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.
|
Title |
Year |
Case summary |
|
Having to sit down during the stand down |
2016 |
Daniel wanted to reduce his insurance premiums. Daniel’s adviser found a new policy that would provide similar benefits at a lower premium. 60 days into his new policy, Daniel was diagnosed with cardiomyopathy. Daniel’s claim under his new trauma policy was declined because it occurred within a 90 day stand down period in his policy. Daniel felt his adviser should have ensured that he had trauma cover before cancelling his old policy. Would Daniel’s claim ever be paid?
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Foreign exchange translating to no money |
2016 |
Li Wei opened a foreign exchange account with a trading platform and began trading. At first, Li Wei received a couple of withdrawals from his account. However, the foreign exchange company suddenly went silent and Li Wei could no longer access the money he had deposited in his account, being almost $65,000USD. |
|
Unrelated illness and injury but same clinical sign |
2017 |
Ligaya’s dog, Dusty, was diagnosed with an autoimmune disease. Ligaya submitted a claim to her pet insurance company for the cost of Dusty’s treatment. However, the insurance company declined the claim as it considered its 21 day stand down period exclusion clause applied. Dusty had previously received treatment for a sore hip within this 21 day stand period, and the insurance company thought this was a sign of the autoimmune disease. Was the insurance company right? |
|
When Peer-to-peer goes bad |
2016 |
Natalie invested with a peer-to-peer lender. The peer-to-peer lender later told Natalie that some of the loans she had invested in had been written off as bad debts. Natalie wanted to know what debt recovery process the peer-to-peer lender had followed to recover her loss. What rights does Natalie have? |
|
Missing conversation about the missing electrode tip |
2016 |
Warren’s vehicle started ‘running rough’. When Warren inspected the motor, he saw that the electrode tip from one of the spark plugs was missing. He made a claim to his insurance company. The insurance company dismantled the engine and found that the broken off electrode tip had caused damaged to Warren’s motor. The insurance claim was declined. Did the insurance policy cover the damage? |
|
Personally guaranteeing a commercial loan |
2016 |
Carol’s business was placed into liquidation and wound up. However, Carol had signed a personal guarantee for a loan to the business to purchase two trucks. The trucks were sold and the finance company pursued Carol for the residual balance. At the same time, Carol had issued proceedings against her ex-partner in the Family Court for the division of their relationship property. |
|
The Big Short (-term loan) |
2017 |
Wendy took out a loan of $4,000 in 2012. Four years later her loan balance was $13,500. Despite now having a stable income and meeting her fortnightly repayments, some time ago Wendy’s loan had gone into default and she was unable to pay enough to catch up on the arrears. With the amount of default interest and fees accruing on her account, her loan had been at a standstill for over a year. What happened for Wendy to have found herself in this position? |
|
Policy sections material for clothing claims |
2016 |
Lindsey’s bag was lost by an airline. The airline paid Lindsey $4,686.74 as compensation for losing his bag. However, Lindsey had calculated that the items of clothing in his bag were worth $7,201.69. Lindsey wanted his travel insurance company to accept his claim for $7,201.69 worth of lost clothing. |
|
Dental denied |
2016 |
During a flight home, Raelene broke her tooth while eating her inflight meal. Raelene visited her usual dentist in New Zealand and the dentist was able to fix her tooth for $150. Raelene submitted a claim under her comprehensive travel insurance policy. She was surprised when the claim was declined as she thought by purchasing a comprehensive policy she had full cover for any event that might happen to her while overseas. |
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Different exchange rates applicable for different methods to load a travel card |
2016 |
Duane was going overseas for a holiday and had organised a travel card to manage his money. When Duane loaded his money onto his card he discovered that the exchange rates used to convert his NZD were different (and less favourable) than the exchange rates advertised on the travel card’s website. The travel card company said that the exchange rates advertised on the website were not the applicable exchange rates for the method Duane used to load money onto the travel card. |
