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

What Strong Insurer Results Mean for Business Insurance Renewals
What Strong Insurer Results Mean for Business Insurance Renewals
05 Aug 2026: Paige Estritori
Latest general insurance performance data from APRA points to an industry that remains financially resilient, with insurers benefiting from disciplined underwriting, investment income and a continued focus on pricing risk accurately. For Australian small and medium-sized businesses, that is useful context heading into renewal season, but it should not be read as a simple promise of cheaper premiums. - read more
What Rising Insurance Disputes Mean for Small Businesses
What Rising Insurance Disputes Mean for Small Businesses
29 Jul 2026: Paige Estritori
Recent industry reporting on the latest insurance complaints environment points to a clear message for Australian small businesses: the hardest part of insurance is often not buying a policy, but relying on it when something goes wrong. Disputes continue to arise around claim delays, declined claims, settlement amounts, policy exclusions and communication breakdowns between customers and insurers. - read more
Why SMEs should double-check AI insurance advice
Why SMEs should double-check AI insurance advice
22 Jul 2026: Paige Estritori
Australian businesses are increasingly using AI tools to research products, shortlist providers and understand policy options. That convenience now comes with a clear warning for small business owners: not every insurance answer surfaced by AI search is coming from a licensed, accountable or locally relevant source. - read more
Lifeline Breach Puts Cyber Cover Back on the SME Agenda
Lifeline Breach Puts Cyber Cover Back on the SME Agenda
15 Jul 2026: Paige Estritori
A reported data breach involving Lifeline Australia has renewed attention on a widening protection gap in the Australian cyber insurance market. While Lifeline has indicated that help-seeker and financial information were not compromised, the incident is a timely reminder that staff, volunteer, client and supplier data can still create serious legal, operational and reputational exposure for any organisation. - read more
Could NSW Levy Reform Make Insurance More Affordable for Small Business?
Could NSW Levy Reform Make Insurance More Affordable for Small Business?
08 Jul 2026: Paige Estritori
New analysis released by the Insurance Council of Australia has put renewed attention on a major cost pressure for NSW businesses: the emergency services levy, commonly known as the ESL. The levy is currently collected through insurance premiums, meaning businesses that choose to insure their assets can face a higher cost for doing so. - read more
Click for more Insurance News
Business Insurance Articles

The Top 5 Insurance Policies Every Australian Start-up Needs
The Top 5 Insurance Policies Every Australian Start-up Needs
When embarking on the entrepreneurial journey of a start-up, it's imperative to safeguard the nascent enterprise with a reliable insurance safety net. Insurance acts as a vital shield, protecting the hard work and innovation of new businesses against unforeseen events and liabilities which can arise in the unpredictable world of start-ups. - read more
Public Liability Insurance in Australia: Cover, Exclusions and Business Requirements
Public Liability Insurance in Australia: Cover, Exclusions and Business Requirements
Public liability insurance can help protect Australian businesses against third-party injury or property damage claims. Learn what it may cover, common exclusions, when it may be required and what to check before arranging cover. - 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
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
Cybersecurity Risk Assessment: An Essential Guide for Business Owners
Cybersecurity Risk Assessment: An Essential Guide for Business Owners
In today's digital age, cybersecurity has become a critical concern for businesses of all sizes. The increasing reliance on technology means that cyber threats are more prevalent than ever, making it essential for business owners to understand and manage these risks. - read more

Knowledgebase
Proximate Cause:
The primary cause of loss in an insurance claim, which sets in motion a chain of events leading to the damage or injury.

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.