AFCA Ruling: Trucking Firm's Claim Invalid Due to Misrepresentation

1

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.

The issue arose when the firm, led by a sole director identified as "B," sought insurance through a broker. The truck, valued at $82,500, was purchased from "C," the director of another company called "CT". The insurance application falsely stated the company had two years of prior operational and insurance history. Additionally, the declared operational radius was less than 600 km, despite the truck operating interstate.

NTI, upon reviewing the claim, refunded the premiums and rejected the coverage, citing misrepresentation. AFCA supported NTI's decision, reinforcing that no previous insurance was held by the complainant, who had operated for only 19 months. AFCA highlighted that while the business relationship with CT may have confused the broker, a reasonable person wouldn't have provided such misleading information.

This case underscores the critical nature of transparency and accuracy in insurance applications. Misrepresentations, whether inadvertent or deliberate, can lead to denied claims and significant financial repercussions. For businesses, particularly those engaging in partnerships or involving third-party brokers, this ruling serves as a reminder of the due diligence required when disclosing insurance history and operational specifics.

The decision also illustrates the strict adherence to policy stipulations regarding insurance history-a key criterion for coverage eligibility. For consumers, it highlights the importance of understanding the details of insurance applications and the potential impact of inaccurate disclosures.

The ruling may prompt businesses to review their insurance policies and application processes, ensuring alignment with operational realities and disclosure requirements. It serves as a cautionary tale for companies relying on brokers or partners to manage insurance applications, emphasizing the need for oversight to prevent costly mistakes.

For insurers, this case could lead to more rigorous checks during the application assessment to verify client information, reducing the risk of similar occurrences. As the financial services landscape evolves, such cases might influence further regulatory updates to safeguard both insurers and policyholders.

Published:Thursday, 10th Apr 2025
Source: Paige Estritori

Please Note: If this information affects you, seek advice from a licensed professional.

Share this news item:

Insurance News

Clear

Surge in Mental Health Claims Reshapes Australia's Insurance Landscape

31 Oct 2025: Paige Estritori

Australia's insurance industry is experiencing a significant shift as mental health conditions have become the leading cause of total and permanent disability (TPD) claims. Recent data from the Council of Australian Life Insurers (CALI) indicates that mental health issues now account for nearly one-third of all TPD claims, marking a substantial change in the industry's claim patterns. - read more

Australian Super's Claim Delays Raise Concerns Among Members

31 Oct 2025: Paige Estritori

Australian Super, one of the nation's largest superannuation funds, is facing criticism over significant delays in processing insurance claims, particularly those related to income protection and total and permanent disability (TPD). Members have reported prolonged waiting periods, leading to financial hardships and uncertainty. - read more

New Legislation Prohibits Life Insurers from Using Genetic Test Results

31 Oct 2025: Paige Estritori

The Australian government has enacted legislation prohibiting life insurers from using the results of genetic tests to refuse coverage or increase premiums. This landmark decision aims to eliminate genetic discrimination and encourage individuals to undergo potentially life-saving genetic testing without fear of financial repercussions. - read more

TAL's $4.7 Billion Payout Reflects Rising Insurance Claims in Australia

23 Oct 2025: Paige Estritori

Leading Australian life insurer TAL has reported a substantial $4.7 billion in life insurance claims paid over the 12 months ending March 31, 2025. This figure underscores the significant role life insurers play in providing financial support to Australians during challenging times. - read more

Encompass Protection Recognized as Best Income Protection Provider in 2025

23 Oct 2025: Paige Estritori

Encompass Protection has been honored with the Income Protection Insurance Award at the 2025 Money Magazine Life Insurance Awards. This accolade reflects the company's commitment to providing exceptional coverage and service to Australians seeking income protection solutions. - read more

Rising Mental Health Claims Reshape Australia's Insurance Landscape

07 Oct 2025: Paige Estritori

Australia's insurance sector is experiencing a significant shift as mental health conditions become the predominant cause of total and permanent disability (TPD) claims. Recent data from the Council of Australian Life Insurers (CALI) indicates that mental health issues now account for nearly one-third of all TPD claims, marking a substantial change in the industry's claim patterns. - read more

Click for more Insurance News