Business Insurance Blog


How the Right Broker Can Help With Rejected Insurance Claims

Insurance companies sometimes get a bad rap for trying to weasel their way out of legitimate claims. We’ve all heard more than our fair share of stories about companies that have denied claims on technicalities, upholding the letter etc. This is not in the spirit of the contract.
In Australia, however, it’s rare for reputable insurance providers to deny a claim. In fact, according to a study published by the Financial Ombudsman Service, only 3% of all insurance claims are denied.
But you’re probably wondering… what if I end up in the 3%? Can my family or my business survive a costly liability? Isn’t that why you’ve been paying for insurance in the first place?

Why are Insurance Claims Refused?

If you ever receive a rejected insurance claim, turn to your broker for assistance to understand the finer points of the insurance policy, and how your circumstances fit within the policy.
The 3 most common reasons for insurance claims being denied are:
1. Limited coverage that does not include the damage within your claim.
2. Claims in excess of the policy limit.
3. Lapsed coverage which can arise for a variety of reasons, including failure to pay your monthly insurance premium.
If your claim is denied for one of the above reasons, the insurance company’s decision may be legitimate. Or, if you’ve done your research, you may still feel the denial is unreasonable. Either way, you should reach out to your broker for help taking further action.
Your broker can quickly help you determine whether there are grounds for challenging the insurer’s decision. Specifically, most insurers subscribe to the General Insurance Code of Practice. This code is in place to ensure fair and timely resolution of customer disputes. If your insurer has violated the code, you can use that violation to demand a fair, equitable, and prompt resolution. Specifically, section 10 of the code deals with complaints and disputes. There are strict time periods in place in which insurers must deal with complaints.

Leverage your Broker’s network

Perhaps the most confusing thing about navigating a rejected insurance claim is the variety of protocols and institutions that play a role in the appeal process.
Under Australian law, insurers are required to provide two separate avenues for appeal.
1. Internal Disputes: Every Australian insurance company MUST provide an internal dispute resolution process, allowing you to appeal the denial directly with the insurer. Most insurance companies don’t promptly reply to these inquiries, so be prepared to wait for a response. However, under law, insurers are required to respond to you within 15 days. Because your broker is often well connected with the insurance company, he/she can help you receive a response as quickly as possible. They can also help you to provide all required information on the first submission so that the review process is not held up further.
2. External Financial Ombudsman Service: Once you’ve gone through the proper internal dispute channels, you can appeal the decision to an independent Australian agency called the Financial Ombudsman Service (FOS). If you’re still not satisfied with the results of your internal dispute, ask your broker to provide you with the proper contacts to initiate an external adjudication through the FOS-.

Your Broker knows your policy

You can measure the quality of your insurance broker by the depth of their knowledge about your policy. The best brokers will know the finer detail about your policy, allowing them to effectively mediate with your insurer if/when your claim is refused.

If you want to know more about whether your insurance policy has you correctly covered please feel free to call us on 1300 167 143.


Insure against bad luck? Yes you can!

We’re all human right? We all have clumsy moments and drop things or become forgetful and lose things. Generally we categorise these moments as bad luck. There is a way to insure against these everyday life accidents, protecting your home and personal belongings – its called Accidental Damage cover. It’s a cover that gives that extra level of insurance protection that you may be missing out on.

In the current market there are two types of home and contents insurance policies which are:
1. Defined events
2. Accidental Damage

Both of these policies offer an extra layer of protection but it’s important to understand what they cover to identify which policy would be most applicable to you.

Defined Events Policy
The type of policy you’ve purchased should always be stated clearly on your insurance paperwork. A Defined Events insurance policy can also go by the name of Listed Events or a Listed Perils Policy. A Defined Events policy will typically limit you to only being able to make a claim for loss or damage caused by:

  • Fire or explosion
  • Lightning
  • Earthquake
  • Theft or attempted the of contents from the home
  • Deliberate or malicious acts
  • Bursting, leaking, discharging or overflowing of fixed basins, shower bases, or other fixed apparatus or fixed pipes used to hold or carry liquid of any kind
  • Fusion of an electric motors less than 15 years old
  • Accidental breakage of fixed glass, hand basins, baths and toilet bowls or cisterns
  • Riot and civil commotion
  • Impact by a vehicle, aircraft, falling tree, anima, television or radio aerial or falling power or communication poles
  • Storm cyclone, hurricane and rainwater
  • Flood

Overall a Defined Events Policy is good but it doesn’t offer cover for those everyday bad luck moments.

Accidental Damage Policy
In comparison to a Defined Events policy, an Accidental Damage policy will cover the same events but it goes above and beyond by covering you for damage to your building and contents that is caused by an accident. So:
• If you accidentally drop and break personal items (at home or away from home)
• If you accidentally leave or lose any personal items (at home or away from home)
• If you accidentally damage your carpets, walls or parts of your building

If you want to be covered for all of the above then Accidental Damage is the cover you require

So just to recap, both the Defined Events and Accidental Damage policies will cover your Building and Contents for the events listed in the Product Disclosure Statement. However the Accidental Damage policy is superior in its coverage and provides accidental damage to your building and contents in your home and to top it off – worldwide cover for loss or damage to your personal items.
As with all insurance policies, limits and maximum values may apply. An Accidental Damage policy will generally have higher limits than that of a Defined Events policy.
If you want to know more about upgrading to an Accidental Damage policy or if you’re not sure what type of policy you have in place, please feel to call us on 1300 167 143.


