Cyber Insurance Online :: News
SHARE

Share this news item!

Insurance Dispute Settled with New Rulings

Insurance Dispute Settled with New Rulings

Insurance Dispute Settled with New Rulings?w=400
In a recent adjudication, a property owner faced a coverage denial due to damage attributed to rodents, offering a revealing insight into insurance claim disputes.
When a strata property holder reported water damage from a damaged dishwasher hose, her insurance claim was thwarted by the involvement of rodents.

The issue arose when the claimant noticed a malfunction in her dishwasher as early as April of the previous year and filed a claim in September. However, Strata Community Insurance Agencies challenged the claim arguing that the damage might engage exclusions pertaining to rodent activity.

Central to this case was a tax invoice detailing observations from a visiting plumber. According to the original report, the plumber suspected damage caused by rodents chewing on the hose. Yet, the said invoice was later altered to omit this suspicion, raising further questions about motive and clarity.

Further dialogue between the plumber and the insurer's representative disclosed that changes to the invoice were requested by the policyholder. Additionally, alternative explanations surfaced, such as potential damage from consistent interaction of the hose with the access hole each time the machine was used. The plumber did not exclude the possibility of continuous friction contributing to the damage.

The insurance provider's expert, however, observed extensive damage on the hose but reported an absence of signs that typical wear and tear would leave. The expert concluded that the use of the dishwasher was unlikely to generate sufficient force to result in such severe damage. They further stated that the condition of the hose strongly indicated rodent activity as initially suggested by the plumber.

During the dispute resolution hearing, the Australian Financial Complaints Authority evaluated the matter. They acknowledged the customer's view disputing the expert judgment but emphasized her failure to present any compelling evidence to counter the presented arguments.

The authority, after reviewing the diverse perspectives and the expert observations, ruled in favor of accepting the view that rodents were probably the primary cause of the damage. While this event originally triggered policy coverage, the clauses excluding rodent damage ultimately prevailed to deny the claim.

Echoing this outcome, an ombudsman for the AFCA commented, “I am satisfied, without evidence to contrary, it is fair that the insurer be permitted to rely on the opinions provided by the appointed consultants.” This position emphasizes the criticality of providing concrete evidence when challenging an insurer's expert analysis.

This case serves as a compelling reminder for policyholders of the complexities and critical nuances involved in insurance claims, especially those involving ambiguous causes like rodent activity. It underscores the importance of detailed documentation and professional assessments when navigating through such disputes.

Published:Thursday, 7th Nov 2024
Source: Paige Estritori

Share this news item:

Insurance News

Insurers Face Intense Scrutiny Over Quake Claim Rejections Insurers Face Intense Scrutiny Over Quake Claim Rejections
21 Nov 2024: Paige Estritori

In recent months, Muswellbrook, a town in New South Wales, has experienced a series of earthquakes that have left residents grappling with both physical destruction and emotional distress. Criticism is mounting against insurers as more than 600 claims have emerged, following these seismic events, yet many remain unresolved or denied. - read more
AI Regulations: A Web of Complications AI Regulations: A Web of Complications
20 Nov 2024: Paige Estritori

The Insurance Council of Australia (ICA) has raised concerns about the potential fallout from a fragmented regulatory approach to artificial intelligence and automated decision-making in the industry. There is fear that this patchwork of reforms could result in conflicting requirements, heavier compliance burdens, and increased industry confusion. - read more
APRA Survey Reveals Impact of Climate Change on Insurance Industry Practices APRA Survey Reveals Impact of Climate Change on Insurance Industry Practices
19 Nov 2024: Paige Estritori

A recent analysis by the Australian Prudential Regulation Authority (APRA) reveals that over 90% of general insurers and reinsurers anticipate climate change will influence their underwriting procedures, posing new challenges to the industry. - read more
Fraudulent Claims Lead to Complete Denial of Compensation Fraudulent Claims Lead to Complete Denial of Compensation
18 Nov 2024: Paige Estritori

In a remarkable case highlighting the severe consequences of insurance fraud, an individual's attempt to inflate a theft insurance claim has resulted in the total denial of compensation. Despite a significant portion of the claim being genuine, fraudulent actions negated any potential payout. - read more
Soaring Insurance Premiums Amid Changing Climate Soaring Insurance Premiums Amid Changing Climate
14 Nov 2024: Paige Estritori

As climate change persists, the impact of severe weather on insurance premiums is becoming more evident, pushing affordability out of reach for many Australians. Bernadette Systa, a mother of five, faced an undeniable financial strain as her annual home and contents insurance costs surged from a modest amount to more than twice what she initially paid. This experience echoes a growing dilemma faced by households across the country. - read more


