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
What happens if the insurer’s standards of restoration are not ‘up to scratch?’ 2017

Jenny owned and rented out an apartment in Auckland. Jenny’s tenant was found dead five weeks after she died. The delay in discovery of the body caused extensive issues with the liveability of the apartment. A considerable amount of work was necessary to restore the apartment to a liveable condition. What was the appropriate amount and standard of work in order to restore the property to its original state?

No medical certificate, no service 2018

Jesse and Robin were overseas when Robin caught a nasty stomach bug. While Robin was recovering, Jesse reorganised their flights home to New Zealand. When they returned to New Zealand, their insurer declined their claim for the cost of the new flights, saying that Jesse and Robin needed to provide a medical certificate as proof Robin was too sick to fly.

A dog’s breakfast of a claim 2017

Jarred’s two dogs, for whom he had taken out insurance, suffered a number of illnesses, before and after policy inception. When Jarred went to make a claim, the insurer declined his claim on the basis of an exclusion. Jarred said the illness his dog had suffered prior to policy inception didn’t directly relate to the treatment he sought cover for.

Why is my insurance punishing me for being a good mother? 2017

Cedric and Veronica had to cancel their trip to Australia when their son began to act out and wouldn’t communicate with them. When the travel insurer declined their claim, Veronica made a complaint to FSCL.

A hard lump to swallow 2017

After Lionel’s trauma insurance claim is declined and then accepted, he complains to FSCL about his insurance adviser

Herbie’s astronomical gastric issues 2017

After a declined pet insurance claim, FSCL investigates whether Herbie has the same clinical signs as he did when his owner first took out insurance.

Two cards stolen in two days 2017

What happens if you notice your wallet is stolen, but forget your card is in the wallet and delay notifying the card provider for 24 hours? Are you liable for the unauthorised transactions?

Interested in interest? 2018

What happens when the loan agreement does not reflect what you told your financial adviser you wanted?

Unilateral cancellation of an account leads to significant financial pressure 2016

Katrina’s account is cancelled without notice, causing her significant stress. How was FSCL able to resolve the issue within a few weeks?

Around the world in 35... 37 days 2017

Ken suffers an injury on the second day of his and his wife’s overseas trip, which was supposed to last 37 days. Can the insurer decline the claim on the basis its policy only provides cover for trips lasting 35 days or less?