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?

Insuring your most valuable asset
Image for Insuring your most valuable assetWhile many people would consider their home or their car to be their most valuable asset, it's your ability to earn an income that is most important in shaping your financial future. Statistically, two thirds of working Australians will suffer an injury or illness that will sideline them for 90 days or more. The majority of these people would not be able to pay their mortgage or meet car finance and other loan commitments without adequate income insurance.
... compare rates & options ...
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

IAG Resolves $4 Billion Greensill Lawsuit
IAG Resolves $4 Billion Greensill Lawsuit
17 Jun 2026: Paige Estritori
Insurance Australia Group (IAG) has reached a confidential settlement in the $4 billion lawsuit initiated by Greensill Bank AG and its insolvency administrator. This legal action stemmed from disputes over insurance coverage related to Greensill's financial products. - read more
Decline in Market Share for Australian Insurers' Business Packages
Decline in Market Share for Australian Insurers' Business Packages
17 Jun 2026: Paige Estritori
A recent analysis by Macquarie has revealed a significant decline in the domestic business package market share held by Australian insurers, dropping to approximately 48% in the fiscal year 2025 from nearly 67% a decade ago. - read more
ACCC Halts IAG's Bid to Acquire RAC WA's Insurance Arm
ACCC Halts IAG's Bid to Acquire RAC WA's Insurance Arm
10 Jun 2026: Paige Estritori
The Australian Competition and Consumer Commission (ACCC) has recently opposed the proposed acquisition of RAC WA's insurance operations by Insurance Australia Group (IAG). This decision stems from concerns that the merger would significantly reduce competition within Western Australia's insurance sector, potentially leading to higher premiums and diminished service quality for consumers. - read more
BizCover and Zurich Collaborate to Enhance Professional Indemnity Insurance for SMEs
BizCover and Zurich Collaborate to Enhance Professional Indemnity Insurance for SMEs
10 Jun 2026: Paige Estritori
BizCover, an online business insurance platform, has expanded its professional indemnity (PI) insurance offerings through a new distribution agreement with Zurich Australia. This partnership enables small and medium-sized enterprises (SMEs) with annual revenues under $7.5 million to access Zurich's PI insurance directly via the BizCover website, with coverage limits of up to $10 million. - read more
Zurich Introduces AI-Powered Cyber Insurance Solution for Australian Businesses
Zurich Introduces AI-Powered Cyber Insurance Solution for Australian Businesses
03 Jun 2026: Paige Estritori
Zurich Financial Services Australia has unveiled 'Prime One', a cutting-edge cyber insurance product designed to bolster the digital resilience of Australian businesses. Developed in partnership with Cowbell, a specialist in adaptive cyber and specialty insurance solutions, 'Prime One' leverages artificial intelligence to streamline the underwriting process, offering rapid and tailored coverage. - read more
Click for more Insurance News
Business Insurance Articles

Essential Insurance Coverages You Need to Protect Your Small Business
Essential Insurance Coverages You Need to Protect Your Small Business
Insurance is a vital component for any small business. It acts as a safety net, helping to protect your enterprise from unexpected financial losses. Whether you run a retail shop, a consultancy, or a manufacturing unit, having the right insurance coverages can make the difference between thriving and merely surviving. - read more
The Essential Checklist: What Every Australian Business Owner Needs to Know About Insurance Cover
The Essential Checklist: What Every Australian Business Owner Needs to Know About Insurance Cover
When it comes to securing the future of your business, insurance isn't just a safety net; it's a vital tool for stability and growth. As an Australian entrepreneur, navigating the complex world of business insurance can be daunting. That's why understanding the importance of choosing the right insurance cover for your venture is critical for success. - read more
Understanding Liability Insurance: A Guide for Small Business Owners
Understanding Liability Insurance: A Guide for Small Business Owners
Liability insurance is a type of coverage that protects businesses from financial losses due to claims of injury, harm, or damages made by third parties. This insurance is crucial for covering legal costs and compensation that might arise from such claims. - read more
Key Factors to Consider When Comparing Business Insurance Options
Key Factors to Consider When Comparing Business Insurance Options
Business insurance is a vital aspect of safeguarding your company's interests and mitigating potential risks. Whether you are a small startup or a well-established organization, having appropriate insurance coverage is essential for protecting your assets, finances, and reputation. - read more
How to Choose the Right Insurance for Your Australian Retail Business
How to Choose the Right Insurance for Your Australian Retail Business
Running a retail business can be a risky endeavor. While you can minimize some of those risks with careful planning and management, you cannot eliminate them entirely. This is where insurance comes in. Having the right kind and amount of insurance coverage can make all the difference in protecting your business from financial loss, should the unthinkable happen. - read more

Knowledgebase
Rider:
An optional provision added to an insurance policy that provides additional benefits or 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.