Denial of Jewelry Claim Upheld: Privacy Concerns Dismissed
Denial of Jewelry Claim Upheld: Privacy Concerns Dismissed
0
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.
A policyholder's complaint, in which his jewelry claim was denied by an insurer due to his refusal to provide phone records, has been unsuccessful in overturning the decision.
The policyholder filed the claim on behalf of his mother, who suffers from dementia, after she lost a bag containing valuable jewelry and other items during a walk on the beach on September 6 of last year. The loss was reported to the police on the following day, and the claim was subsequently filed with Suncorp on September 14.
As part of its investigation into the claim, Suncorp requested various pieces of information from the policyholder, including valuation certificates for the lost jewelry, bank statements, and phone records covering the period from August 20 to September 20.
The policyholder complied with some of the requests but refused to provide the phone records, claiming it would violate his privacy and was unnecessary for the investigation.
Suncorp argued that the phone records were relevant for confirming the circumstances of the loss and the policyholder's movements during that period. Despite sending multiple follow-up letters to the policyholder regarding the request, Suncorp ultimately denied the claim, citing the policyholder's failure to cooperate as the reason for being unable to complete its investigation.
The Australian Financial Complaints Authority (AFCA) supported Suncorp's decision, stating that the phone records were indeed relevant to the claim. AFCA's ombudsman acknowledged the policyholder's privacy concerns but emphasized that the insurer is bound by the terms of the Privacy Act 1988 (Cth), which regulates the use and disclosure of personal information by insurers.
AFCA further confirmed that the insurer had the right to decline the claim due to the policyholder's non-compliance with the information request. The authority specified that it would only consider reopening the investigation if the phone records were provided.
"Since the policyholder did not provide the records, despite their reasonable request by the insurer, I am satisfied that he has failed to cooperate as required under the policy," stated AFCA.
"Until the policyholder provides the phone records and bank statement, the insurer is within its rights to deny the claim on the grounds of non-cooperation," the authority concluded.
The ruling also addressed the policyholder's allegations against Suncorp's investigator regarding improper conduct after questions were raised regarding the health and cognitive ability of the policyholder's mother.
AFCA clarified that the investigator's inquiries about the policyholder's mother, who is the policyholder herself, were general and non-intrusive. The investigator clarified that the purpose was to assess whether the policyholder's mother had the capacity to participate in an interview.
Recognizing that the dementia was too advanced for an interview, the investigator quickly moved on to other topics.
In a significant development for policyholders, TAL has expanded its Health Sense Plus program to encompass income protection (IP) policies. This initiative, effective from August 8, 2025, aims to incentivise proactive health management by offering premium discounts to clients who engage in preventative health checks. - read more
Australia's insurance sector is facing unprecedented challenges 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) reveals that mental health issues now account for nearly one-third of all TPD claims paid out. - read more
Shine Lawyers has initiated class action proceedings in the Federal Court against Rest Superannuation, alleging that the fund wrongfully deducted income protection premiums from members' accounts between December 2008 and June 2019. The lawsuit claims that up to 500,000 Rest members may have been affected by these deductions. - read more
Marine Skippers Insurance has recently unveiled a new international coverage plan tailored for captains navigating vessels to and from Australia. This development is particularly timely, coinciding with preparations for the upcoming Sydney to Hobart yacht race. - read more
NM Insurance has solidified its position in the marine insurance sector by entering into a five-year agreement with capacity provider Zurich. This strategic partnership is set to bolster NM Insurance's growth trajectory and instill greater confidence among brokers. - read more
Life insurance is a crucial part of any comprehensive financial plan, providing peace of mind that your loved ones will be financially secure in the event of your passing. - read more
When it comes to life insurance, a pre-existing condition refers to any medical condition or illness that you have been diagnosed with before applying for a life insurance policy. - read more
The digital age has fundamentally transformed how we approach almost every aspect of our lives, including the way we shop for life insurance in Australia. Gone are the days when one had to schedule meetings with insurance agents or flip through pamphlets to understand life insurance policies. Today, obtaining life insurance quotes online has become the norm, offering a hassle-free and incredibly accessible platform for individuals to safeguard their financial future. - read more
Welcome to a pivotal guide dedicated to empowering you with the essentials of income protection insurance in Australia. As we navigate through times of uncertainty, safeguarding your financial wellbeing becomes not just a priority, but a necessity. Income protection insurance stands as one of the key pillars of financial security, ensuring a steady flow of income during periods when you're unable to work due to illness or injury. - read more
For many millennials, navigating the complexities of personal finance and future planning can feel like a bewildering journey. Among these financial responsibilities, life insurance emerges as a paramount consideration. More than just a safety net, life insurance can be the cornerstone of a sound financial strategy, providing peace of mind for both the policyholder and their loved ones. - read more
Start Here !
Apply now for your free Insurance assessment and price comparisons!
Knowledgebase
Disability Insurance: A type of insurance protection that pays a portion of a person's income lost due to a total or partial disablement arising from either an accident or a sickness.
