The Australian Financial Complaints Authority (AFCA) intervened, reducing the payout by $56,546. This amount corresponds to the difference the landlord would have owed AIG in premiums to insure a building unoccupied for more than 90 consecutive days — an arrangement the landlord neglected, despite receiving clear directives from a broker.
The landlord, with guidance from their broker, had filed a claim last July after criminals gained access through a leased security gate, prompting AIG to refuse the claim due to the structure’s vacant status, which wasn't covered under the policy.
Prior to the unfortunate event, the broker had made the building owner and managing agent aware of the need to refresh AIG of the vacant situation, potentially affecting claims, and the possibility of acquiring extra coverage by adjusting the premium.
Despite the advice, the owner failed to take action, leading to AIG being notified about the vacancy only post-theft. AFCA indicated that AIG would likely have underwritten the unoccupancy risk had they been told, and determined it fair to authorize the claim — factoring in the supplemental premium and other conditions like an excess charge.
Section 54 of the Insurance Contracts Act became pivotal, with AFCA stating that the breach pertained to not informing the insurer of the decision to leave the property vacant beyond 90 days without seeking written permission — not merely the fact that the premises were left empty.
An AFCA official explained, “I am not of the view that the complainant’s failure to request the insurer’s written consent ... can reasonably be regarded as being capable of causing or contributing to the malicious damage and theft event.”
They emphasized, “The insurer cannot refuse to pay the claim by reason only of the post-contractual act, that is, by reason only of the complainant’s failure to seek its written consent. The insurer is, however, entitled to reduce its liability to the extent that it has been prejudiced.”
AFCA specified that AIG had not proved the extent of its disadvantage equaled its ability to completely dismiss its liability under the policy. Instead, AFCA accepted that the liability compared to the additional premium deemed appropriate if the vacancy had been disclosed.
Arguments suggesting partial occupancy, due to daily visits from a property manager and maintenance by contractors, were rejected, as was the claim that it was unjust to deny coverage because the theft transpired over a weekend when the premises would be unoccupied even if tenanted.
This information originally featured in an article in Insurance News Magazine.
Published:Friday, 1st Nov 2024
Source: Paige Estritori
Missed Insurance Coverage Turns Costly for Long-Time Client 09 Dec 2024: Paige Estritori In a challenging outcome for a long-standing customer, a car owner has faced rejection in his bid for damage compensation after it was established that his insurance coverage had been terminated over five years before the incident. - read more |
Driving App in Focus: Safer Roads Through Tech-Savvy Incentives 09 Dec 2024: Paige Estritori Technology is reshaping how we approach road safety, and AAMI, a subsidiary of Suncorp, has taken a significant leap with its driver-focused rewards program. The initiative has reportedly succeeded in fostering better driving habits among participants. - read more |
Mental Health Claims: A Growing Concern for Young Adults 06 Dec 2024: Paige Estritori Recent findings highlight a significant trend: an increase in Total and Permanent Disability (TPD) claims among 30- to 40-year-olds, with mental health as a key factor. Over the past decade, these claims have soared, the Council of Australian Life Insurers (CALI) reports. - read more |
Bakery Blaze Sparks Allegations of Insurance Fraud 05 Dec 2024: Paige Estritori A bakery owner in Western Australia has been engulfed in controversy following accusations of deliberately setting her business premises on fire. Officials allege this was an attempt to secure a hefty insurance payout. - read more |
Heat Claims Denied: Insurer Cites 'Oven Effect' in Container Dispute 05 Dec 2024: Paige Estritori A local business operator suffering significant heat damage to pool covers stored within shipping containers has experienced a setback, as a recent ruling favored the insurer's interpretation of their policy terms. The implications of this decision represent a crucial discussion point for businesses storing items prone to temperature sensitivity. - read more |
Life Insurance Takes Backseat in Cost-Cutting Measures 03 Dec 2024: Paige Estritori As Australians tighten their belts in the face of rising living costs, life insurance is rapidly being placed on the chopping block. The Council of Australian Life Insurers (CALI) reports that individuals are more likely to reduce life cover rather than home or car insurance. - read more |
The Myth of Unaffordability: How to Find Value in Income Insurance Policies Income protection insurance is often surrounded by the myth of being unaffordable, deterring many Australians from safeguarding their most valuable asset—their ability to earn. This introduction aims to address this misconception head on, revealing the real value that income insurance policies can provide. It is crucial to understand that the cost of such a policy pales in comparison to the potential financial hardship faced without one. - read more
