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//Having a Dispute with your Insurer and Need a Lawyer?

Having a Dispute with your Insurer and Need a Lawyer?

If you believe your insurer’s services, products or their response to a claim is a mistake, then as a consumer you are entitled to make a complaint. These errors can vary from something minor like a simple misunderstanding that can be dealt with via phone to something more complex that can tangle matters, take more time and will need the assistance of a compensation lawyer to settle.

There are times when claims can be brought to address damage caused to property, be that to your vehicle, your home or the contents of your home. But before you make any decision about what to do, it’s important that you read and fully understand your insurance policy. You need to consider how your concerns fit in with what your insurer agreed to when selling you the insurance. If you cannot work out whether the insurer is at fault or not, seek the help of a lawyer who can assess the situation and advise you on what steps to take next.

Insurance companies are required under Australian law to supply two clear-cut complaints processes; one internal (within the company) and the other, an independent, external dispute resolution system to make sure disputes are resolved in a fair and straightforward manner.

Therefore, your insurer will have processes in place to handle complaints, so check your product disclosure statement (PDS) document or read it online, for these details. Remember, all insurance companies have a legal requirement to provide policyholders with clear information on their internal dispute resolution procedures.

To resolve your complaint promptly and with fairness, your insurer will work with you and inform you of any progress made with the review of your claim in at least 10 business days. An agent from your insurance company will be given the task of reviewing your dispute and will write to you within 15 business days to inform you of the outcome.

Reasons your insurance company might give for rejecting or lessening your claim could be that you haven’t given them enough information about your reasons for claiming, or that your policy doesn’t cover the damage or losses you have outlined in your claim.

If your policy has limits for certain claims, such as risks defined in your policy as exclusions, or if you are under-insured, your insurer might decide to only pay you a portion of what you are claiming for. They might also say you haven’t met the conditions outlined in your policy, that your policy was cancelled, or that you have not kept up the payments or the excess. Another reason can be that you did not maintain the property.

The kinds of damages that are usually the cause of disputes with insurance companies are those to do with flooding of homes or damage to cars in motor vehicle accidents. These claims usually end up in long negotiation processes with insurance companies. This can be frustrating as well as time-consuming and insurance companies have in the past been known to reject claims or drag them out unfairly.

If this process does not resolve your dispute to your satisfaction, your insurer must supply you with information about the kinds of options open to you. These can include a referral to the external disputes resolution program. This is free and independent, administered by the Financial Ombudsman Service. If you are still not happy, your compensation lawyer can negotiate on your behalf with the insurers, making sure you get the best outcome possible.


By | 2018-03-14T08:40:35+00:00 September 21st, 2017|PK Simpson Blog|Comments Off on Having a Dispute with your Insurer and Need a Lawyer?

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