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
Tummy troubles 2017

Samantha’s kitten was unwell, but insurance policy excluded cover for gastro-intestinal disorders. Would the kitten be covered?

“Why can’t I claim insurance when I can’t use my business?” 2017

Sam’s business was severely affected by the Kaikoura earthquakes. Though his building was not materially damaged, a neighbouring building needed to be demolished before he could begin trading again. Was Sam able to use his business interruption insurance to cover his stop in trading in the intervening 8 months?

“It’s all mother nature’s fault, not mine!” 2017

Sally and her family were unable to get to Vanuatu for their planned holiday because of the impact that Cyclone Cook had on their flights. Sally and her family travelled by taxi from Wellington to Napier in order to try and make their international flight from Auckland. Twenty minutes from Napier, they learnt that the flight from Napier was also cancelled. The insurance company refused to pay for the taxis.

“How am I meant to know my conditions are related? I’m not a doctor.” 2017

Tim had a double bypass and aortic aneurysm a number of years ago, but had suffered no issues since. His medicine for these conditions hadn’t changed in a number of years. After declaring these conditions in his medical declaration, Tim obtained travel insurance with these conditions excluded from the policy. Days before he left on his trip to South Africa, Tim experienced major ‘cramp’ in his leg and could no longer travel. Did he have cover?

‘Have you heard the one about high value items?’ 2017

Thomas lost his hearing aids while holidaying in Hawaii. His claim for $9000 was accepted by his travel insurer, but a sub-limit for ‘electronic equipment’ meant he only received $2000 in settlement of his claim. The insurer said that if Thomas had wanted to insure his hearing aids for their full value, he should have specified them in the policy. Thomas said he didn’t know he had to specify hearing aids and he disputed that hearing aids were electronic equipment. Is the insurer right?

‘Party hard but keep your belongings close’ 2016

Miguel and Selina were living it up at a Las Vegas casino pool party in a beach cabana. During the party, Miguel’s wallet was stolen from a bag on a sunbed in the cabana which Miguel and Selina frequently returned to. The loss was reported to police, but Miguel’s travel insurer declined to pay his claim saying the loss was due to the wallet being unattended in a public place.

What’s my (debt’s) name again? 2016

Can a person be pursued for payment of an old company debt?

“A quick exchange with FSCL resolves an exchange rate complaint.” 2017

What exchange rate does a travel insurer use when calculating a claim settlement in New Zealand dollars?

Warning: travel card active immediately 2017

Traveller was unaware his travel card was active, and left it with the PIN in his hotel room allowing a thief easy access to his account

Superannuation slip-up 2017

A miscalculation of the benefit to be paid when a superannuation scheme was wound up caused stress and inconvenience