We have had a couple of clients in recent times who have either had an insurance claim denied or unreasonably investigated.
Our client had a fire at his unoccupied holiday home. It was investigated by fire services and police. Our client submitted a claim, for substantial damage to the property. The insurer contracted an investigation service to investigate the claim. Our client then received requests to:
- Take part in a video recorded interview
- Supply his mobile telephone records for dates two weeks prior and two weeks post the incident.
- Provide his financial and banking records
- Provide his current employment records.
This also caused a significant delay in the processing of our clients claim.
Most insurance policy documents state that as the insured you have an obligation to “reasonably cooperate” with the insurer when managing your claim.
The word “reasonable” is often used in a legal context and can mean a variety of things.
In this situation we informed the insurer that our client was neither a suspect nor a person of interest in relation to the fire. We maintained that the requests made of our client were not reasonable and did nothing but delay the claim process.
The insurer has since dispensed with the need for our client to provide his personal information and expedited the claim.
If you have made a claim with an insurance company and are being asked to provide personal financial documents or information that concerns you, we strongly recommend that you obtain legal advice.
If you have had an insurance claim denied by the insurer there are a number of courses of action available to you:
- Make a complaint in writing to your insurer’s dispute resolution department
- Complain to the Australian Financial Complaints Authority (AFCA) – General Insurance Division
- Go to Court
- Take no action
Both the (AFCA) and the State consumer tribunals cannot accept claims over a certain monetary amount. If your claim exceeds the appropriate amount you will need to go to Court or reduce your claim to the maximum allowed at AFCA or Tribunal.
In the event that your claim is denied we would urge you to make an appointment with us for advice.
You can also find further information in our: Children and Family Law - Frequently Asked Questions, Children and Family Law, Family Law Property - Frequently Asked Questions, Family Law Property, Child Support, Divorce, Purchasing Property, Selling Property, Subdivisions, Business Sales and Acquisition, Building And Planning, Small Business, Debt Recovery, Leases and Agreements, Power of Attorney, Wills and Estates Planning, Probate and Guardianship sections.
If you require advice, assistance or guidance, in any legal matter, please call today on (03) 59757611 or Enquire Online.