Even the most comprehensive and protective automobile insurance contract cannot excuse certain behaviors on the part of the driver.
Whether the latter was traveling without having the right to do so in the eyes of the law, or even he was guilty of a serious traffic offense, the insurer is justified in refusing him any compensation in certain cases called “Warranty exclusions”.
Some exclusions are known and others a little less, which can therefore lead to cruel disillusionment for the driver who thought he was protected and is then forced in the worst case to reimburse substantial sums to victims who have suffered an accident prejudice through his fault.
The exclusions obey a precise regime, which it is advisable to know well!
According to the constant case-law of the Court of Cassation, an exclusion of cover can be defined as a contractual provision that “deprives the insured of the benefit of the cover in consideration of particular circumstances” linked to the conditions in which the loss occurred and the risk has materialized.
It is therefore a sanction taken by the insurer, in particular when the loss is directly linked to bad behavior on the part of the driver.
The insurer, depending on the elements of which it is aware (for example the opening of legal proceedings for drunk driving) decides alone to raise an exclusion of cover, provided that the latter is well provided for within the auto insurance policy in question.
Exclusion is a severe measure since it has the effect of depriving the insured of any compensation (but not his victim of course).
The exclusion should not be confused, even if it is often, with the “forfeiture of guarantee” which has the same effects but sanctions the insured when the fault is committed after the loss ( late or even false declaration, clearly exaggerated prejudice…).
A formalism to respect
Because of their very important consequences for the insured, exclusions of cover must obey draconian rules of formalism.
Article L112-4 of the Insurance Code requires any provision enacting a nullity, forfeiture, or exclusion to appear in the body of the contract, and “in bold letters .”
There is therefore no question for the insurer to add a reason for exclusion by a footnote written in lowercase characters: you would then be justified in contesting the legitimacy of this clause.
Any warranty exclusion, on the other hand, must be very clearly presented as such in the contract, with the mandatory use of the word “exclusion”.
Most often, and for greater convenience, the various exclusions provided for by the insurer are grouped under a single chapter of the contract entitled “Cover exclusions”, and therefore easily identifiable.
This does not exempt you from being wary, and from reading the entire terms of the document carefully before committing yourself!
Free quote, guaranteed savings
Auto insurance is a budget… To drive serenely without breaking the bank.
- Legal warranty exclusions
There are two types of warranty exclusions.
They are provided for by law, and therefore mandatory for both the insurer and the insured, and those known as contractual which are freely added to the contract.
There are only two exclusions from legal or “public order” guarantees, and are set out in article 211-10 of the Insurance Code:
If he was driving without a driver’s license, or following the invalidation suspension or cancellation of his license the insured person will not be entitled to claim compensation.
In this case, remember that it also incurs a criminal penalty, since the lack of a driving license constitutes an offense.
However, this exclusion does not apply if the vehicle has been used by someone other than the insured, without his knowledge, or unwittingly ( theft of the vehicle, unauthorized borrowing, etc.).
If passengers were transported in non-compliant safety conditions, the insurer may refuse to assume the cost of their compensation, in particular in the event of serious injuries suffered by the latter.
Be careful, however: he will assume the compensation at first, but will then turn against his insured to have him reimburse the advanced costs.
The driver is responsible in all circumstances for the safety of his passengers, and in particular of minor passengers.
“Non-compliant safety conditions” are assessed on a case-by-case basis: generally, however, be aware that not wearing the seat belt will not be considered sufficient to justify a total exclusion, and will instead result in a reduction in the amount of compensation.
Read also: Covid – 19 Tax Implementation
- Contractual warranty exclusions
Apart from the cases provided for by law, insurers take care to add other exclusions to their contracts.
The exclusion of cover following the commission of a traffic crime is the most classic.
It notably includes driving under the influence of alcohol or drugs, refusal to comply, high-speed crime, or even hit and run.
The insurer will only be able to take advantage of it if the loss is linked, at least partially, to the infringement. A drunk driver, for example, may still try to claim compensation following an accident caused by the other motorist.
This case, however, remains very rare!
Other clauses leave the field of criminal law, and are content to set limits on the conditions of use of the vehicle: certain exclusions relate.
for example; the loan of the steering wheel to another driver, the use of the vehicle within the framework of automobile races, and the towing of caravans when the insured vehicle is not intended for this.
Finally, and if automobile insurance includes protection against the theft of objects inside the passenger compartment, it is generally accompanied by an exclusion of guarantee when the theft is committed without breaking (doors unlocked) or when the objects were stolen are precious.
Consequences of a disclaimer
Even if the conditions of the loss validate the exclusion of cover in an indisputable manner, the insurer remains free to make his decision.
He can first of all refuse any compensation entirely or, in the presence of a victim compensate the latter and then take action against the insured.
Depending on the context, the insurer may nevertheless also be lenient and accept the principle of partial compensation.
How do I dispute a disclaimer of warranty?
If you are not involved in any claim at present, but you simply wish to contest in principle an exclusion of guarantee that you have just discovered to exist in your contract, the possibilities of contesting are thanks.
In this case, wait for the date of the first anniversary of your automobile insurance contract.
From that day, and under the new provisions of the Hamon law for the automobile, you can terminate your contract at any time and choose one another less restrictive.
If you are the subject of an exclusion of cover which you consider excessive or disproportionate, it is first of all necessary to send officially to your insurer a letter of a dispute as precise and complete as possible by registered letter with acknowledgment of receipt.
In the absence of an answer that satisfies you, it is then advisable to consult a lawyer specializing in insurance law before taking any other steps: only this professional can tell you whether your case has a chance of reaching court