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

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
Business Insurance Articles

How to Customize Your Business Insurance to Fit Your Company’s Needs
How to Customize Your Business Insurance to Fit Your Company’s Needs
Business insurance is a type of coverage that protects your company from financial losses that may occur during regular operations. These losses could be due to a variety of risks like property damage, legal liability, or employee-related incidents. - read more
Navigating Cyber Threats: Essential Cyber Insurance for Your Start-up
Navigating Cyber Threats: Essential Cyber Insurance for Your Start-up
Starting a new business venture is an exciting endeavor, but amid the myriad decisions start-up founders face, one must not overlook the importance of insurance. In today's digital-first world, the potential for cyber threats is a reality that can no longer be ignored by businesses of any size or sector, especially start-ups aiming to secure their future. - 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
Understanding Liability Insurance: Essential Coverage for Your Business
Understanding Liability Insurance: Essential Coverage for Your Business
Liability insurance is a crucial component of a business's risk management strategy. It provides protection against claims resulting from injuries and damages to people or property. Businesses of all sizes face potential risks daily, and this type of coverage is designed to shield businesses from significant financial losses. - read more
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

Knowledgebase
Insurance Underwriter:
An insurance company, a financial institution that sells insurance.