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


Insurance News

Deloitte's 2026 Insurance Predictions: Key Trends Shaping the Future
Deloitte's 2026 Insurance Predictions: Key Trends Shaping the Future
17 Apr 2026: Paige Estritori
As Australia's insurance industry stands on the cusp of significant transformation, Deloitte's latest report, 'Insurance Predictions 2026,' offers a comprehensive analysis of the key trends poised to reshape the sector. The report underscores the imperative for insurers to adapt to rapid technological advancements, escalating climate risks, and evolving regulatory landscapes. - read more
APRA Warns of Heightened Risks in Australia's Insurance Industry
APRA Warns of Heightened Risks in Australia's Insurance Industry
17 Apr 2026: Paige Estritori
The Australian Prudential Regulation Authority (APRA) has recently issued a cautionary statement regarding the elevated risks confronting the nation's insurance sector. This alert underscores the necessity for insurers to bolster their resilience against a backdrop of climate hazards, cyber incidents, and global geopolitical tensions. - read more
Private Health Insurance Premiums Set to Increase by 4.41% in April 2026
Private Health Insurance Premiums Set to Increase by 4.41% in April 2026
17 Apr 2026: Paige Estritori
Australian private health insurance policyholders are set to experience a significant premium increase, with rates rising by an average of 4.41% from April 2026. This adjustment marks the most substantial hike since 2017, reflecting the escalating costs associated with medical and hospital services. - read more
Debate Intensifies Over Proposed Legal Fee Caps in Australian Insurance
Debate Intensifies Over Proposed Legal Fee Caps in Australian Insurance
09 Apr 2026: Paige Estritori
The Australian insurance sector is currently witnessing a significant debate over the Insurance Council of Australia's (ICA) proposal to implement caps on legal fees associated with civil liability claims. This initiative aims to address the rising insurance premiums that have been a concern for small to medium business owners across the nation. - read more
Premium Affordability and Cybersecurity Emerge as Top Challenges for Australian Insurers
Premium Affordability and Cybersecurity Emerge as Top Challenges for Australian Insurers
09 Apr 2026: Paige Estritori
In the dynamic landscape of the Australian insurance industry, a recent survey conducted by Gallagher Bassett has shed light on the primary challenges confronting insurers in 2026. The findings underscore a significant reshaping of priorities, with premium affordability, cybersecurity, and labour shortages emerging as the most pressing concerns. - read more
Click for more Insurance News
Business Insurance Articles

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
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
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
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
Financing Your Business: The Role of Loans and Insurances
Financing Your Business: The Role of Loans and Insurances
Starting a new business is an exciting journey filled with opportunities and challenges. One of the most critical aspects to ensure your venture's success is adequate financing. Whether you're launching a small local shop or a larger enterprise, having a solid financial foundation is essential. - read more

Knowledgebase
Occupational Hazard:
A risk associated with the nature of a particular occupation, which may affect insurance premiums.

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.