majority of people fail in their 'duty to understand their legal obligations'.
Especially the named drivers. There's an enormous gap between 'duty' and what happens in the real world.
Do you read all the T&C's when you buy something online, or just skip to the end and click on Accept. maybe you do but you're in a small minority.

15.4% is a sizable share of the market given the number of insurers. There are other insurers mentioned on here but it is disproportionately Admiral. Same across other forums. The maths (anecdotally) does not stack up. Maybe the demographics of Admiral customers is different.

I've refreshed my list of insurers who have an alcohol clause.

I've quickly searched the policy wording of the top 10 insurers - Searched for Alcohol

Axa, Esure, RSA have similar wording as Admiral

Hastings says no cover but nothing about recovery.

Aviva, Direct Line, LV, NFU, Ageas don't have a specific drink and drugs exclusion that I can see.

Perhaps you can provide links to the wording for the ones I can't find.

I am not qualified to give legal advice either and always suggest to people they seek expert help.

Hi DD,

I won't go through the full list - This website is not my life just a method to help others - quick google of "aviva sample motor policy wording" (the first on your list) provides a link to the standard Aviva policy wording which, at number 6 (so don't have to go far down) says "

We will not pay for:-

6 Any accident, injury, loss, damage or liability which occurs where any person driving the car or any person using but not driving the car a has at the time of the accident giving rise to the claim a breath blood or urine alcohol/drug level above the legal limit shown in the Road Traffic Acts and any further regulations; or b is convicted of or has a prosecution pending for an offence under the Road Traffic Acts involving alcohol or drugs arising from the accident or the occasion giving rise to the claim.

OR https://www.directline.com/assets/pdf/car-insurance-policy-document.pdf

Direct line "what we will not pay for"............. (see page 9)

We could go through this for ever my friend and i'm sure you feel mightily aggrieved but someone has lost out, someone has to pay and the company that has to pay wants their money back. Insurer's will NOT cover anything that is illegal.

I wish you the best of luck

 

[Depressed Dad]

I don't need luck, just the facts. I'll go on about it until they are established. I'm happy to be corrected if there is clear evidence.

It really doesn't make any difference to my life but I continue to have empathy for those going through the stress of being chased for large sums of money. I don't have any sympathy for people that drink and drive, they get their punishment through the courts.

I've already found that random Google searches don't take you to the current document.

Re: Aviva I'm looking at the Policy Wording Document in the Important Documents section Here You need to scroll down some way.
It is clearly the current document that customers would read from cover to cover before taking out a policy. I can't find the exclusion.

Let's look at Direct Line section you selectively referred to, in full:

No cover for:
• legal costs or expenses related to charges connected with speeding, driving under the influence of alcohol or drugs, or for parking offences;

Sorry but this is not a drink and drugs exclusion clause. This excludes any help with legal fees relating to you breaking various laws. Seems fair to me.

It's currently my belief that 5 of the top 10 UK motor insurers do not have specific Drink and Drug exclusion clauses. 4 do and 1 is a bit vague about recovery of costs.

I invite people the confirm or refute my findings but please back it up with some proper evidence.

P.S. Never drink and drive and always read policy documents from cover to cover before choosing your insurer and make sure your named drivers read it all too.

 

[Paul W]

I don't need luck, just the facts. I'll go on about it until they are established. I'm happy to be corrected if there is clear evidence.

It really doesn't make any difference to my life but I continue to have empathy for those going through the stress of being chased for large sums of money. I don't have any sympathy for people that drink and drive, they get their punishment through the courts.

I've already found that random Google searches don't take you to the current document.

Re: Aviva I'm looking at the Policy Wording Document in the Important Documents section Here You need to scroll down some way.
It is clearly the current document that customers would read from cover to cover before taking out a policy. I can't find the exclusion.

Let's look at Direct Line section you selectively referred to, in full:



Sorry but this is not a drink and drugs exclusion clause. This excludes any help with legal fees relating to you breaking various laws. Seems fair to me.

It's currently my belief that 5 of the top 10 UK motor insurers do not have specific Drink and Drug exclusion clauses. 4 do and 1 is a bit vague about recovery of costs.

I invite people the confirm or refute my findings but please back it up with some proper evidence.

P.S. Never drink and drive and always read policy documents from cover to cover before choosing your insurer and make sure your named drivers read it all too.

and expenses are not a cost? they have had to pay money to someone ... actually don't matter - interpret as you wish. Your PS is correct.

Good luck and i mean that.
Paul

 

[Depressed Dad]

Come on Paul - That one is clear.

You engage a lawyer to defend you in court for your misdemeanor. His bill will include the charge for his services and his expenses, probably his bus fare to get to court and his Greggs vegan sausage roll that he had for lunch.

Unfortunately your Direct Line policy won't cover those charges and expenses.

Mind you, if people don't understand that one then what hope do people have reading, understanding and accepting all the other T&Cs in the policy document.

 

[DJLINNEN]

Anybody going through this at the moment with insurance, I thought I'd be honest due to the seriousness of my situation as I failed breathalyer but then passed bloods. I haven't had a court date yet just told that I'm being charged for dangerous driving causing serious injury but already had my insurance cancelled month early and letter in post stating that as I failed breathalyer they will be reclaiming money after settlement. The settlement I expect will be over 100k and I don't own anything of value any ideas how the situation will be resolved as from what I have seen on citizen advice website you can't just go bankrupt for a person injury claim against you.

 

[Depressed Dad]

Anybody going through this at the moment with insurance, I thought I'd be honest due to the seriousness of my situation as I failed breathalyer but then passed bloods. I haven't had a court date yet just told that I'm being charged for dangerous driving causing serious injury but already had my insurance cancelled month early and letter in post stating that as I failed breathalyer they will be reclaiming money after settlement. The settlement I expect will be over 100k and I don't own anything of value any ideas how the situation will be resolved as from what I have seen on citizen advice website you can't just go bankrupt for a person injury claim against you.

Probably have to agree a repayment plan, payable over a very long period of time and likely to increase in line with any increase in income. You need a good lawyer and some debt management advice.

Which insurer?
What were the readings at the roadside and for the blood test?