My insurance company is looking for a loop hole.....Advice please!.

**Hitcher** · 10th April 2006, 15:54

So the insurance company is saying its only duty of care to accept the information you provide to them is correct is when you make a claim? They're happy to accept your premium payments on the voracity of the information you provide and only check this when you claim? They should be exposed and subjected to public ridicule.

**Oscar** · 10th April 2006, 16:01

Originally Posted by Hitcher

So the insurance company is saying its only duty of care to accept the information you provide to them is correct is when you make a claim? They're happy to accept your premium payments on the voracity of the information you provide and only check this when you claim? They should be exposed and subjected to public ridicule.

Actually this is what all insurance companies do.
An insurance contract is completed on the principal of "utmost good faith" on both sides. Both parties to the contract most make full disclosure, anything else would require huge investigative resources. Think about it - if insurers checked up on every policy they issued, your premiums would increase by a factor of 10.

**Suzi Q** · 10th April 2006, 16:03

I work for an Insurance company in the claims department and completely agree - if you have forgotten about a couple of speeding tickets you should be OK, especially if you have told them about others. If you have said you had some and given them info on the ones you can remember then you were not deliberately with holding info. if they decline your claim you can lodge a written complaint that goes though the head office to be relooked at by their technical people. If you took out the insurance over the phone ask if they can listen to the call.
The speeding tickets or criminal convictions never relate to the actual claim it is whether the insurance would have been offerred in the first place or the terms and conditions of the insurance may have been different - higher excess etc.

Originally Posted by Oscar

If you've only failed to mention two speed camera tickets you should be OK.
The Insurance Law Reform Act says that an insurer can only use non-disclosure to decline a claim if the information is a "material fact". It then says that a "material fact" is information that if know, would have caused the underwriter to decline or modify cover in the first place.

In other words, had the insurer known about your speeding tickets when you originally proposed for cover, would they have declined to insure you? Doubtful.

**ManDownUnder** · 10th April 2006, 16:04

Escalate it inside the insurance co, and if there's no joy, take it straight to the insurance ombudsman highlighting the process thus far and the fact you seem to be unduly held up on this.

Keep a diary of everything you've done, and get a copy of the submitted paperwork if you can.

As I understand it, the assessors have a budget to hit in respect of the claims they don't pay out on (i.e. the money saved) and I suspect you're a victim of this.

There are a couple of insurance types in KB - I'm sure they'll be able to give you the real inside word on what's going on... but if you're in the right - don't stop pushing till you've got your money.

**Oscar** · 10th April 2006, 16:06

Originally Posted by ManDownUnder

As I understand it, the assessors have a budget to hit in respect of the claims they don't pay out on (i.e. the money saved) and I suspect you're a victim of this.

.

Where did you hear this?

**Suzi Q** · 10th April 2006, 16:07

How do you know there is a budget that they can not go over? - I am sorry but that is BS. A claim can not be declined because it may cost the company too much. I believe you are living in the clouds here!
Also only escalate ift if they decline the claim, you ahve no idea what they are thinking at the moment, give them a chance to review everything.

Originally Posted by ManDownUnder

Escalate it inside the insurance co, and if there's no joy, take it straight to the insurance ombudsman highlighting the process thus far and the fact you seem to be unduly held up on this.

Keep a diary of everything you've done, and get a copy of the submitted paperwork if you can.

As I understand it, the assessors have a budget to hit in respect of the claims they don't pay out on (i.e. the money saved) and I suspect you're a victim of this.

There are a couple of insurance types in KB - I'm sure they'll be able to give you the real inside word on what's going on... but if you're in the right - don't stop pushing till you've got your money.

**Momentum** · 10th April 2006, 16:17

Fish just sent you a pm about this?

Will pass on the info my old man gave me to you tonight.

ps: the old man owns Frankton Law down here

**Lou Girardin** · 10th April 2006, 16:17

Wait and see what happens next. If they do try to decline your claim, write to the Insurance Ombudsman.

**bugjuice** · 10th April 2006, 16:19

Originally Posted by Lou Girardin

write to the Insurance Ombudsman.

is that those 3 frogs that sit in the pond and drink that beer..??

soz, couldn't help it

**marty** · 10th April 2006, 16:23

Originally Posted by Fishslayer

Shit how are we to remember ALL traffic offences other than parking fines over the last 5 years?!.

umm let me think.

oh that's right, a parking ticket in sydney last year, and a 61 in a 50 on marine pde at the mount in 2002.

oooh that smarts.

edit: oh yeah parking tickets don't count

**Finn** · 10th April 2006, 16:24

Sorry to hear about your incident but at least you did it in style mate. There's just something to be said for "Yeah, I wrote off a litre bike"

My advice is not to piss them off otherwise the little twerp on the other end will dig their toes in. Remain calm and pleasant. Do everything they ask of you.

We've just picked up an Insurance Co as a customer...PAY BACK TIME!!! Lets see if they read the small print.

Edit: Just realised I've posted over 1000 posts. Jesus, how did you guys put up with all that dribble?

**The_Dover** · 10th April 2006, 16:26

Some people will do anything to get a Suzuki in their garage, eh?

**Ixion** · 10th April 2006, 16:27

Originally Posted by Oscar

Actually this is what all insurjnnies do.
An insurance contract is completed on the principal of "utmost good faith" on both sides. Both parties to the contract most make full disclosure, anything else would require huge investigative resources. Think about it - if insurers checked up on every policy they issued, your premiums would increase by a factor of 10.

No, it is not, and no they do not. Insurance companies insist on full disclosure by the applicant, but never disclose anything themselves. How many people taking out insurance have had the insurance company tell them what percentage of claims they decline. Or how many people they knocked back last week. Or how many applications they decline. Or even present you with a copy of their balance sheet (after all, there's been many an insurance company go belly up , and leave the insured persons in the lurch).

Shall I mention Trans Tasman Insurance ? Mutual utmost good faith ? Humbug.

No offence to any here who work in the industry, but insurance companies are blood sucking leeches of the first degree who have made bad faith into an art form. First on the list for nationalisation.