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
“The compounding interest complaint compounds” 2016

When fees are reversed by lenders, how do they factor in a credit to compensate for the compounding interest originally accrued on those fees?

“Whose definition is definitive?” 2017

Aja’s work travel was covered by her employer’s group insurance policy. Whilst overseas Aja needed monthly check-ups (and prescriptions) for ADHD and claimed the expenses under her insurance policy. The insurer declined the claim saying a number of exclusion clauses applied. Aja disputed the declinature.

What happens if I make a genuine mistake but it’s excluded from my policy? 2017

Gerry applied for a visa online for his trip to India. He received a reply which stated his ‘application’ was confirmed. Gerry had received a similar response for his visa to Bhutan so thought he had all the necessary documentation. Gerry was denied permission to board his flight in Abu Dhabi because he didn’t have a valid visa for India. He claimed insurance for the costs of having to stay in Abu Dhabi for an additional 4 nights, and rebooking a new flight.

“Who’s right? My doctor or my insurer?” 2017

Holly’s insurer declined her claim for treatment and antibiotics for a urinary tract infection (UTI) while Holly was overseas. Because she had consulted a doctor and received treatment for a number of UTI’s in the two years prior, her insurers classed it as a pre-existing medical condition. Holly believed each infection was an isolated incident.

“Neck on the line” 2017

James’ claim was declined on the basis of non-disclosure. He argued his insurance adviser told him not to disclose a pre-existing neck injury which the insurer later relied on to decline his claim when he applied for insurance.

“What if I can’t be sure where I lost my possessions?” 2017

Radisha was on a flight home to NZ. When disembarking she forgot her bag in the overhead compartment. It contained her laptop and $1568 (USD). Hours later, upon arriving home, Radisha realised she was missing her bag. She contacted the airline but a subsequent search failed to find it. Radisha sought to claim insurance for this loss.

‘FSCL foils felonious filch’ 2017

A company’s forex accounts were seized by its transactional service provider (TSP) to pay for the TSP’s own debts. The company considers the actions to be theft but the TSP says it is permitted to take the company’s funds due to changes to its account terms and conditions. Does the amended contract apply to the company, and can the TSP take the funds?

“Please share your intentions for my shares with me”. 2016

George owned some shares which were managed on his behalf by an investment adviser. The adviser sold George’s shares in two companies at what George considered was an inopportune time. Did the adviser act outside his authority?

(lack of) Iron-man? 2017

Monty sought to be reimbursed for the costs of a trip to Rarotonga. A few days before Monty was due to go, he felt unwell and went to see his doctor. He had low iron levels. The day before he was meant to leave Monty returned to the doctor and it was agreed he was too sick to go. Monty’s claim was declined because the insurer determined that his low iron levels were a pre-existing medical condition.

“What happens to cover when you’re made redundant from your own company?” 2017

Michael and April bought travel insurance for their trip to Georgia months before their scheduled departure (May 2017). In the meantime, Michael lost his job. Michael cancelled the flights in December 2016 because his family had lost their main source of income and he did not find another job until March. The insurer denied the claim for cancellation costs because Michael wasn’t made ‘redundant.’