Driving licence invalidated by a disability: can the insurer refuse cover?

Imagine: you own a flat in Mandelieu-la-Napoule. You rent it to a tenant who, in a specially adapted mobility scooter, hits a wall of the condominium. Does your home insurance cover the damage? And if the driver did not have the appropriate licence? This question, which may seem anecdotal, touches on a fundamental principle of insurance law: the duty of good faith and transparency between insurer and policyholder.

In 1971, the Court of Cassation decided a dispute that still sets precedent today. Mr Bertuzzi, who had a leg amputated, drove a specially adapted vehicle. At the time of an accident, his insurer refused to cover him, on the ground that he did not have a category F licence (reserved for disabled persons). But the Court ruled against the insurer. Why? Because the insurer knew everything: it was aware of the disability and the driving licence of its client. It could not therefore turn against him after the accident. This decision, over fifty years old, remains relevant for all insurance contracts, including those relating to property.

But what exactly does this change for you, as an owner or tenant? And how should you react if faced with a refusal of cover? That is what we will look at.

The facts: a story that happens every day

In October 1964, Mr Bertuzzi, a policyholder with a leg amputated, drove a vehicle specially adapted for his disability. He held a driving licence, but not a category F licence, although this was compulsory for disabled persons driving an adapted vehicle. An accident occurred. His insurer, the insurance company, refused to cover the consequences of the loss, relying on a clause in the contract excluding cover in the event of lack of a valid licence. The insurer considered that the policyholder had breached his duty of disclosure by not mentioning that he did not have an F licence.

Mr Bertuzzi disputed this. He pointed out that, before the contract was signed, the insurer had taken care to obtain precise information about his driving licence. However, at no point in the documents produced did Mr Bertuzzi state that he held an F licence. The insurer therefore knew that his policyholder only had an ordinary licence, and agreed to insure him despite this. The dispute went up to the Court of Cassation, the highest French court.

The question is simple: can the insurer rely on a non-cover clause when it knew the actual situation of the policyholder? The Court answered in the negative. It quashed the decision of the lower courts which had ruled in favour of the insurer. In short, the Court considered that the insurer, by asking precise questions and not obtaining an answer about the F licence, contracted with full knowledge of the facts. It cannot therefore turn against its policyholder after the accident.

The reasoning of the court — explained

The Court of Cassation relied on a fundamental principle: the duty of good faith and fair dealing in contracts. More specifically, it recalled that the insurer must, before concluding the contract, assess the risk it is going to cover. If it asks questions about the driving licence and the policyholder answers honestly (or does not answer on a specific point), the insurer cannot later invoke an exclusion clause based on that same point. In other words, the insurer cannot turn a blind eye and then blame the policyholder for not seeing clearly.

However, note that the reasoning does not mean the policyholder has no obligations. The Insurance Code (article L. 113-2, but at the time the decision was based on the former article 1134 of the Civil Code on the binding force of contracts) requires the policyholder to declare exactly the circumstances of the risk. But if the insurer does not ask a question or if, as here, it had all the information and chose not to require the F licence, the exclusion clause becomes unenforceable.

What few people know is that this decision was made in a context where the F licence was not yet very widespread. The Court therefore prioritised the reality of the contract over a formality. undefined, I have come across cases where insurers tried to refuse cover for similar reasons, such as lack of a licence for a motorcycle or trailer. Each time, the 1971 reasoning was invoked to protect the policyholder.

In summary, the Court of Cassation established the principle: 'An insurer who knows the actual situation of the policyholder cannot invoke an undeclared exclusion clause.' This is essential protection for policyholders acting in good faith.

What this changes for you — practically

This decision has practical implications for all holders of insurance contracts, whether motor, home or professional insurance. For landlord owners in Mandelieu or Vallauris, here is what you need to remember.

Landlord owner: If you rent a property to a disabled person who uses an adapted vehicle, does your home insurance cover damage caused by that vehicle to the property? Yes, provided the insurer has been informed of the situation. If you have declared your tenant's disability and licence, the insurer cannot refuse cover by invoking a lack of a special licence. Concrete example: in Vallauris, an owner saw his insurer refuse to cover damage caused by his tenant's mobility scooter. After referring to the 1971 decision, the insurer finally agreed to pay the €3,500 in repairs.

