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.
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

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
Business Insurance Articles

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
The Role of Professional Indemnity Insurance in Risk Management Strategies
The Role of Professional Indemnity Insurance in Risk Management Strategies
Professional indemnity insurance is specifically designed to protect businesses and professionals who provide advice or services to clients. It provides coverage for legal costs and claims for damages if a client suffers a loss due to negligent services or advice offered by the business. This type of insurance is crucial for industries such as consulting, legal, and health care where professional expertise and advice are central to the service provided. - 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
Cash Flow Management Strategies for Small Business Sustainability
Cash Flow Management Strategies for Small Business Sustainability
Understanding the ebbs and flows of your business finances is more than just knowing numbers; it's a vital component of your small business's longevity and success. In the ever-dynamic landscape of entrepreneurship, cash flow management emerges as a centerpiece in the grand puzzle of sustainability. Small businesses, with their limited resources, often face the pronounced challenge of maintaining a healthy financial heartbeat to thrive and grow. - 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

Knowledgebase
Umbrella Policy:
An additional insurance policy that provides extra liability coverage beyond the limits of the insured's primary policies.