Insurance Archives

Levels of disability

Ben’s claim for a total disability benefit under his insurance is declined due to him not reaching the threshold of “totally disabled”.

Mia was an international student studying in New Zealand when she fell very ill and needed ongoing medical treatment. Mia submitted claims to her medical insurer but was not satisfied with the time it took to process her claims and with the insurer’s service in general. Mia asked FSCL to investigate her concerns.

A steep ‘learner’s’ curve

Ratan was involved in a motorbike accident and then discovered his insurer would not pay the costs of repair, because he only had a learner’s motorbike licence.

The real cost of keeping quiet

You file a claim under your professional indemnity policy with your insurer for costs of appearing before a disciplinary tribunal. Your insurer investigates your claim and finds you had appeared before the same tribunal 3 years prior on a similar matter but you had not disclosed this to your insurer. Although you try to explain the situation, your insurer not only declines your claim but cancels your insurance and avoids the policy for the last 3 years. Can they do this?

Los Angeles to London not covered but Los Angeles to Lower Hutt would be

While on holiday in America, you receive terrible news. Your mother, who has been living in London, passes away. You arrange to travel to her funeral and meet with family and friends. After the funeral you return to America and are able to catch your scheduled return flight to New Zealand. Once home in New Zealand you file your travel insurance claim for return flights from Los Angeles to London. Your claim for the flights is declined because your mother was not resident in New Zealand and you did not return to New Zealand for the funeral. Is this reasonable?

Insurance application form changed leaving customer underinsured

Application form altered removing loss of use cover leaving Hamish underinsured after an accident

Insurer’s response to traveller’s responsibility

Complainant was unable to board her flight to Fiji because she did not have six months’ validity on her passport. The insurance company declined the claim on the basis that the complainant’s loss was not unforeseen and not outside her control.

A sudden but foreseeable death of a parent means there is no cover under a travel insurance policy

Laurence’s father is diagnosed with bowel cancer in August 2013 at the same time Laurence starts planning an overseas trip for his family in July 2014. Sadly, Jim passes away on 5 July 2014 and Laurence reschedules the trip for later in the year. FSCL investigates whether there is cover for the rescheduling costs under Laurence’s travel insurance policy.

High threshold for Total Disability Insurance

Douglas suffered significant damage to his spine. He made a claim under his Total Permanent Disability insurance policy. Douglas’s insurance company denied his claim because his injuries fell outside of the policy’s scope.

40 day round trip – a requirement to trigger cover

Return flights to South Africa booked for a travel period of 50 days. You misplace your Ipad 2 at Heathrow while in transit, and make a claim, to discover that you are only covered if your travel period is for 40 days or less.