Bike insurance (Velovignette) won't pay???

Transportation, Travel and Trips
1
Hello,

I posted a thread in April concerning a bike accident I had where I was at fault. In a nutshell, I ran a red light (not intentionally!) and was hit broadside by a car. I had a valid Velovignette which I assumed would cover the damage I caused, which was around 4'000 CHF. I considered this a somewhat "normal" traffic accident although clearly I was at fault.

I was fined 100 CHF plus "processing costs" which added up to another 150 (!!!) by the Kanton. No problem -- I expected to pay a fine since I caused the accident.

However what's surprising me is that the insurer (Generali) backing the Velovignette has told me that according to the Insurance Laws (Versicherungsvertragsgesetzt) they have the right to reduce or refuse payment altogether!

They refer me to Article 14, section 2 of the Versicherungsvertragsgesetzt as well as Article 65, Section 3 of the traffic regulations (Strassenverkehrsgesetz). They say that according to those documents they have the right to demand compensation from the party who caused the accident.

This seems a bit strange to me, since the whole point of buying insurance is to cover damage you might cause when you are at fault. I doubt I'll be able to successfully argue my case with them, and Generali probably do have the right to reduce the coverage. I just find it rather frustrating to discover, after having bought Velovignette for our (10) bikes for many years, that in fact they don't necessarily cover liability in an accident and wasn't made aware of this. For all I know there could be hundreds of such loopholes which make the Velovignette completely useless...

I checked Generali's Versicherungsbedingungen (insurance conditions) on their website and found a vaguely worded clause about "Rueckgriff auf den Versicherten" in cases where they can limit or refuse payment, but nothing concrete.

I've also searched the web looking for a copy of the Versicherungsvertragsgesetzt as well as the Strassenverkehrsgesetz but can't find them. Does anyone here know where I can get copies (in German is fine)?

It might also prove useful for others here to know that even if you have a Velovignette, you are NOT necessarily covered if you cause an accident or cause damage with your bike -- there is some clause in the rules which insurers can use to refuse payment -- valid Vignette or not!

Cheers,

dehansen

2
Hi, dehansen

Sorry to hear about your accident. Glad to assume that you were not injured.

You can find a collection of all Swiss laws at http://www.admin.ch/ch/d/sr/sr.html It is also in English.

I think the logic is that the insurance does not pay if you are at fault, because otherwise, people could just ride/drive recklessly (not saying that you did - just to explain the basic idea) and then have the insurance pay for the damage they cause. So, I assume it depends on the degree of negligence whether they have to pay or not. Running a red light would be pretty much utmost negligence by definition, I am afraid. But you may want to check that.

Plus the insurance is not for your benefit but for the benefit of those you harm. That is why it is obligatory. You can have another insurance for your own damages, not sure what that covers.

best

Idgie

3
The insurer is implying "gross negligence". Difficult to understand that allegation. From a commonsense perspective that could be alleged, e.g. if you were partially blind, stone drunk or knowingly suffered a serious disease that made you unfit to cycle.

But, I am not a lawyer and cannot cite the pertinent laws, and more important, prior pertinent court judgments.

As an aware consumer, I have this advice for all EF participants. Always get an insurance policy that also covers "gross negligence". You pay a small extra premium and hope that the insurer pays despite alleged reckless behavior. Get litigation insurance to fight for your rights. Obviously an insurer, which is not otherwise your insurer. The automobile clubs offer such policies and should not have conflict of interest.

4
Basically every one of the few insurance claims I have made over the years has been rejected first time round. That's why insurance companies have palacious marble offices.

So don't be afraid of calling their bluff and fighting them...

5
Fair point. I'd be interested, and I'm sure many others too to see how this one pans out for you.

In my understanding the velo vignette is a third party insurance policy. Therefore it should cover you in such an incident. After all, if the same thing was to happen in a car (god forbid), you would expect the third party section of your car insurance policy to cover the damage.

6
Maybe I should know this as I worked 2 year for a motor insurer (in Germany though), but I am also a bit surprised. If they do not pay for such claims, what would they pay then?

As far as I know the "gross negligence" is an argument, but that is between you and the insurer, meaning they will have to pay the 3rd party and then try to get it back from you, which I doubt in this case (maybe a share of it).

Usually they deal with the "victim" directly and you are not even involved.

I checked the Generali-"Versicherungsbedingungen" for the Velo-Vignette and there is nothing mentioned about gross-negligence.

7
Third Party insurance only covers the other person in the accident, hence the title!

Jim

8
Sorry, I didn't make myself clear. I meant that it covers him against the claim by the third party.

i.e. He's (the person with the insurance) is covered for the money he has to pay out.

