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

Vero's 2026 SME Insurance Index Uncovers Critical Risk Management Gaps in Australian Small Businesses
Vero's 2026 SME Insurance Index Uncovers Critical Risk Management Gaps in Australian Small Businesses
27 May 2026: Paige Estritori
Vero's recently released 2026 SME Insurance Index has brought to light significant disparities in risk management practices between small and large Australian businesses. The survey, encompassing over 1,500 enterprises, underscores the pressing need for enhanced risk strategies among small and micro businesses to bolster their resilience in an increasingly volatile economic landscape. - read more
Australian Commercial Insurance Market Maintains Soft Conditions Through First Half of 2026
Australian Commercial Insurance Market Maintains Soft Conditions Through First Half of 2026
27 May 2026: Paige Estritori
The Australian commercial insurance landscape has sustained its soft market conditions through the first half of 2026, characterised by competitive pricing, expanded underwriting capacity, and heightened competition among insurers. This environment presents both opportunities and considerations for businesses seeking to optimise their insurance portfolios. - read more
EML Group's Strategic Acquisition of Guild Insurance to Drive Growth and Innovation
EML Group's Strategic Acquisition of Guild Insurance to Drive Growth and Innovation
27 May 2026: Paige Estritori
In a strategic move poised to reshape the Australian insurance landscape, EML Group has acquired a majority stake in Guild Insurance. This partnership is set to unlock new growth opportunities and expedite the development of technological and artificial intelligence (AI) capabilities within the sector. - read more
IAG Enhances Coverage by Integrating RACQ Insurance into 2026 Reinsurance Program
IAG Enhances Coverage by Integrating RACQ Insurance into 2026 Reinsurance Program
19 May 2026: Paige Estritori
Insurance Australia Group (IAG) has successfully integrated RACQ Insurance into its 2026 catastrophe reinsurance program. This strategic move is designed to bolster the company's capacity to manage catastrophic events and provide enhanced coverage for Australian policyholders. - read more
Rising Legal Costs and Regulatory Hurdles Escalate Small Business Insurance Premiums
Rising Legal Costs and Regulatory Hurdles Escalate Small Business Insurance Premiums
19 May 2026: Paige Estritori
Small businesses across Australia are grappling with a significant surge in insurance premiums, with rates escalating by up to 60% since 2019. The Insurance Council of Australia (ICA) attributes this sharp increase to outdated liability laws, escalating legal expenses, and cumbersome government regulations. - read more
Click for more Insurance News
Business Insurance Articles

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
Must-Have Insurance Policies for Australian SMEs in 2025
Must-Have Insurance Policies for Australian SMEs in 2025
In today's rapidly evolving business environment, insurance has become an essential component for the survival and success of small to medium enterprises (SMEs). As businesses navigate through uncertainties, unexpected events can pose significant threats. Insurance not only provides a safety net but also conveys a sense of stability and trust to partners and customers. - 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
Assessing the Insurance needs of your Australian Labour Hire firm
Assessing the Insurance needs of your Australian Labour Hire firm
As a labour hire firm, it is important to assess your insurance needs to protect your business from the risks it faces. Assessing your insurance needs involves identifying potential risks specific to your industry and taking steps to mitigate them. With the right coverage, you can protect your employees, clients, and business assets from unforeseeable circumstances, which could otherwise result in costly lawsuits or accidents. - 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

Knowledgebase
No-Fault Insurance:
A type of car insurance where your insurer pays for your damages regardless of who is at fault in an accident.

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.