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
Cracked driveway 2018

Tom had a large crack in his driveway that he wanted his insurance company to pay the repairs for. The insurer declined Tom’s claim based on the cause of damage. Tom felt that insurer had not properly assessed the cause of damage before making their decision and complained to FSCL.

Saving grace 2018

Ravi is ill and unable to live within his means, but he’s not 65. Can he access his KiwiSaver money early?

Falling between the cracks 2018

What happens when two brokers are involved, one made the mistake but the other broker renewed an insurance policy without checking the policy was appropriate for the client’s needs

Biting off more than one can chew 2018

Pam wanted her travel insurance to pay for her husband’s dental treatment overseas. The insurer declined to pay costs that did not relate to emergency dental treatment. Pam complained this was unfair as the dental costs arose as a result of her husband’s tooth injury.

Fast and Spurious 2018

Jax bought a motorcycle but did not tell his insurers that he did not have a motorbike licence. The motorbike was stolen from his garage. The insurer declined to compensate Jax for his loss.

Heart surgery and travel do not mix 2018

Hari suffered complications during heart surgery requiring him to cancel his overseas travel to China. The insurer declined to pay for the cancellation costs noting Hari’s heart condition was a pre-existing medical condition and his inability to travel after surgery was a foreseeable event. Was the insurer unfair in declining Hari’s claim as his doctor had cleared him for travel?

An expensive heartache 2018

Roger suffered complications during heart surgery requiring him to cancel his overseas travel. The insurer declined to pay for the cancellation costs noting Roger’s heart condition was a pre-existing medical condition. Roger complained that this was unfair.

Eating is an emergency 2018

Veronica lost her dentures on her return flight and needed her dentures to eat. She made a claim under the emergency dental section of her travel insurance policy but was turned down by the insurer.

Baby’s day out 2018

Katie’s infant daughter was not allowed to board a plane in south America because the airline printed an incorrect boarding pass. Katie had to purchase new flights and accommodation to continue with her trip. Katie’s travel insurance company refused to reimburse her because the travel insurance policy excluded cover for incidents arising from the airline’s negligence.

Travelling with a foot injury 2018

Tina suffered an injury to her foot that required her to cut short her holiday in Japan and return to New Zealand. The insurer declined to pay Tina’s claim noting she had not obtained a medical certificate. Was this right?