It is not uncommon for an insurer to reject your claim or make a decision about your insurance policy that negatively impacts you. Insurers will generally rely upon one or more of the following grounds to reject your insurance claim:
- Non-Disclosure – as the person named on the insurance policy, you have a duty to disclose relevant information in a truthful, accurate and comprehensive manner. This applies at the time of taking out the insurance policy and at the time of any subsequent renewals. Failing provide accurate or comprehensive information is likely to result in your insurer rejecting or reducing the value of your claim.
- Exclusion Clauses – Your insurer may rely upon certain clauses in your insurance policy to decline your claim. This is on the basis that your insurance policy does not cover the loss, damage or injury you are complaining of.
- Fraud – It is not unusual for an insurer to cite fraud as the reason for declining your claim. An insurer is likely to rely on fraud if it has any reason to believe that you have acted fraudulently.
- Policy Cancellation – Sometimes an insurer will cancel a policy during the course of the period of cover. One reason this may occur is the insurer determining that you pose too high a risk for them due to a change in your circumstances. More commonly however a policy is cancelled due to your failure to pay the insurance premium. Although insurers will generally contact you in the event you miss a payment, you bear the responsibility of keeping your payments up to date. For this reason, it is important to make sure that you are on top of your payments.
At GDA Lawyers we can help you dispute decisions made by your insurer in relation to your insurance policy. We do this by advising you on whether you have a valid insurance claim, lodging a dispute with the insurer against a decision they’ve made, lodging a claim with the NSW Ombudsman or representing you in court if your claim is not paid in full.