Edite Teixeira-Mckinon, Lead Ombud of the Non-life Insurance Division of the NFO
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.
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 Non-life Insurance Division of the National Financial Ombud Scheme (NFO) 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.
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 93 of 1996 (“the 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.
“In fact, 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. That denial isn’t punitive; it’s principled and ensures that premiums remain fair for those who uphold their end of the bargain,” says Edite Teixeira-Mckinon, Lead Ombud of the Non-life Insurance Division of the NFO.
She said that by proactively maintaining your vehicle in a roadworthy condition, you can reduce the likelihood of an accident and frequent breakdowns. 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 Act declares that no person shall operate a motor vehicle with a tyre where the tread is level with the tyre tread depth indicator.
The expert concluded that the worn left rear tyre could not disperse the amount of water which the front tyres were channelling towards the rear tyres. This resulted in the left rear tyre aquaplaning on the wet road surface. The right rear tyre then also aquaplaned which led to the complainant losing control of the vehicle. On considering all the evidence and submissions made by the insurer and insured, the NFO decided that the insured’s complaint could not be upheld. The insurer had demonstrated on a balance of probabilities that the unroadworthy tyre was the proximate cause of the accident.
It is 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, Teixeira-Mckinon said the insurer rejected a claim for accident damage on the basis that the brake shoes on the vehicle and the right rear brake disc were worn. In the claim form submitted by the complainant, he stated that he swerved to avoid a pothole when the vehicle fell to its side.
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. No mention had been made of the brakes being applied at the time of the loss and, therefore, the insurer had not established a causal connection between the unroadworthy brakes and the accident.
The NFO issued a provisional ruling for the insurer to settle the claim, which the insurer agreed to abide by.
“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.
“Follow the maintenance intervals recommended by your vehicle’s manufacturer. By not maintaining your vehicle’s roadworthiness, you run the risk of not only compromising your insurance cover in the event of a claim and possibly having to pay for your own vehicle’s repairs but also having to pay for any damage you cause to another motor vehicle and property.
“Ensuring that your motor vehicle is roadworthy is not only a legal requirement but a contractual obligation if your vehicle is insured,” said Teixeira-Mckinon.
ENDS
