Case Studies

Our case notes show how we deal with the many different issues that arise in our case investigations. The case notes aim to provide consumers and participants with guidance as to the approach we are likely to take in a particular type of case or highlight some of the many different ways in which a complaint can be resolved.

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Title Year Case summary
Flight delay upon flight delay 2016

Lynley’s flights home to New Zealand are going to be delayed by more than 48 hours. Lynley takes daily medication, but only has enough tablets to cover her for 24 hours’ delay. Lynley books new flights to get her back to New Zealand within 24 hours. Does Lynley’s travel insurance policy provide cover for the costs of her new flights?

Poorly dog results in a costly bill 2016

Simon’s dog fell ill and needed treatment. Simon submitted a claim for the veterinarian costs to his pet insurance company. However, the pet insurance company declined his claim because the illness had occurred within the policy’s 21 day stand down period.

A steep ‘learner’s’ curve 2015

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.

Shanghai Nights 2016

Under duress, Steve is forced to sign a credit card voucher authorising a payment of $2,500 while in a bar in Shanghai. We look into Steve’s travel insurer’s decision to decline the claim.

Bill’s boat bother 2016

During a charter fishing trip, water gets into the motor on Bill’s boat, causing damage. Bill submits a claim to his insurer for the costs of repairing his boat, but the insurer declines the claim because in its view, the loss was caused by the boat having a ‘design flaw’.

The authorised financial adviser and the un-authorised disclosure 2016

An authorised financial adviser (AFA) advises his clients to invest in real property and refers them to a building company. The building company experiences severe difficulties and is placed into liquidation causing the clients loss. We investigated whether the AFA was responsible in any way for those losses.

I’m sick, but not sick enough’ to meet the policy definition of ‘cancer’ 2016

Following a mammogram, Diane’s doctors discover she has Ductal Carcinoma in Situ (DCIS) and she undergoes a left mastectomy. Diane claims under her cancer policy, but her claim is declined because her cancer is ‘non-invasive’.

Business burnt when cover cancelled 2016

Sawmill burns down days after arranging new insurance, but cancellation of existing cover leaves the business underinsured.

Zap goes the Dolphin 2015

The fridge on Darryl’s boat stopped working. On closer inspection Darryl found that all the boat’s electrical components are damaged and the inverter has failed. An electrical inspector thinks the inverter failed because of a power surge from the mains power supply while the boat was charging at the dock. Will Darryl’s insurance respond?

Lost bag a lost cause 2016

When Ashish accidentally left his laptop bag on the backseat of a taxi. Ashish made a claim for his lost bag. However, his insurance policy specifically excluded cover for items left behind in a taxi. Ashish thought the policy was fraudulent and he had been misled.