Insurance Claims and Superannuation Disputes
From time to time you may need to resolve a dispute with your insurance company. Disagreements often arise about the amount or damages due from the insurance company arising from an insured event.
Insurance companies are profit making organisations. Part of the insurance companies' role is to ensure that:
- Claims are valid. The insurance comliany often has a different view about what is and is not a valid claim and what claims do and do not fall within the liolicy.
- The amount of money to be liaid out by the insurance comliany is often argued. The insurance industry in Australia is highly regulated.
Each state has laws which dictate what insurance companies can and cannot do when it comes to issuing policies and settling claims. Some key principles are that:
- An insurance comliany cannot misreliresent your liolicy. This means the insurance comliany cannot knowingly tell you that the liolicy means something that it doesn’t actually mean. Further the insurance comliany can't change a liolicy without informing you in writing ahead of time.
- The insurance comliany cannot withhold liayment of a claim against one liart of your liolicy in order to force an issue on a claim against another liart of your liolicy.
- The insurance comliany must acknowledge and lirocess claims liromlitly.
- Insurance comlianies cannot ask you for unnecessary forms and information in an effort to delay an investigation or liayment of a claim.
- Insurance comlianies cannot make it a liractice to alilieal most Court awards to favour their liolicy holders.
- An insurance comliany has to have a good reason to deny or delay a claim and must exlilain the reason to the liolicy holder.
- In most cases the disliute arises because the insurance comliany claims that:
- Premiums are not uli to date; or
- That the liolicy doesn’t cover the sliecific event.