The number no one is watching
New NZTA data obtained under the Official Information Act shows 39 people died in fatal crashes caused by a medical event in 2025, the highest annual figure in at least ten years. That beats the previous peak of 33 deaths in 2022 and more than doubles the decade low of 19 in 2018.
Here is the part that should make business owners sit up. Deaths caused by a medical event are excluded from the official road toll maintained by the Ministry of Transport. So this category attracts almost none of the routine scrutiny that drink-driving or speed does. It is a growing risk hiding outside the headline number everyone else is arguing about.
A caveat matters here. NZTA notes that before 2023, some medical-event cases may have been left out of the records, so the long-run comparison needs care. But the direction of travel over the reliable years is real.
An ageing workforce is the driver
The demographics behind this are not a mystery. The number of licensed drivers aged 75 and over has jumped 53% in the past decade, far outpacing the 17% growth in the total licensed driving population. As of April 2026, 11,806 people aged 90 held a current licence, up 40% on ten years ago.
The AA’s road safety spokesperson connected the threads directly, warning that with an ageing population and more people living longer with chronic conditions, there is more chance of a stroke, heart attack or seizure leading to a crash. The AA also cautioned against over-reading one year, saying it would want to see the increase sustained over several years before calling it a genuine shift.
For employers running trades vans, delivery routes, sales fleets or company cars, the implication is structural. An older workforce in driving roles carries a higher baseline risk of a medical event behind the wheel, and that risk climbs as your team ages.
The licensing system won’t catch it for you
Don’t assume a valid licence means a fit driver. NZTA’s own December 2024 fitness-to-drive guidance concedes that most drivers under 75 hold 10-year licences, which is “enough time for medical conditions to develop to a point where drivers become medically unfit.” The guidance states plainly that the country needs confidence that all drivers are medically fit, and that failing to assess it puts lives at risk.
That system leans on GPs to flag concerns between renewals. It is passive by design. It depends on patients disclosing conditions and doctors raising a subject many people would rather avoid. Nowhere in that framework is there anything facing the employer. A worker can hold a valid New Zealand licence while being medically unfit to drive, and the business may have no way of knowing.
Where the liability sits
This is why the story belongs on a business owner’s desk, not just a transport analyst’s. The Health and Safety at Work Act 2015 requires businesses to eliminate or minimise foreseeable risks to workers and others. Driving on work business is a work activity, full stop, and it has to be managed like one.
Most fit-to-drive policies cover fatigue, alcohol and drugs, because those have visible indicators and established testing. Medical fitness for chronic conditions such as cardiovascular disease, diabetes, epilepsy or early cognitive decline is harder to check and often not addressed at all. That is the gap. Industry commentary has long argued that driving is the work activity most likely to cause serious harm, yet many firms fail to treat it with the rigour they apply to cyber or financial risk. Australia already runs formal Chain of Responsibility laws that push liability up to schedulers and directors. New Zealand has no direct equivalent, but WorkSafe has shown it will pursue organisations, not just drivers, where governance failures contribute to harm.
The cost of getting it wrong
The exposure is not trivial. The Ministry of Transport values the social cost of a road fatality at more than $15 million, and consultancy analysis reported by RNZ found the true cost of a crash can run up to 70% higher once network disruption is counted. For context, NZTA’s OIA crash data recorded 250 fatal crashes in 2024, so 39 medical-event deaths is a meaningful slice of the annual total.
For a business whose employee causes a fatal crash on work duty, the bill extends well past the vehicle. WorkSafe investigation, possible prosecution, civil liability, reputational damage and lost productivity all stack up.
What to fix now
The practical questions are straightforward. Does your fit-to-drive policy explicitly cover medical conditions, not just fatigue and substances? Do you have a route for staff to disclose new diagnoses or medication changes? For older workers, is there a structured health check in your fleet programme? And have you cross-referenced your policy against NZTA’s fitness-to-drive standard?
The road toll everyone watches is holding, with the October to December 2025 quarter recording 60 fatalities, below the average of 87.2 since 2021. But the medical-event line is heading the other way, sitting quietly outside the official count. As your workforce ages, it becomes a fleet risk you own whether you have planned for it or not.
Sources
- 1News: Fatal crashes caused by medical events jump in latest figures (2026-07-10)
- 1News: Are older drivers more dangerous? What data shows as NZ’s population ages (2026-06-24)
- NZTA: Medical aspects of fitness to drive – a guide for health practitioners (2024-12)
- Ministry of Transport: Road Safety Objectives Report Q4 2025 Q1 2026 (2026-03-13)
- NZTA: OIA-20271 fatal and serious crash data 2014-2025 (2025-11-17)
- Ministry of Transport: Safety – Road deaths
- RNZ: Crashes cost up to 70% more than expected, data shows