6 things you cannot ignore when it comes to your commercial building insurance

As a commercial property owner, the cost of being underinsured can be significant. Yet, so many owners underestimate the total cost of rebuilding their commercial property. To add insult to injury, if your building is not insured for full replacement value, your insurer can apply an under-insurance clause that will limit your claim payment.

With the help of your Insurance Broker, make sure to factor in these 6 additional expenses when working out the replacement value for your building:

  • Debris Removal – This is often overlooked, but you WILL have to remove the damaged building at your property location before you can start to rebuild and replace. Plan accordingly.
  • Architects, Engineers, etc. – Before you can start the rebuild, you’ll need to hire a variety of people to get the project underway. This includes, but is not limited to, surveyors, architects, and (in some cases) engineers.
  • Government Regulations – If your property currently occupies an area that’s governed by local building regulations, you’ll need to factor compliance with those standards into the final cost. Example: Accessibility, Fire Safety, Etc.…
  • Goods & Services Tax (GST) – As you already know, end-consumers are required to pay a 10% GST on most sales. After calculating the total expected costs of a full rebuild, add 10% of that total to ensure that your GST is covered.
  • Legal Expenses – Legal disputes are an unfortunate reality when building, or rebuilding, your building. Be sure to factor in possible disputes with your local government, or with the contractors, architects, and engineers that you pay to complete the project.
  • Material and Labour Costs – Be sure to update your building sum insured on a regular basis to keep inline with inflation. While you may be depreciating the value of your building for tax purposes, the actual cost to rebuild your building will generally go up over time due to an increase material and labour costs.

If you want to learn more about commercial property insurance, call Guard Insurance Brokers on 1300 167 143 and speak to one of our friendly Insurance Brokers.


Key Concerns for Business Owners

A recent survey conducted by Vero has provided valuable insight into the primary concerns of small to medium business owners. The top concerns identified were; 

  • Increase in costs 
  • Economic downturn
  • Competitors 
  • Being unable to trade
  • Equipment breakdown
  • Adverse publicity 
  • Adverse regulatory changes 
  • Workplace accidents 
  • Political instability 
  • Cyber attack

As a business owner, it’s very important to identify the key risks to your business and have a plan in place to minimise any negative financial impacts. 

While insurance is not the answer to all the concerns listed above, it is an important step in building a risk management plan for your business and protecting the financial security of you and your family. 

If you would like to discuss how insurance can play a part in protecting your business, please call us. Our team of professional brokers are happy to help. 


Management Liability Insurance: Are you covered?

Over the last couple of years, we’ve noticed legal proceedings concerning negligence and / or breaches of legislation occurring more frequently. As a business owner, you’re exposed to significant legal defence costs and fines. Even if you’ve done nothing wrong, you can still be required to pay legal expenses to defend yourself if a disgruntled employee brings a case against you. 

Management liability insurance is designed to protect companies from the expenditure involved in defending their business and payouts / fines that may be awarded.   

Management Liability covers a broad range of areas. Key sections include issues pertaining to OH&S, Employment Practices, Employee Crime, and Statutory Liability. To help you develop a better understanding of this insurance, one of our insurance partners have provided a few real claims examples below.

If you would like to discuss Management Liability insurance in more detail, please give us a call.


Public Liability Insurance – Injury to Sub-Contractors

Over the last couple of years, we have noticed insurers starting to ask a lot of questions around the use of sub-contractors, particularly in any trades related industry. This additional underwriting is a result of increasing claims for personal injury to sub-contractors. 

As a sub-contractor is not deemed to be an employee, they are not covered under the businesses workers compensation insurance. So if a sub-contractor is injured while working under your direction, they (or their workers compensation insurer) can bring claims against the business owner’s public liability insurance. Claims are being made on the basis of business owner’s not providing (and documenting) adequate training, safety procedures or insuring a safe working environment. 


Business Insurance – Are you Underinsured?

New research from CGU has revealed that underinsurance is potentially a serious risk to the sustainability of many small businesses with many operators facing devastation if they suffer a major setback or loss.

The research, carried out in partnership with loss adjusters McLarens Young International, reviewed actual levels of underinsurance – not just business perceptions of the problem.


What is Business Interruption Insurance?

To put it simply, Business Interruption insurance protects against loss of profit resulting from an interruption to your business activity. Interruption to your business activity has to be caused by an insurable event such as Fire, Storm, Accidental Damage, Machinery Breakdown or other events you are insured against as stated in your business policy.

Common problems suffered by businesses as a result of interruption include:

  • loss of profit margin on stock destroyed;
  • non-fulfilment of standing orders;
  • breaking of contracts and / or loss of customers to competitors;
  • certain continuing expenses, for example, rent, payroll, interest;
  • additional expenditure in order to minimise loss of income, like rental of temporary operating premises, or working additional shifts;
  • the availability of replacement plant and machinery or parts for damaged plant and machinery;

Business Insurance – The Risk of Under-Insurance

Apart from the obvious risk of not insuring your business assets for full replacement value, an additional risk lurks in the fine print of your business insurance policy. The clause I am referring to is generally called an “Under-Insurance” or “Co-Insurance” clause.

It’s a difficult clause to explain, and I do recommend you refer to your policy wording for worked examples, however the general provision of the clause allows the insurance company to only pay a percentage of a claim in the event your business is under insured.