Friday 29th April 2022 from 9am

Wills & Estates Senior Associate Debbie Sage will join Robyn Hyland to talk about the importance of planning for end-of-life care and what options are available.

Has Your Insurance Company Denied Your Claim?


Come and see us for legal advice on what your rights are in relation to a claim. Commercial litigation lawyer Charles Lethbridge discusses some of the issues that arise with claims against insurance companies.

Attwood Marshall has a long history of fighting insurance companies across a broad spectrum of claims.

The majority of people hold insurance policies for a wide variety of cover. The average family has insurance for their home and contents (including cover for public liability claims), motor vehicle insurance, business insurance and total and permanent disability and death cover with your superannuation policies. Most business people and professionals have compulsory professional indemnity insurance to cover them for claims in the event of negligent advice or work that results in their clients or customers suffering losses. The majority of people pay their premiums for most of their lives and rarely or never actually end up lodging a claim in respect of these policies. This is what the insurance companies hope will happen so that they make money from the premiums that they collect.

In most cases people feel secure that they hold insurance and therefore are able to rely on this if a claim ever has to be made. Unfortunately, nothing could be further from the truth. Insurance companies have a habit of denying liability for claims that are lodged with them for various reasons. Most people don’t bother to read the fine print of their policies and do not understand what exclusions apply to their insurance cover.

For example, if you hold comprehensive insurance on your motor vehicle, it is a common exclusion in most policies that if you leave the keys in your car and it is stolen, you are not covered for this. This applies even if the car is securely parked in your garage at home! We had a recent case where a client was in his business vehicle and got out of the car to quickly check whether he was at the right place (he left the car running a couple of metres away on the road). When he came back to the car someone had jumped in and taken off with it. The claim was rejected on the basis that he left the keys in the car and did not properly secure it. It was an expensive lesson for the client. The car was still under finance and because he had no insurance cover, it cost him over $40,000.00.

There are other obvious exclusions with motor vehicles that people often overlook:-

  • The age and/or experience of the driver – some policies only cover drivers over a certain age, i.e. over 25 years;
  • If you have an accident and you are over the limit for drink driving (.05) or you are charged with driving under the influence of drugs;
  • If you have an accident and are charged with certain offences you are not covered by the insurance;
  • If you fail to disclose your traffic record before taking out the insurance or the traffic record of certain drivers, insurers may attempt to deny liability on the basis that they would not have covered you had you disclosed your driving record.

Another area where insurers often deny liability claims is where there has been a fire that destroys a home or business premises. The insurance companies appoint investigators who go to great lengths to attempt to gather evidence which may show that the fire was deliberate. We have been involved in many cases where there has been an accidental fire but the clients have been literally put through hell by the insurance investigators who treat them like criminals and attempt to show that they have deliberately lit the fire for financial reasons or some other exclusion point that would allow the insurance company to deny the claim.

Not only are the customers already distraught over losing their house and contents due to fire, they then have to deal with the lengthy and upsetting process of dealing with the insurance investigators. In many cases, it is not until clients have engaged lawyers and threatened to sue the insurance companies that they have finally reluctantly agreed to pay for the claim made under the policies. In many cases these claims are made by clients who have had insurance all their lives and have never made a claim. Similar issues arose with the recent weather disasters that hit NSW and Qld. There were many claims denied for various reasons but many of them centred around the definition of “flood damage” and other technical issues that were very distressing to home owners who lost everything in some of the storms and flooding that affected these two states in recent times.

There has been a proliferation of new insurance companies that have flooded the market in recent times promising cheaper premiums and better service. As with all insurance or financial products, you should ensure that you carefully read the terms and conditions of the insurance policies and be very clear about what exclusions apply to your cover. This may not necessarily assist you because many of the policies are worded in such a way that it is difficult to clearly understand what circumstances are covered and which are not. Lawyers struggle with interpreting their own policies and in some cases it is more prudent to utilise the services of a reputable insurance broker. Insurance brokers know the terms and conditions of the policies that they deal in and also shop around for the best deal for your particular circumstances. Normally their fee is paid by the insurance company who they recommend you to.

If you have a claim against an insurance company and you believe they have unfairly denied liability for the claim, please contact us to obtain preliminary legal advice in relation to your rights. In many cases we will accept claims on a “no win no fee” basis if you have reasonable prospects of success and your financial circumstances are such that you cannot afford to pay for your legal services.

If you would like more information or want to obtain the best possible chance of a successful outcome in your dispute , please contact our Commercial Litigation Department Manager, Amanda Heather on direct line 07 5506 8245, email or free call 1800 621 071.

We have an experienced dedicated Commercial Litigation team that practices exclusively in these areas.

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Charles Lethbridge - Partner - Commercial Litigation

Charles Lethbridge

Commercial Litigation

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The contents of this article are considered accurate as at the date of publication. The information contained in this article does not constitute legal advice and is of a general nature only. Readers should seek legal advice about their specific circumstances. 

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