Priority Disputes in the World of Accident Benefits - Diamond and Diamond Lawyers
  • Tuesday, 28 June 2016

Priority Disputes in the World of Accident Benefits

#AskTaniaFleming

Priority disputes are common in the world of accident benefits. In many cases, it can be difficult to determine which insurance company to file a claim under. This becomes more pronounced when driving a company car or borrowing a friend’s vehicle.

The general rule is that if you have your own policy, are listed as a driver on a policy, have a spouse with a policy or are dependent on someone for financial support or care, priority will always go to that policy. It does not matter where the accident occurred, if you fall under any of these you must apply to that policy first.

In situations where clients are covered under multiple policies, for example, personal policy (their own or their spouse) and an employer’s policy, priority in that situation will fall to the vehicle there were in at the time of the accident. For example if a person was driving their own vehicle but are also listed on an employer’s policy, they would claim under their own.

If a person is involved in a motor vehicle accident as a passenger or a pedestrian and truly does not have any insurance policies they would fall under, then priority falls to the vehicle they were in at the time of the accident or the vehicle that struck them (depending on the situation).

In rare circumstances, for example, a pedestrian that is struck and the vehicle leaves the scene, an application can be made to the Motor Vehicle Accident Claims Fund.Regardless of all the above scenarios, priority disputes still do occur. This is not something the claimant needs to worry about. During the dispute, the insurance company receiving the claim will still need to adjust the file accordingly and in good faith until the dispute is resolved. If the file does end up being transferred to a different insurer who is determined to have greater priority over the claim, the transition is smooth and does not affect the claim.

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