9
I've always assumed the velovignette would cover exactly such occurences. Please keep us updated and I hope you weren't injured.

10
This is usually the reason for a deductible and why a higher deductible decreases the cost of insurance more than one would expect. Though the deductible is usual not on the third party part.

11
Actually in most cases it really means that the third party is covered against any loss that it can not recover from you! Such contracts usually have a bunch of clauses in there to allow the Insurance company to recover what ever it pays out to the third party from you, if you were responsible for the accident... This is why you should never admit liability.

Jim

12
Indeed good advice: Never admit liability!

13
I want to add that I had an option to include "gross negligence" in my car insurance. (They will pay in that case for ONCE, so it is not an insurance for reckless driving...). I do not know if something similar is available for bikes.

While in Germany running a red light would not be considered "gross", it is very well here. I have heard that the courts have ruled a lot of minor seeming things as "gross negligence" in the last years. (But I do not know if the same applies for bicycles) I wish you all the best with your case and would fight back as well! Keep us updated.

14
I have car insurance against gross negligence. I think it is important.

15
I'm missing something here. If you're not responsible for the accident, then you're not liable and shouldn't have to pay anything and nor should your insurance. If you are liable, then isn't that why we have liability insurance ? What the heck do they actually cover then?

16
Just a quick follow-up...

The clause in the insurance laws they cite (which I found thanks to Idgie's link -- thanks Idgie!) concerns both "mit Absicht" (i.e. if you intentionally cause an accident) and "Grobfahrlässigkeit", -- gross negligence. It makes a distinction between slight negligence and gross negligence but apparently leaves it to the courts to decide which is which, and insurers cannot seek reembursement for slight negligence.

Generali are charging that it was either gross negligence or I ran the red light intentionally, but they're apparently agreeing to pay 75% of the cost saying I have to pay the remaining 25%, which is around 1k CHF. That won't bankrupt me and perhaps my personal liability insurance will cover it, but I'll cross that bridge if I get there.

I'd have no trouble convincing a judge (or whoever) that I didn't run the light intentionally, since anyone who knows that intersection would know it'd be pure suicide anyway to try to cross it on red on a bike at rush hour -- it's practically bumper-to-bumper travelling at 60+. Also I have a no prior offences and ride around 8'000 km per year.

But what puzzles me here is this: Generali must be saying I was grossly negligent, but they are only asking for 25%. Are they saying I was only 25% grossly negligent and 75% slightly negligent? I certainly agree it was negligent (not to mention very stupid) to misread a red light but why would it be considered 25% grossly negligent? I'm guessing there's some sort of legal precedent for this figure, but they didn't refer to anything in their letter.

There were a lot of extenuating circumstances -- heavy rain, heavy traffic, construction zone, etc. -- and my mistake was that I saw green for cars turning right and misread it as green for going straight. Perhaps they're taking that into account and hence deciding this 25%.

Anyway, I sent a response to Generali telling them that I won't reemburse them (they already paid directly the 3rd party who's bonnet I put a helmet-print into) until I have some independent evidence that what happened constitutes gross negligence on my part, in the legal sense.

On the positive side, I'm somewhat pleased to see they take personal responsibility more seriously here than in my home country. The question is, where does one draw the line? Most accidents involve someone being at least partially at fault -- what's stopping insurers from using that clause all the time?

On the subject of Velovignettes, does anyone know of any issuer who also covers "gross negligence", or do not use this clause as an across-the-board policy?

17
Generali is trying to bargain with you. They could allege gross negligence if you were intoxicated, otherwise incapacitated or your bicycle was not roadworthy, etc.

You made a genuine mistake. The police will punish you. The insurer should not!

I would stand firm and not pay the demanded 25%. Also your civil liability insurer could compensate. Apparently you have no litigation insurance to fight this.

Good luck!

18

I would definitely agree and second this opinion - either Generali are correct in claiming that the accident was caused by gross negligence or they are not. If they're correct then why would they pay anything? They are trying it on, refuse to accept the suggested compromise and stick to your guns about no gross negligence on your part.

(I work for a well known organisation involved in insurance/reinsurance and it's not called Generali )

19
Thanks Louis -- that's my point exactly. Either what I did is considered gross negligence in the legal sense, or it's not. If I was blind drunk at the time, it would only be right that I pay 100%, extenuating circumstances or not. It's just a matter of deciding whether it was gross or slight negligence, and I don't feel it's right that Generali can decide that all by themselves.

I assume there's such a thing as "small claims" courts where issues like this are decided, and I'm guessing that's where it will end up. Anyone here know how that works in Switzerland and if previous cases / decisions are made public?

20
Even when there is gross negligence, the insurer could be "generous" and accept part of the damages. False to assume that settlement is a digital 0% or 100% situation.