Homeowner Successfully Challenges Insurer in Disclosure Dispute

9

According to Auto & General Services, it denied the claim for flood damage because the homeowner failed to disclose that he had been running an air conditioner and refrigerator retail business from the shed. The insurer pointed out that during the most recent policy renewal, the homeowner confirmed that no part of the property was used for business activities or for buying, selling, or storing business products or equipment.

The homeowner admitted to operating a business out of the shed but argued that he was not required to disclose the details because the policy specifically excluded coverage for business and farming structures, including sheds. He emphasized that the policy referred to the insured dwelling as a "freestanding house" and that any losses to the shed were covered by a separate business insurance policy.

The Australian Financial Complaints Authority (AFCA) sided with the homeowner, stating that the home and contents policy did not cover the shed and it was fair for him not to disclose the business. AFCA ruled that when the homeowner answered the insurer's question about whether any part of the "property" was being used as a business premises, he understood the question to refer only to the freestanding residential dwelling where he lived. AFCA also noted that the certificate of insurance specifically mentioned the freestanding home and did not include any reference to outbuildings or sheds.

As a result of the ruling, Auto & General is now required to accept the claim and appoint a qualified expert to prepare a scope of works for repairs to the insured property. The insurer must arrange and complete the repairs or provide a cash settlement with a 15% contingency. AFCA has also instructed Auto & General to assess the homeowner's entitlement to temporary accommodation benefits and reinstate his policy.

Published:Saturday, 9th Dec 2023
Source: Paige Estritori

Share this news item:

Insurance News

Car Collector Fails in Bid for $122k Insurance Windfall 24 Jul 2024: Paige Estritori A car enthusiast's efforts to boost his insurance payout from $78,000 to $200,000 after his rare vehicle was destroyed by fire have been thwarted. - read more

Financial Advice Landscape Set for Further Overhaul 24 Jul 2024: Paige Estritori Financial industry professionals are bracing for significant changes as new reforms surrounding commission consent in financial advice have moved into effect. With the successful passage of the Treasury Laws Amendment (Delivering Better Financial Outcomes and Other Measures) Bill 2024, the sector anticipates a substantial shift in how financial advisories are delivered to retail clients. - read more

Queensland Renters Face Significant Financial Risk Without Contents Insurance 23 Jul 2024: Paige Estritori Queensland renters are increasingly vulnerable to financial setbacks due to a lack of contents insurance, warns RACQ Insurance. An alarming 78% of renters in Queensland forgo this critical coverage, primarily underestimating the value of their belongings. Other reasons for this trend include the cost of insurance and a general lack of knowledge regarding coverage options. - read more

Massive Fines Hit Rogue Builders Over Fake Insurance 20 Jul 2024: Paige Estritori On July 19th, 2024, in a significant crackdown on fraudulent building practices, Aycon Constructions along with its director, Seyit Ayranci, received a record-setting fine of $250,000 from the Victorian Building Authority (VBA). The enforcement action came after the construction firm was implicated in the use of falsified insurance certificates to secure building permits. - read more

Liberty Mutual Re insurance Unit Further Solidifies Aussie Market Reach 20 Jul 2024: Paige Estritori Liberty Mutual Insurance Group's LM Re insurance unit is making impactful strides with the inception of a dedicated Australian branch. At the helm of this initiative is Mark De La Mare from Aon, who will guide the underwriting team nestled in Sydney. - read more