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

Workers Compensation Reform Puts Employer Cover Back in Focus
Workers Compensation Reform Puts Employer Cover Back in Focus
16 Sep 2026: Paige Estritori
Renewed debate around proposed changes to the NSW workers compensation system is a timely reminder that employee injury cover is not a set-and-forget obligation for business owners. While the details of reform are still being scrutinised by government, regulators, unions, employers and insurers, the underlying issue is clear: claims costs, psychological injury trends and scheme sustainability are placing pressure on how workplace injury risk is funded and managed. - read more
Cyber Underinsurance Is Becoming a Bigger SME Risk
Cyber Underinsurance Is Becoming a Bigger SME Risk
09 Sep 2026: Paige Estritori
Fresh industry attention on cyber underinsurance is a timely reminder that many Australian small and medium businesses are still treating digital risk as an IT problem rather than a balance sheet risk. As more trading, payments, customer records, bookings and supplier relationships move online, a cyber incident can quickly become a cash flow, legal, operational and reputational event. - read more
Disaster Resilience Debate Puts SME Cover Back in Focus
Disaster Resilience Debate Puts SME Cover Back in Focus
02 Sep 2026: Paige Estritori
Fresh industry attention on disaster resilience is a timely reminder that Australian small and medium businesses cannot treat severe weather as an occasional inconvenience. The message emerging from the insurance sector is increasingly consistent: premiums, availability of cover and claims outcomes are being shaped not only by what a business owns, but by where it operates, how exposed it is, and what practical risk controls are in place. - read more
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
Click for more Insurance News
Business Insurance Articles

Financing Your Business: The Role of Loans and Insurance
Financing Your Business: The Role of Loans and Insurance
Starting a new business is an exciting journey filled with opportunities and challenges. One of the most important parts of planning for a new venture is understanding how financing and insurance can work together to support a stronger financial foundation. - read more
Common Insurance Mistakes Small Business Owners Should Avoid
Common Insurance Mistakes Small Business Owners Should Avoid
Running a small business in Australia comes with its unique set of challenges and risks. One crucial aspect that every small business owner must consider is liability insurance. Liability insurance is designed to protect businesses from various claims and lawsuits that can arise in the course of their operations. Whether it's a customer slipping and falling in a store or a disgruntled employee filing a lawsuit, having the right insurance can provide a financial safety net. - read more
10 Common Insurance Terms Every Business Owner Should Know
10 Common Insurance Terms Every Business Owner Should Know
As a business owner, understanding the ins and outs of insurance can feel like navigating a maze. The terminology alone can be daunting, yet it's crucial to grasp these concepts to make informed decisions about protecting your enterprise. - read more
How to Assess Business Insurance Needs for Different Occupations
How to Assess Business Insurance Needs for Different Occupations
Different occupations face different business risks. This guide explains how Australian sole traders, contractors, consultants, retailers, trades and other small business owners can assess which types of business insurance may be relevant to their activities. - read more
The Importance of Adequate Insurance Coverage for Your Small Business
The Importance of Adequate Insurance Coverage for Your Small Business
For small businesses, navigating the intricacies of sustainability is a critical task that can be made more manageable through the prudent use of business insurance. Understandably, many small business owners prioritize immediate operational concerns over seemingly discrete matters like insurance. However, as we will explore, insurance is not a mere formality—it's a vital backbone to enduring success. - read more

Knowledgebase
Premium:
The amount paid for an insurance policy, usually on a regular basis, to maintain 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). Check our licensing details on the ASIC registers: Clark Family Pty Ltd ACR, Clark Family Pty Ltd AR, 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.