Travel Insurance Online :: News
SHARE

Share this news item!

Insurance Dispute Settled with New Rulings

Insurance Dispute Settled with New Rulings

Insurance Dispute Settled with New Rulings?w=400
In a recent adjudication, a property owner faced a coverage denial due to damage attributed to rodents, offering a revealing insight into insurance claim disputes.
When a strata property holder reported water damage from a damaged dishwasher hose, her insurance claim was thwarted by the involvement of rodents.

The issue arose when the claimant noticed a malfunction in her dishwasher as early as April of the previous year and filed a claim in September. However, Strata Community Insurance Agencies challenged the claim arguing that the damage might engage exclusions pertaining to rodent activity.

Central to this case was a tax invoice detailing observations from a visiting plumber. According to the original report, the plumber suspected damage caused by rodents chewing on the hose. Yet, the said invoice was later altered to omit this suspicion, raising further questions about motive and clarity.

Further dialogue between the plumber and the insurer's representative disclosed that changes to the invoice were requested by the policyholder. Additionally, alternative explanations surfaced, such as potential damage from consistent interaction of the hose with the access hole each time the machine was used. The plumber did not exclude the possibility of continuous friction contributing to the damage.

The insurance provider's expert, however, observed extensive damage on the hose but reported an absence of signs that typical wear and tear would leave. The expert concluded that the use of the dishwasher was unlikely to generate sufficient force to result in such severe damage. They further stated that the condition of the hose strongly indicated rodent activity as initially suggested by the plumber.

During the dispute resolution hearing, the Australian Financial Complaints Authority evaluated the matter. They acknowledged the customer's view disputing the expert judgment but emphasized her failure to present any compelling evidence to counter the presented arguments.

The authority, after reviewing the diverse perspectives and the expert observations, ruled in favor of accepting the view that rodents were probably the primary cause of the damage. While this event originally triggered policy coverage, the clauses excluding rodent damage ultimately prevailed to deny the claim.

Echoing this outcome, an ombudsman for the AFCA commented, “I am satisfied, without evidence to contrary, it is fair that the insurer be permitted to rely on the opinions provided by the appointed consultants.” This position emphasizes the criticality of providing concrete evidence when challenging an insurer's expert analysis.

This case serves as a compelling reminder for policyholders of the complexities and critical nuances involved in insurance claims, especially those involving ambiguous causes like rodent activity. It underscores the importance of detailed documentation and professional assessments when navigating through such disputes.

Published:Thursday, 7th Nov 2024
Source: Paige Estritori

Share this news item:

Insurance News

Insurance Dispute Settled with New Rulings Insurance Dispute Settled with New Rulings
07 Nov 2024: Paige Estritori

In a recent adjudication, a property owner faced a coverage denial due to damage attributed to rodents, offering a revealing insight into insurance claim disputes. When a strata property holder reported water damage from a damaged dishwasher hose, her insurance claim was thwarted by the involvement of rodents. - read more
Financial Sectors Grapple With High Reporting of Breaches Financial Sectors Grapple With High Reporting of Breaches
07 Nov 2024: Paige Estritori

The landscape of financial services in Australia is facing challenges as recent disclosures highlight the magnitude of self-reported compliance breaches across industries. The Australian Securities and Investments Commission (ASIC) report for the last financial year has revealed that the insurance sector reported the second-highest number of breaches. - read more
Call for Stronger E-Scooter Insurance Regulations in NSW Call for Stronger E-Scooter Insurance Regulations in NSW
07 Nov 2024: Paige Estritori

The rapid increase in e-scooter usage across New South Wales has prompted renewed calls for improved insurance regulations to safeguard both riders and pedestrians. Genevieve Henderson, president of the Australian Lawyers Alliance NSW, is advocating for mandatory insurance policies that would cover private e-scooter owners and council-managed e-scooter sharing programs. - read more
Surge in Claims for Non-Advised Disability Income Insurance Surge in Claims for Non-Advised Disability Income Insurance
06 Nov 2024: Paige Estritori

Recent analysis reveals individual non-advised disability income insurance is leading the pack with a remarkable claims paid ratio of 113%. In stark contrast, individual policies acquired through personal advice boast a much lower ratio of 68%, as outlined by the latest prudential data. - read more
Controversial Fire Ruling: AFCA Endorses Claim Denial Controversial Fire Ruling: AFCA Endorses Claim Denial
06 Nov 2024: Paige Estritori

