How to Challenge Unfair Insurance Disputes & Rejections

Insurance Disputes

How can I challenge my insurance claim rejection if I feel it was unfair?

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

While 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

Business Insurance Articles

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

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

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

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

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

Insurance News

Australian Insurers Face Challenges in Cyber and AI Risk Readiness

08 Mar 2026: Paige Estritori

Recent findings from the PwC Insurance Banana Skins Survey have raised concerns about the preparedness of Australian insurers in managing emerging risks, particularly those associated with cyber threats and artificial intelligence (AI). The survey, which gathered insights from 698 insurance executives across 42 territories, including 37 from Australia, indicates that Australian insurers scored 6.6% lower on the Preparedness Index compared to their global counterparts. - read more

Rising Insurance Premiums Pose Challenges for Australian Businesses

08 Mar 2026: Paige Estritori

Businesses across New South Wales are grappling with substantial increases in insurance premiums, prompting calls for urgent reforms to alleviate financial pressures. According to Business NSW's latest Business Conditions Survey, nearly 80% of businesses have experienced double-digit hikes in insurance costs over the past year, with one in three reporting increases of 30% or more. These surges significantly outpace the annual inflation rate of 2.5%, placing an undue burden on the business community. - read more

AUB Group's Strategic Acquisition of Prestige Marks Global Growth

20 Feb 2026: Paige Estritori

In a strategic move to bolster its international footprint, AUB Group, a prominent Australian insurance broker, has announced the acquisition of UK-based Prestige for $432 million. This acquisition signifies a pivotal step in AUB Group's global expansion strategy, enhancing its presence in the international insurance market. - read more

ACCC Halts IAG's Proposed Acquisition of RAC Insurance

20 Feb 2026: Paige Estritori

The Australian Competition and Consumer Commission (ACCC) has recently opposed Insurance Australia Group's (IAG) proposed $1.35 billion acquisition of RAC Insurance. The regulator's decision is rooted in concerns that the merger could substantially reduce competition in Western Australia's home and motor insurance markets. - read more

Business NSW Advocates for Urgent Insurance Reforms to Alleviate Rising Premiums

12 Feb 2026: Paige Estritori

Business NSW, the leading business advocacy group in New South Wales, has raised alarms over the escalating insurance premiums that are placing significant financial strain on businesses across the state. Recent findings from their Business Conditions Survey reveal that nearly 80% of businesses have encountered double-digit increases in insurance costs over the past year, with one in three reporting hikes of 30% or more. These surges starkly contrast with the annual inflation rate of 2. - read more

Click for more Insurance News

Knowledgebase

Disability Insurance:
A type of insurance protection that pays a portion of a person's income lost due to a total or partial disablement arising from either an accident or a sickness.