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NSW Insurance Claim Denied, HELP!

Discussion in 'Politics, Laws, Government & Insurance' started by flyindutchie, Apr 15, 2013.

  1. Hey people,

    here's my issue with my current insurance company (QBE). I had a minor prang a few weeks ago on my bike, but not small enough to pay for it myself right now, and am a everyday rider, so i decided to claim on the insurance. I have had the insurance (platinum cover, highest grade they offer) for 7 months, paid it always on time without a hitch.

    my issue is that they have gone through the paperwork and come back to me with "we wouldnt have insured you in the first place because your point rating is too high on our scale, so we cannot pay out your claim or fix your bike, as you shouldn't have been insured in the first place"

    now, because i own part of the bike, and another part is owned by a financier, the insurance was obviously a must. However, at the time of purchase, i was asked all the licencing questions by the dealership, which is protocol on seeing if you are actually insurable or not, and answered them to what i knew to be true (which matches my driving record, so no issue there).

    what QBE are saying is that there is no records with them of previous fines or driving offences when the insurance was put through, which is strange since i passed on that information to the dealership via telephone (they are based in queensland, im in nsw). my retort was that i didnt even see the insurance put through, recieve any paperwork or put it through myself as the guy at the dealership did it all for me. i have other paperwork from the dealership but nothing insurance related.

    i wouldn't have been able to buy the bike if the insurance hadnt gone through, since the other amount that was financed wouldnt have been since i couldnt get insured. so my question is, what do i do now?
  2. how much will the repair cost vs what you have paid for insurance so far?
  3. contact the insurance ombudsman.

    they were happy to take your money, they may claim they will refund it and not pay out on the claim, but the fact is if they, or their agent had not given you the insurance in the first place then you would have had the opportunity to get insurance elsewhere.

    insurance companies will ALWAYS try to dick you round, they profit from it, more often than not in my experience you just need to stick to your guns and not accept their decision.

    PS. best of luck.
    • Like Like x 4
    • Agree Agree x 2
  4. You could appeal the decision, with he financial services ombudsman.

    Your non disclosure may require you to pay a higher premium though.
  5. #5 mainstage, Apr 15, 2013
    Last edited: Apr 15, 2013
    Yes to this (y) and check and read all your paper work

    And also op who is the dealership you speak of ?
  6. Contact the dealership.
    It's going to be difficult to prove this since all you have is what you said.
    You should have received paperwork. No clue how they do this through a dealer but I'd think it should have been you who filled out the application and signed it.
    I'd contact the dealer. Ask for review through the insure and then the Ombudsman is a possibility.
    If you shouldn't have been insured by them then you might be entitled to a refund unless there PDS says not or they claim you were untruthful. A refund might cover the cost of repair depending on how much you pay.
    You'll need new insurance or confirmation that the existing one is valid. A new policy might be difficult since you have now been denied insurance unless it is sorted out.
  7. I've explained the issue to the insurance manager who has gone to make a few more phone calls back to the dealership. Conveniently enough, the guy who i was dealing with no longer works for the company so it's all looking downhill at the moment. I would put the dealerships name down, but will be nice enough to hold off on slagging them until it gets resolved, because in my mind i am very biased right now.

    Is it worth getting in touch with the ombudsman before the insurers give their direct answer on paper?
  8. #8 NSSherlock, Apr 15, 2013
    Last edited: Apr 15, 2013
    Ombudsman's usually require you to have taken steps to try and resolve an issue first. Often that requires going through a company's internal review system.
    It won't hurt to contact them for advice though.

    Would anyone else have insured you at the time you bought the Bike considering your record? Maybe do some quotes but answer them as if it was when you bought the Bike.
    • Informative Informative x 1
  9. The ombudsman will be the course of action to follow once the insurer has completed an internal review if you are not happy with their decision.

    Generally, complaint to manager, not happy then complaint to insurers internal dispute resolution, not happy then ombudsman.

    I'm not sure i'm understanding all the details of this though.

    They are denying your claim because of your driving history. You said this was fully disclosed to the dealership? And i assume you understood that this was passed onto the insurer. How did the Insurer now know what your driving history is in order to deny the claim/insurance policy? Why was this not done when it was taken out? Did the dealer not pass this on? Do you have a poor driving record?

    Also, If they say they would not have insured you had they been provided the full information, then they should cancel it back to inception and refund you any premium paid.
    • Like Like x 1
  10. also. Ask them for the ORIGINAL contract. The one you must have signed to get the insurance in the frst place. see if the error is on the part of the dealer (not filling it in and you as the dummy not checking it) or on the part of the insurance company for providing you insurance, against their policy, but with full access to your details.... If the paperwork they received has all the accurate information on it... SCREW THEM.

    if they come back and say they lost it, call bullshit...
  11. I reckon they only check it when they "need" to. They don't "need" to when taking your money but when a payout comes along they will often do most anything to prevent it and hence will check it.
  12. These are the questions im putting to the insurer now :) I lost my licence 2 years ago for 3 months, and had a red light cam pick me off about a year ago. Thats the lot. But this was disclosed to the dealership prior to insurance being taken out.
  13. 'Hey we can't insure you, but why not pay for a policy anyway?'

    Well done QBE
    • Like Like x 1
  14. do an online quote with them and disclose everything, see if it gives you a price or tells you to call up.
  15. if this information was provided to the insurer with your application and they accepted your application then the error is theirs and while they might try and get out of it, they shouldn't be allowed to by the ombudsman.

    this sort of behaviour, checking paperwork when it comes to claims but accepting the payments in meantime completely undermines the risk mitigation that having insurance provides, it is dishonest, and it robs the individual of the opportunity to gain insurance elsewhere.... it's the sort of thing the ombudsman should be very concerned about.

    ... perhaps it is a mistake... but it's probably a mistake the insurer would want to hide and would pay more than your repairs to avoid highlighting.
    • Like Like x 2
  16. Little up side here you could have been riding around for 2 3 5 years paying and renewing your insurance for northing and then your bike is toteled or stolen and you go thorgh this !

    Let us know how you go . Good luck
    • Like Like x 3
  17. Unfortunately a contract can be found invalid if either party wasn't aware of the details. So if the dealer lied to the insurance company to get the sale and the finance, then QBE will win in the end.

    Your beef then becomes with the dealer, not the insurance company.
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    • Agree Agree x 1
  18. Western QBE are the worst. They pulled the same kind of thing on me when I had a bike that had some scratches that I bought through dealer and insurance through the dealer then claimed that it had "preexisting damage". Yeah but your agent knew that.

    And it wasn't even their money, it was the taxi's fault so they could recover the money anyway. They eventually paid.
  19. I am interested to know how the insurance company can get access to your driving history. Surely this is protected by privacy laws. I can imagine them asking you to provide information or proof, but can they just contact a Government department and ask for it ?
  20. How much was the insurance and how much would the damage be, would the refund on the insurance cover it?
    • Dumb Dumb x 1