A recent decision has stirred considerable attention as an Australian Financial Complaints Authority (AFCA) ruling supported RAC Insurance's denial of a fire claim amidst significant controversy and debate. - read more


Travel Insurance Articles

Clever Ways to Save on Accommodation: Budget Travel Hacks for Aussies Clever Ways to Save on Accommodation: Budget Travel Hacks for Aussies
The concept of travel in Australia inherently brings to mind sweeping landscapes, rugged coastlines, and vast outback adventures. For many Australians, the dream of traversing this scenic wonderland is often tempered by the cold reality of expenses, with accommodation often being a prominent budgetary concern. Yet, far from dimming the wanderlust, this challenge invites a more clever approach to journeying through the land Down Under. - read more
10 Must-Have Items in Your Travel Kit for Financial Security While Abroad 10 Must-Have Items in Your Travel Kit for Financial Security While Abroad
When it comes to travelling abroad, there's more to preparation than just packing the right clothes and booking your flights. For Australian travellers venturing overseas, assembling a financial travel kit is just as vital as a passport. This kit serves as your safeguard, ensuring that even when faced with the unpredictable, your journey remains as smooth as possible. - read more
The Essential Guide to Travel Insurance for Australian Travelers The Essential Guide to Travel Insurance for Australian Travelers
Planning a trip is always an exciting experience, but it’s essential to be prepared for unexpected events. This is where travel insurance comes in. For Australian travelers, having the right travel insurance can make all the difference, offering peace of mind and financial protection. - read more
The Essential Guide to Travel Insurance for Australians on a Working Holiday in Canada The Essential Guide to Travel Insurance for Australians on a Working Holiday in Canada
Welcome to your guide to embark on an amazing journey from Australia to the breathtaking landscapes of Canada on a working holiday. This adventure presents an inviting blend of work and travel, allowing you to immerse yourself fully in Canadian culture while supporting your explorations financially. - read more
How to Choose the Right Travel Insurance for Your Overseas Holiday How to Choose the Right Travel Insurance for Your Overseas Holiday
Travel insurance is an essential component of any overseas trip, especially for Australians. While exploring new destinations and experiencing different cultures can be exciting, it's crucial to be aware of the potential risks and challenges that can arise along the way. From unexpected medical emergencies to lost luggage or trip cancellations, unforeseen events can quickly turn your dream holiday into a nightmare. - read more
How to Save Money on Travel Insurance Without Compromising on Coverage How to Save Money on Travel Insurance Without Compromising on Coverage
Travel insurance is an essential component of any trip, providing protection and peace of mind for Australian travelers. Whether you are planning a short weekend getaway or an extended overseas adventure, unforeseen circumstances such as medical emergencies, trip cancellations, or lost luggage can quickly derail your plans and drain your finances. - read more
The Essential Guide to Travel Insurance for Australians on a Working Holiday in Canada The Essential Guide to Travel Insurance for Australians on a Working Holiday in Canada
Welcome to your guide to embark on an amazing journey from Australia to the breathtaking landscapes of Canada on a working holiday. This adventure presents an inviting blend of work and travel, allowing you to immerse yourself fully in Canadian culture while supporting your explorations financially. - read more
How to Choose the Right Travel Insurance for Your Overseas Holiday How to Choose the Right Travel Insurance for Your Overseas Holiday
Travel insurance is an essential component of any overseas trip, especially for Australians. While exploring new destinations and experiencing different cultures can be exciting, it's crucial to be aware of the potential risks and challenges that can arise along the way. From unexpected medical emergencies to lost luggage or trip cancellations, unforeseen events can quickly turn your dream holiday into a nightmare. - read more
Travel Troubles: How Travel Insurance Protects You from Unexpected Events Abroad Travel Troubles: How Travel Insurance Protects You from Unexpected Events Abroad
For many Australian travellers, setting off on a global adventure is an exciting prospect. Yet, amidst this excitement, it's crucial to acknowledge the unexpected twists and turns that could arise. That's where travel insurance steps in. Not just a safety net, it serves as a vital component of travel planning, providing peace of mind as you explore the world. - read more
The Essential Guide to Travel Insurance for Australian Travelers The Essential Guide to Travel Insurance for Australian Travelers
Planning a trip is always an exciting experience, but it’s essential to be prepared for unexpected events. This is where travel insurance comes in. For Australian travelers, having the right travel insurance can make all the difference, offering peace of mind and financial protection. - read more



Knowledgebase
Term Life Insurance:
A form of life insurance that is a pure protection policy with no cash or maturity value which lasts for a specific length of time, called a term.