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Will an insurance company pay an auto accident claim if a driver has a dementia diagnosis?

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If the person with dementia has been told my their doctor to stop driving, or if they have had their license revoked, the insurance company is within their rights to not cover a claim, even if the person with dementia is not responsible for the accident.

If the person with dementia has not been told to stop driving, here losing driving privileges is not automatic with a diagnosis of early dementia, then the insurance company should pay out.

I am in BC, Canada, and worked for many years doing billing as well as other admin and patient facing tasks at a Physio clinic. We always recommended getting a lawyer to represent you in a car accident, whether or no you were at fault.
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RebeccaCP Sep 2020
I am in the U.S. and work in the legal department of a large insurer (8 years P & C, including claims, and 7 years on the life/annuity side). Tothill summed it up nicely. If the license is still in force, and not revoked, or the revocation process not finalized, the insurer should cover it. As one person below mentioned, you might not be renewed if the dementia played a factor somehow and the insurer is put on notice as to that fact.

I've seen plenty of cases, where an unauthorized or unlicensed driver causes an accident with the insured vehicle, where the insurer paid the damages and injuries to the third party, but not the policyowner's damages and injuries.

It's somewhat fact-specific as to what could happen - we don't know the license status of the person who was involved in the accident. We don't know what happened at the scene (i.e., did the officer have concerns as to his capacity to be driving, and turn it in to the DMV for review and possible revocation). But if he/she has a license, and you have no notice as to a revocation proceeding, and you have insurance, the insurer may very well cover it. If not, depending on the policy, the innocent third party may be covered at least.

And talking to an attorney, and bringing the policy to them for review, is certainly an option.

Best wishes.
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The insurance company may pay but will probably drop the policy.
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Another factor to consider is who caused the accident?   Do you have a copy of the police report yet?
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Pose the question to his insurance company, just as you did here: as a hypothetical.
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Isthisrealyreal Aug 2020
If you do this it puts a mark on your insurance, because to many people do this and then don't report the accident for one reason or another. It is not worth checking unless you are actually going to put the claim in.

Yea, I was completely shocked by this information as well.
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I can't speak for other States, but if there is a diagnosis of dementia in California, then this is reportable by doctors to the DMV. I must assume that there would be some sort of action taken by the DMV, but I don't know. I think the place to get this information is from an insurance company itself.
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