Business Insurance Online :: Articles

Insurance Disputes

How can I challenge my insurance claim rejection if I feel it was unfair?

Insurance Disputes

The information on this website is general in nature and does not take into account your objectives, financial situation, or needs. Consider seeking personal advice from a licensed adviser before acting on any information.

Just because your insurer has rejected your claim, does not necessarily mean that your case is closed. If you think that you have been unfairly treated, here are some ways to get the insurer decision overturned.

What to do

  • Inform the insurance company as soon as you can following the event. It is sometimes a good idea to write the details of the event as soon as you can, and then use that as a reference to make the written claim.
  • Be consistent. Remember, it will be awkward if you want to change your story later on.
  • Keep all documents that are relevant to the claim.
  • Make sure the staff of the insurance company can get in touch with you.

If the claim is rejected?

There are circumstances where you may in fact have the legal right to be reimbursed for your loss even though the insurer refused to pay the claim. Although you can sometimes make this judgement yourself, it is sometimes a good idea to get legal advice. See our fact sheets on "Disputes".

Check the policy

If the claim is rejected ask your insurer to identify specifically the clause of the contract on which they rely. If you do not have a current policy make sure they supply one.

What caused the loss?

If the insurer claims that you caused the loss, and this is in breach of the policy, make sure that this is so.
For instance, if you were smoking in bed at the time of a fire, and a fire caused this way is a breach of your policy, you may not in fact be in breach if the fire was caused by an electrical fault. In this case the fact that you were smoking in bed would be coincidental and not the cause of the fire.

Pre-existing conditions

The policy may stipulate that a known pre-existing situation or condition is not covered. For instance, if you have disability insurance but at the time you signed the policy you had a tumor. However, under the law it would be crucial whether you actually knew you had this condition. If you were unaware of it you should still be covered.

Ignorance of the terms

Under the law the insurer has a legal obligation to inform you about the restrictions in the insurance policy. This must be done before you sign the application and the policy is issued. This means (in part) that:
  • you must be given a copy of the policy; and
  • the wording of the policy must be clear and unambiguous.
If these pre-conditions were not met it may be possible to retain your coverage for your loss. Again, it may be necessary to obtain legal advice.

Is it worth the claim?

Many types of insurance contracts will have an excess. This is common in a car insurance contract, or similarly you may lose part of the no-claims bonus. Some companies now reward rating one drivers with a lifetime rating one guarantee. At times you will have to decide whether the amount of the claim is worth the long term loss that results from the effect on rating or no-claims bonuses, especially after taking into account the amount of the excess.

Published: Sunday, 1st Aug 2021
Author: Paige Estritori

Rate this article

Sign in with Google to rate

0 Comments

No comments yet. Be the first to share your thoughts.


Insurance News

Why lithium-ion batteries are now a business insurance issue
Why lithium-ion batteries are now a business insurance issue
26 Aug 2026: Paige Estritori
Lithium-ion batteries are moving from a workplace convenience to a serious insurance consideration for Australian small and medium businesses. As more businesses rely on rechargeable tools, e-bikes, scooters, point-of-sale devices, backup power units and portable electronics, insurers are paying closer attention to how those items are stored, charged and managed. - read more
Storm claims surge shows why SMEs need to test their cover
Storm claims surge shows why SMEs need to test their cover
19 Aug 2026: Paige Estritori
Fresh industry updates on severe weather claims are a reminder that storm, flood and cyclone losses are no longer rare planning scenarios for Australian small and medium businesses. Claims linked to major weather systems affecting Queensland and New South Wales continue to move through insurer assessment, repair and settlement processes, with businesses facing familiar pressure points: damaged premises, interrupted trading, ruined stock, delayed repairs and uncertainty about what is actually covered. - read more
New ransomware reporting rules put SME cyber cover under scrutiny
New ransomware reporting rules put SME cyber cover under scrutiny
12 Aug 2026: Paige Estritori
Australia's mandatory ransomware payment reporting regime is now a practical compliance issue for many business owners, not just a technology concern. Under the national cyber security reforms, entities above the relevant annual turnover threshold must report certain ransomware and cyber extortion payments within a short statutory timeframe. For SMEs operating close to, or above, that threshold, the change adds another layer to an already complex risk environment. - read more
What Strong Insurer Results Mean for Business Insurance Renewals
What Strong Insurer Results Mean for Business Insurance Renewals
05 Aug 2026: Paige Estritori
Latest general insurance performance data from APRA points to an industry that remains financially resilient, with insurers benefiting from disciplined underwriting, investment income and a continued focus on pricing risk accurately. For Australian small and medium-sized businesses, that is useful context heading into renewal season, but it should not be read as a simple promise of cheaper premiums. - read more
What Rising Insurance Disputes Mean for Small Businesses
What Rising Insurance Disputes Mean for Small Businesses
29 Jul 2026: Paige Estritori
Recent industry reporting on the latest insurance complaints environment points to a clear message for Australian small businesses: the hardest part of insurance is often not buying a policy, but relying on it when something goes wrong. Disputes continue to arise around claim delays, declined claims, settlement amounts, policy exclusions and communication breakdowns between customers and insurers. - read more
Click for more Insurance News
Business Insurance Articles

