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
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?

The fees of our fathers 2018

Leighton’s father passed away after taking out a mortgage. The lender charged over $15,000 in mortgagee sales fees to the estate, even though the sale didn’t go ahead. Was the lender entitled to charge $15,000 in fees?

The stock loss shock 2018

Tom’s jewellery shop was burgled twice within three days, and $101,200 worth of stock stolen. Tom was shocked when his insurer only paid him $52,500, being his insurance policy’s limit for stock not stored in a safe/in window displays after hours. Tom’s insurance policy schedule never showed the limit. Did Tom’s insurance broker cause his loss?

A lead balloon 2018

An application to refinance a balloon payment into regular loan repayments is declined

Is all fair in love and war? 2018

Dan had been sending money to a young woman in a war zone. One day the foreign exchange service declined to complete a transaction. Dan became very upset and complained about the service he received.