Insurance contract: special
case of driver or private life accident cover
In the presence of bodily injury, the assessment of the compensation due by the responsible third party will be determined according to the common law regime detailed in the previous sections.
The situation may be considerably different when it comes to assessing the contractual indemnity due under an insurance contract.
The occurrence of bodily injury may in fact give rise to the application of the guarantees provided for in insurance contracts known as “private life accidents” or the “driver’s guarantee” appearing in the automobile insurance contract of the victim.
In the case of the driver's guarantee, this type of guarantee is most often not combinable with the compensation that would be due by a responsible third party.
This therefore means that the driver’s guarantee will – in principle – be applicable in the long term if, and only if, the victim driver is held to be at fault and therefore cannot receive any compensation from a third party involved in the accident.
This clarification having been made, the determination of the contractual compensation due by the insurer offering private life guarantees and driver’s guarantee is sometimes made with reference to tables incorporating specific scales, and sometimes with reference to certain items of damage, compensated according to the rules of common law.
A clarification must be made concerning this last scenario.
Several insurance contracts still on the market refer to the old bodily injury assessment nomenclature.
For example, it is not uncommon to find the notions of partial permanent incapacity (IPP), or total temporary incapacity (ITT).
In this case, and more generally in all situations where the insurer is called upon to interpret the contractual stipulations, the victim must be vigilant so as not to be prejudiced in his rights.
Depending on the meaning to be given to the terms of the contract, the compensation due to a victim may in certain cases increase by a factor of ten, for the same conclusions of medical expertise.
Your lawyer is at your disposal to support you and assert your rights.