|
Breaking Down the Barriers: Understanding Income Protection for Self-Employed Aussies Hello to all the self-employed Aussies out there! Embarking on the journey of self-employment brings with it a unique set of challenges and freedoms. One area we often overlook is the need for a solid financial safety net, customized to our varied incomes and work lifecycles. That's where income protection insurance steps in as a critical component for ensuring financial stability. - read more
|
Benefit and Wailting Periods: Choosing the Right Combination for Maximum Protection and Value In Australia, income protection insurance stands as a vital safeguard for professionals, ensuring security during times of unexpected illness or injury. It acts as a financial buffer, providing a percentage of your regular income, so you can maintain your lifestyle without the stress of lost earnings. - read more
|
Important Tips to Streamline Your Income Protection Claim in Australia In today's unpredictable world, securing your financial future is more important than ever. Income protection insurance plays a pivotal role for working Australians by providing a safety net in case illness or injury prevents you from earning an income. As an essential part of your overall financial planning, understanding income protection is crucial for peace of mind and stability. - read more
|
Avoiding Overinsurance: How to Choose Adequate Coverage Without Wasting Money Income protection insurance is a key component of financial planning that safeguards your earning potential in the untimely event of illness or injury. In Australia, it reassures individuals that their most valuable asset, the ability to earn, is shielded against unforeseen circumstances. Adequate income protection can provide peace of mind, with the security of a regular income even when you're unable to work. - read more
|
What Australians Need to Know Before Choosing an Income Protection Plan Income protection insurance is a critical safety net for Australians, offering financial security in the event that one is unable to work due to illness or injury. The peace of mind it brings cannot be overstated, as it ensures that individuals and their families can maintain their standard of living even when the unexpected happens. - read more
|
What Australians Need to Know Before Choosing an Income Protection Plan Income protection insurance is a critical safety net for Australians, offering financial security in the event that one is unable to work due to illness or injury. The peace of mind it brings cannot be overstated, as it ensures that individuals and their families can maintain their standard of living even when the unexpected happens. - read more
|
Dispelling the Myths: Why Income Protection is More Accessible Than You Think Income protection insurance serves as a financial safety net, designed to support individuals in the event that they are unable to work due to illness or injury. The significance of this type of insurance lies in its ability to provide a continuation of income during tough times, ensuring that one's financial responsibilities are taken care of. - read more
|
Avoiding Overinsurance: How to Choose Adequate Coverage Without Wasting Money Income protection insurance is a key component of financial planning that safeguards your earning potential in the untimely event of illness or injury. In Australia, it reassures individuals that their most valuable asset, the ability to earn, is shielded against unforeseen circumstances. Adequate income protection can provide peace of mind, with the security of a regular income even when you're unable to work. - read more
|
The Myth of Unaffordability: How to Find Value in Income Insurance Policies Income protection insurance is often surrounded by the myth of being unaffordable, deterring many Australians from safeguarding their most valuable asset—their ability to earn. This introduction aims to address this misconception head on, revealing the real value that income insurance policies can provide. It is crucial to understand that the cost of such a policy pales in comparison to the potential financial hardship faced without one. - read more
|
Maximizing Your Income Protection Payout: Tips and Strategies In the realm of personal finance, security is a cornerstone that cannot be overlooked, and this is where income protection insurance steps in. For Australians, the peace of mind that comes with knowing you're covered against loss of income due to illness or injury is invaluable. This form of coverage acts as a financial safety net, ensuring that life's unexpected twists do not leave you in a lurch. - read more
|
Breaking Down the Barriers: Understanding Income Protection for Self-Employed Aussies Hello to all the self-employed Aussies out there! Embarking on the journey of self-employment brings with it a unique set of challenges and freedoms. One area we often overlook is the need for a solid financial safety net, customized to our varied incomes and work lifecycles. That's where income protection insurance steps in as a critical component for ensuring financial stability. - read more
|