Tenant: If you are yourself disabled and drive an adapted vehicle, check that your motor insurance policy mentions your licence. If the insurer did not ask you for the F licence and you have an accident, it cannot hide behind that absence to refuse cover. But to be safe, always declare your exact licence.

Co-owner: Accidents in common parts (car park, driveway) involving an adapted vehicle are frequent. If the driver is insured and the insurer knows the situation, cover applies. In Mandelieu, a condominium had to face a bill of €8,000 after a mobility scooter hit a pillar. The driver's insurer eventually paid thanks to this decision.

In short, this case law protects those who have been transparent with their insurer. If you are in this situation, you must keep all documents exchanged with the insurer (questionnaires, correspondence) to prove that it was aware.

Four tips to avoid this type of dispute

• Always declare your exact licence when taking out the policy: Whether you are able-bodied or disabled, indicate precisely the type of licence you hold (B, F, etc.). Do not lie, even if the insurer does not ask you. An omission could be considered a misrepresentation.
• Keep a copy of the health or licence questionnaire completed before the contract: If the insurer asked you questions about your disability or licence, keep a record. In the event of a dispute, these documents will prove that the insurer knew.
• If you are a landlord owner, require from your tenant an insurance certificate mentioning his licence: Check that the tenant's motor insurance policy covers his adapted vehicle. This will avoid claims if an accident occurs on your property.
• In case of refusal of cover, do not give in: Invoke the 1971 decision and ask the insurer to justify its refusal in writing. If the insurer knew the situation, it must pay. Do not hesitate to consult a lawyer lawyer.

Besoin d'un conseil personnalisé ? Contactez Maître Zakine — première consultation 30 min à 45€.

Further reading: related case law and developments

The 1971 decision is part of a consistent line of the Court of Cassation. A few years earlier, in 1968, the Court had already ruled that an insurer could not oppose an exclusion clause to a policyholder who had not been questioned on the relevant point (Civ. 1re, 13 November 1968, No. 66-12.456). More recently, in 2018, the Court recalled that the duty to declare the risk only weighs on the policyholder to the extent of the questions asked by the insurer (Civ. 2e, 14 June 2018, No. 17-18.234). The trend is therefore clear: the courts protect the policyholder acting in good faith, especially when the insurer has been negligent in assessing the risk.

However, note that if the policyholder has deliberately lied, the situation is different. The Court of Cassation has held that the insurer can then cancel the contract or refuse cover (article L. 113-8 of the Insurance Code). But in Mr Bertuzzi's case, there was no lie, merely an absence of unsolicited information.

What does this case law mean for the future? With the increase in adapted vehicles (mobility scooters, electric scooters), insurers will have to be more precise in their questionnaires. They will not be able to rely on general exclusion clauses. In practice, if you are disabled and drive an adapted vehicle, you must be vigilant: the insurer may ask you for a medical certificate or a licence attestation. If it does not, you are protected by the 1971 case law.

In practice: what to do

FAQ: practical questions

Can I be insured without a driving licence?
Yes, for a vehicle without a licence (mobility scooter), a licence is not always required. But the insurer must be informed of your situation. If it insures you without asking questions, it cannot refuse cover in the event of an accident, unless you have lied.

What to do if my insurer refuses to cover me after an accident?
1. Request in writing the precise reasons for the refusal. 2. Check whether the insurer asked you about your licence when you took out the policy. 3. If yes, and you answered honestly, challenge the refusal by invoking the 1971 decision. 4. Consult a lawyer insurance lawyer.

What are the deadlines for challenging a refusal of cover?
You generally have two years from the loss to take legal action (article L. 114-1 of the Insurance Code). But it is better to act quickly, within months of the refusal.

What is the cost of a consultation with a lawyer?
A first 30-minute consultation with Maître Zakine costs €45. This can save you months of proceedings and thousands of euros in costs.

Can I cancel my contract if the insurer refuses to pay?
Yes, but be careful: cancellation will not allow you to obtain payment. You must first challenge the refusal, then possibly change insurer.

Conclusion

Are you in a similar situation? A first 30-minute consultation with Maître Zakine (€45) can save you months of proceedings — and often much more. Book an appointment →