Most Australians have insurance on their homes, cars or when they travel overseas. But you might also have insurance on any loans, credit cards or club memberships.
If you have a business you will probably have professional indemnity insurance and also business interruption, income protection or key man insurance. Some insurance claims can be straightforward but many are complex, the insurer mucks you around and some claims are rejected.
Berrill & Watson Lawyers are experts in general insurance claims and disputes. For FREE advice, and help with your claim call Berrill & Watson on 03 9448 8048 or email us at firstname.lastname@example.org
General insurance covers:
Travel insurance is either sold through a travel agent or purchased online. It covers financial losses for cancelled airfares and accommodation, theft and damage to baggage and personal items, and medical, hospital and transportation expenses for sicknesses and injuries.
Baggage and personal items must be lost or stolen when in your possession or control. Cancelled flights and accommodation must be because of unforeseen circumstances.
The biggest area of dispute in travel insurance claims is for medical and hospital expenses which may be because of pre-existing sicknesses or injuries. You will be covered automatically for injuries or sicknesses that occur after you take out the policy. However, if you want cover for pre-existing conditions, you will have to apply for cover before you go overseas and provide a report from your doctor that your condition is under control and you are not an adverse risk of getting sick when overseas. The insurer will then decide whether to cover you for that condition, maybe with a premium loading. You can appeal if they refuse to cover you.
This covers your home and its contents if you own or are renting a home against damage from fire, bushfires, storm, flood, accidental breakage, leaks and related mould damage etc. You will also be indemnified if someone gets injured on your property.
However, policies exclude liability for things such as wear and tear, smoke damage, primary mould damage, if your home is unoccupied for 60 days or if your home is not properly secured or maintained etc.
The terms and conditions are set out in a glossy booklet or an online Product Disclosure Statement (PDS).
This covers you for damage to your car (comprehensive) or by your car (third-party)
Comprehensive insurance also covers the theft of your car as well as hail, fire and flood damage.
Exclusions include damage from unlicensed driving or intoxication, theft of unlocked cars and damage done to due to illegal modifications.
You should get a glossy booklet with all the terms and conditions in the mail every year
This insurance works in much the same way as motor vehicle insurance (above)
These policies pay monthly payments or lump sums for death or disability or pay off credit card or loan repayments because of death, disability or involuntary unemployment.
Almost all policies exclude pre-existing injuries or sicknesses, although some will allow cover if you had no treatment in the six months before or after the policy started.
The terms and conditions will be set out in master policies but often it’s hard for you to get a copy of the policy-although you may be able to get a PDS online.
Many people don’t even know they have got these policies.
Most small businesses have professional indemnity insurance which indemnifies them for damages and court costs from their negligence, defamation, breach of statutory duties, product liability etc. Business interruption insurance covers businesses for financial losses if the business has to shut down or is affected by unforeseen events such as fire, burglary, storm damage or injury or sickness to you or your premises, or perhaps to direct suppliers or receivers of your goods and services. You might also have income protection or key man insurance-although this is usually life insurance. These policies are often arranged by insurance brokers.
Most general insurance policies last for 12 months or maybe less (eg travel insurance) and are renewed after the insurer notifies you in writing when the next premium is due. They must also notify you in writing if the policy lapses because you don’t pay the renewal premium.
When you take out or renew a general insurance policy, you will have to answer any questions the insurance company asks truthfully and disclose anything that might be relevant to whether they will cover you e.g. any previous rejected claims, fraud convictions, speeding fines, medical conditions etc. It depends on the policy and what the insurer asks you.
If you don’t, the insurer might reject your claim-although you have rights of appeal.
Claims can sometimes be made on the phone but you will need to fill in a claim form and give the insurer documents to prove your case and your losses. Depending on the type of insurance claim, this will include medical reports, details of lost items and financial documents.
It’s very important you get the information and documents right so you will need HELP.
You should lodge the claim as soon as possible-although you may be able to make it years later. But keep in mind there is a 6-year time limit to lodge a court case from the date of the insured event and a similar time limit to go to the Ombudsman. Get HELP.
Claims can take many months-although an insurer is supposed to make a decision within four months.
If your claim is rejected or you are being mucked around, you can lodge an internal complaint. The insurer then has 45 days to deal with your complaint.
If you are still not happy, you can lodge a dispute with the Financial Ombudsman Service or lodge a court case. You will need to get HELP.
If you have any questions about your insurance policies, your rights or any claims, call Berrill & Watson for FREE advice.
We will also do any insurance claims and appeals for you no-win/no charge, conditions apply.