As a result,
any insurance claim that remains dependent on such test results could
potentially end up being considerably delayed.
According to Justus van
Pletzen, Chief Executive Officer at the Financial Intermediaries Association of
Southern Africa (FIA), pathology results can often be vital in the finalisation
of certain insurance claims.
"Forensic test results are often essential
in serious cases such as those where someone has been killed or seriously
injured in an accident. This is particularly relevant if alcohol or drugs are
thought to be contributing factors."
Van Pletzen says such results can
also be vital if an insurance company is investigating claims for damage to
property. "If someone has a car accident or damages property whilst under the
influence of drugs or alcohol then an insurer can repudiate a claim. However,
this may need to be proven through a forensic test which can potentially delay
any settlement.
He says the FIA has been assured by a number of
insurance companies that they are aware of the situation and will take every
possible step not to delay decisions regarding the settlement of such claims.
"It is positive that insurance companies are choosing not to simply wait
for the official test results before deciding whether to settle on a claim, even
though this may often be a stipulation of the policy.
"Insurers can
obtain relevant information in a number of other ways including police reports,
witnesses and family members, as well as examining the particulars of the event
and past history in order to reach a reasonable conclusion."
He says in
some cases the outcome may be a partial interim payment, while other insurers
have agreed to meet a claim on condition that an 'acknowledgement of liability'
statement is signed, guaranteeing that the amount will be paid back to the
insurer should an eventual analysis find traces of alcohol / drugs."
Van
Pletzen says that while insurance companies are actively trying to work with
clients to find solutions to the ongoing delays, it is important for consumers
to be aware of their rights in such a situation. "Insurers should not repudiate
a claim on the basis that the insured (consumer) needs to provide satisfactory
proof that they did not have traces drug / alcohol in their system.
"These delays are frustrating for all parties involved and cases that
require forensic pathology tests are often by their nature traumatic. However,
by working together, consumers and insurers can attempt to alleviate some of the
stress involved to ensure a speedy resolution, even if a test result is not
available," says Van Pletzen.