You’ve been responsible and taken all the right steps; you assessed your risk and took out the appropriate policies to cover your insurance needs. When an incident occurs, you’re sure that the precautions you’ve taken will help put you and your business back on your feet in no time.

This is the ideal circumstance for business and farm insurance customers and other policyholders when faced with potential losses. Unfortunately, this is not what happens for everyone. In some cases, filing an insurance claim can lead to a lengthy and stressful dispute between the insurer and the client.

Insurance made up 26 per cent of complaints to the FOS in 2015.


Insurance claim disputes in Australia

The issue of claim disputes has come under close scrutiny lately, with the publication of a report by the Australian Financial Rights Legal Centre (FRLC), Guilty until Proven Guilty: Insurance Investigations in Australia. The report takes a look at insurance investigation practises in particular.

Insurance-related claims were the second-highest type of complaint received by the Financial Ombudsman Service Australia (FOS) in 2015. Data from the FOS’s Annual Review 2014-2015 shows that general insurance matters made up 26 per cent of the nearly 32,000 disputes received over the year.However, only 17.7 per cent of cases were established as fraud on the balance of probabilities, according to the FRLC report.

Maintain clear and accurate records of any incident when filing an insurance claim.

Strategies for insurance holders

There’s more to financial security than just obtaining the right coverage and minimising your risk of accidents. These are some steps that are essential for giving policyholders a strong case in an insurance claim dispute.

  • Be prepared: Gather any documentation of the incident. This can include any photographs or video of the damage, as well as records of the value of any damage caused.
  • Be timely: Many insurance policies will have a time limit for filing a claim. It is essential that you act as soon as possible. This also ensures that all the information is still clear and hasn’t gotten foggy over time.
  • Be clear: Making a claim is difficult if you’re fuzzy on some details of the incident. Make sure you take note of any relevant dates, times and other parties involved, and share that with your provider.
  • Be accurate: Having accurate and consistent information is essential. Avoid exaggerating any details such as the cost of damages or the severity of the incident.

When it comes to business insurance and other types of coverage, it is crucial to have a partner who can work with you and navigate policy details. Contact a broker at MGA to find out how we can support you and your insurance needs.