Creating a Risk Management Plan: A Guide for Small Business Owners
Creating a Risk Management Plan: A Guide for Small Business Owners
In today's ever-evolving business landscape, risk management has become an essential practice for small business owners. With uncertainties ranging from economic fluctuations to natural disasters, being prepared for potential crises is more important than ever. As an owner, you must be proactive in identifying and mitigating risks to safeguard your business's future. - read more
Understanding Business Insurance: How to Safeguard Your Australian Small Business
Understanding Business Insurance: How to Safeguard Your Australian Small Business
Welcome to the elucidative journey through the realm of business insurance and the pivotal role it plays for small businesses in Australia. In the ever-evolving business landscape, having a solid safety net is not merely an option, but a necessity to thrive amidst unforeseen challenges. - read more
5 Common Insurance Mistakes Startups Make and How to Avoid Them
5 Common Insurance Mistakes Startups Make and How to Avoid Them
Starting a new business is an exciting and challenging endeavor, particularly in the vibrant and innovative startup landscape of Australia. However, amidst the rush of ideas and the race to launch, many startups overlook the crucial aspect of insurance. Insurance is not merely an additional cost but a vital protective measure that safeguards your emerging business against unforeseen hurdles. - read more
How to Lower Your Insurance Costs Without Sacrificing Coverage
How to Lower Your Insurance Costs Without Sacrificing Coverage
Insurance costs can be a significant expense for businesses in Australia, and it is crucial to understand how they can affect your bottom line. With premiums on the rise, many business owners are looking for ways to cut costs while maintaining the coverage they need to protect their operations. - read more
Is Your Business Protected? The Importance of Comprehensive Insurance
Is Your Business Protected? The Importance of Comprehensive Insurance
Running a business in Australia comes with its own unique set of challenges and rewards. One of the most crucial aspects of ensuring your business thrives is having comprehensive insurance in place. But what exactly does 'comprehensive insurance' mean for your business? - read more

Knowledgebase
Underwriting:
The process by which an insurer determines the risk of insuring a client and decides the terms of coverage.

Quick Links: | Business Insurance | Business Insurance Quotes | Commercial Insurance | Public Liability Insurance | Small Business Insurance | Professional Indemnity Insurance | Business Insurance Comparison | Cyber Insurance | Business Interruption Insurance | Business Insurance Australia | Workers Compensation Insurance
This website is owned and operated by Clark Family Pty Ltd (ACN 010 281 008) as Trustee for the Clark Family Trust (ABN 35 957 893 714), 43 Larch Street Tallebudgera QLD 4228. Clark Family Pty Ltd is an Authorised Representative (AR 1298860) of Unique Group Broker Services Pty Ltd (AFSL 509434) for financial product referrals and an Authorised Credit Representative (ACR 401491) of Saccasan Pty Ltd (ACL 386297). Check our licensing details on the ASIC registers: Clark Family Pty Ltd ACR, Clark Family Pty Ltd AR, Saccasan Pty Ltd, Unique Group Broker Services.
IMPORTANT: We act solely as an introducer and refer enquiries to licensed third-party brokers, insurers, and lenders. We do not provide financial product advice or credit assistance. We may receive a fee or commission from these third parties in consideration for the referral. Before any action is taken to obtain a product or service referred to by this website, advice should be obtained (from either the third party to whom we refer you or from another qualified intermediary) as to the appropriateness of obtaining those products having regard to your objectives, financial situation and needs. Whilst we have our own process for validating the legitimacy of our referral partners, you should independently verify the credentials and licensing of any adviser or provider you engage. Visit the ASIC website for further information.