Cyber Insurance Articles

Strengthen Your Defences: Implementing Effective Cybersecurity Protocols Strengthen Your Defences: Implementing Effective Cybersecurity Protocols
In today's digital age, understanding the cyber threat landscape in Australia is not just important—it's essential. Cyber attacks are becoming more sophisticated and are affecting businesses and individuals at an alarming rate. Common types of cyber attacks include phishing, ransomware, and data breaches, each with the potential to cause significant harm. The impact of cybersecurity breaches on both the economy and the reputation of affected entities is profound, ranging from financial loss to long-lasting reputational damage. - read more
Understanding the Cost of Cyber Attacks on Small Businesses and How to Avoid Them Understanding the Cost of Cyber Attacks on Small Businesses and How to Avoid Them
Cybersecurity refers to the practice of protecting systems, networks, and programs from digital attacks. These cyber attacks are usually aimed at accessing, changing, or destroying sensitive information, extorting money from users, or interrupting normal business processes. - read more
Case Studies: The True Impact of Cyber Attacks on Australian Small Businesses Case Studies: The True Impact of Cyber Attacks on Australian Small Businesses
As we delve into the digital era, the number of cyber threats that challenge Australian small businesses is significantly on the rise. Cyber attacks have become more sophisticated, frequent, and continue to disrupt the operations of small enterprises, often with devastating consequences. The need to fortify defenses against such threats has never been more paramount. - read more
From Phishing to Hacking: Examining the Coverage Options of Cyber Insurance Policies From Phishing to Hacking: Examining the Coverage Options of Cyber Insurance Policies
In today's digital landscape, Australian small businesses face a myriad of cyber risks that can threaten their operations and financial stability. From sophisticated phishing scams to debilitating hacking attacks, the need to safeguard against such digital threats has never been more pressing. This introductory guide serves to illuminate the complexities of the cyber risk environment within Australia, focusing on the small business sector's unique vulnerabilities. - read more
The Essential Guide to Cyber Insurance for Australian Small Businesses The Essential Guide to Cyber Insurance for Australian Small Businesses
In the digital age, Australian small businesses find themselves navigating a world where online presence isn't just an advantage, it’s a necessity. With this increased online activity comes heightened vulnerability to cyber threats, making the protection of digital assets an urgent priority. - read more
Case Studies: The True Impact of Cyber Attacks on Australian Small Businesses Case Studies: The True Impact of Cyber Attacks on Australian Small Businesses
As we delve into the digital era, the number of cyber threats that challenge Australian small businesses is significantly on the rise. Cyber attacks have become more sophisticated, frequent, and continue to disrupt the operations of small enterprises, often with devastating consequences. The need to fortify defenses against such threats has never been more paramount. - read more
Understanding the Cost of Cyber Attacks on Small Businesses and How to Avoid Them Understanding the Cost of Cyber Attacks on Small Businesses and How to Avoid Them
Cybersecurity refers to the practice of protecting systems, networks, and programs from digital attacks. These cyber attacks are usually aimed at accessing, changing, or destroying sensitive information, extorting money from users, or interrupting normal business processes. - read more
Navigating the Aftermath: Your Cyber Attack Recovery Roadmap Navigating the Aftermath: Your Cyber Attack Recovery Roadmap
In an age where digital presence intertwines with daily operations, the threat landscape in Australia has magnified, exposing businesses to an evolving array of cyber threats. From sophisticated phishing attempts to ransomware attacks, the risk of digital insecurity looms large. Australia, with its growing technological adoption, finds itself facing an upsurge in cyber threat incidents year over year. - read more
Understanding the Importance of Cyber Insurance in the Digital Age Understanding the Importance of Cyber Insurance in the Digital Age
As we dive deeper into the digital era, the topic of cyber security becomes increasingly critical. With businesses and individuals relying heavily on digital technologies, the threat of cyber attacks looms larger than ever. This introductory section aims to unpack the concept of cyber insurance as a tool to mitigate these risks. - read more
From Phishing to Hacking: Examining the Coverage Options of Cyber Insurance Policies From Phishing to Hacking: Examining the Coverage Options of Cyber Insurance Policies
In today's digital landscape, Australian small businesses face a myriad of cyber risks that can threaten their operations and financial stability. From sophisticated phishing scams to debilitating hacking attacks, the need to safeguard against such digital threats has never been more pressing. This introductory guide serves to illuminate the complexities of the cyber risk environment within Australia, focusing on the small business sector's unique vulnerabilities. - read more


Your free Cyber insurance quote comparison starts here!
First Name:
Postcode:

All quotes are provided free (via our secure server) and without obligation. We respect your privacy.

Knowledgebase
Endorsement:
An amendment or addition to an existing insurance policy that changes the terms or scope of the original policy.