Life Insurance Online :: Articles

Insurance Disputes

How can I challenge my insurance claim rejection if I feel it was unfair?

Insurance Disputes

The information on this website is general in nature and does not take into account your objectives, financial situation, or needs. Consider seeking personal advice from a licensed adviser before acting on any information.

Just because your insurer has rejected your claim, does not necessarily mean that your case is closed. If you think that you have been unfairly treated, here are some ways to get the insurer decision overturned.

What to do

  • Inform the insurance company as soon as you can following the event. It is sometimes a good idea to write the details of the event as soon as you can, and then use that as a reference to make the written claim.
  • Be consistent. Remember, it will be awkward if you want to change your story later on.
  • Keep all documents that are relevant to the claim.
  • Make sure the staff of the insurance company can get in touch with you.

If the claim is rejected?

Insuring your most valuable asset
Image for Insuring your most valuable assetWhile many people would consider their home or their car to be their most valuable asset, it's your ability to earn an income that is most important in shaping your financial future. Statistically, two thirds of working Australians will suffer an injury or illness that will sideline them for 90 days or more. The majority of these people would not be able to pay their mortgage or meet car finance and other loan commitments without adequate income insurance.
... compare rates & options ...
There are circumstances where you may in fact have the legal right to be reimbursed for your loss even though the insurer refused to pay the claim. Although you can sometimes make this judgement yourself, it is sometimes a good idea to get legal advice. See our fact sheets on "Disputes".

Check the policy

If the claim is rejected ask your insurer to identify specifically the clause of the contract on which they rely. If you do not have a current policy make sure they supply one.

What caused the loss?

If the insurer claims that you caused the loss, and this is in breach of the policy, make sure that this is so.
For instance, if you were smoking in bed at the time of a fire, and a fire caused this way is a breach of your policy, you may not in fact be in breach if the fire was caused by an electrical fault. In this case the fact that you were smoking in bed would be coincidental and not the cause of the fire.

Pre-existing conditions

The policy may stipulate that a known pre-existing situation or condition is not covered. For instance, if you have disability insurance but at the time you signed the policy you had a tumor. However, under the law it would be crucial whether you actually knew you had this condition. If you were unaware of it you should still be covered.

Ignorance of the terms

Under the law the insurer has a legal obligation to inform you about the restrictions in the insurance policy. This must be done before you sign the application and the policy is issued. This means (in part) that:
  • you must be given a copy of the policy; and
  • the wording of the policy must be clear and unambiguous.
If these pre-conditions were not met it may be possible to retain your coverage for your loss. Again, it may be necessary to obtain legal advice.

Is it worth the claim?

Many types of insurance contracts will have an excess. This is common in a car insurance contract, or similarly you may lose part of the no-claims bonus. Some companies now reward rating one drivers with a lifetime rating one guarantee. At times you will have to decide whether the amount of the claim is worth the long term loss that results from the effect on rating or no-claims bonuses, especially after taking into account the amount of the excess.

Published: Sunday, 1st Aug 2021
Author: Paige Estritori


Insurance News

Australia Prohibits Use of Genetic Test Results in Life Insurance Underwriting
Australia Prohibits Use of Genetic Test Results in Life Insurance Underwriting
24 Apr 2026: Paige Estritori
In a significant development for the Australian life insurance industry, the Parliament has passed the Treasury Laws Amendment (Genetic Testing Protections in Life Insurance and Other Measures) Act 2025. This legislation, enacted on 1 April 2026, prohibits insurers from using genetic test results to influence underwriting decisions for life, income protection, or trauma insurance policies. The ban is set to take effect on 8 October 2026. - read more
Rising Mental Health Claims Reshape Australia's Life Insurance Landscape
Rising Mental Health Claims Reshape Australia's Life Insurance Landscape
24 Apr 2026: Paige Estritori
The Australian life insurance industry is witnessing a significant increase in mental health-related claims, with recent data indicating that these claims now account for nearly one-third of all total and permanent disability (TPD) claims paid. This trend underscores the growing impact of mental health issues on the workforce and the broader community. - read more
AIA Australia Highlights Need for Structural Reforms in Life Insurance Industry
AIA Australia Highlights Need for Structural Reforms in Life Insurance Industry
24 Apr 2026: Paige Estritori
AIA Australia CEO Damien Mu has raised concerns about the sustainability of the current life insurance model, citing rising mental health claims, increasing premiums, and ongoing cost-of-living pressures as key factors necessitating structural changes within the industry. - read more
Queensland Farmers' Market Threatened with Eviction Over Insurance Dispute
Queensland Farmers' Market Threatened with Eviction Over Insurance Dispute
23 Apr 2026: Paige Estritori
In a developing situation in south-east Queensland, the Three Creeks Farm Stall, a popular farmers' market operating in Eileen Hose Park near Gympie, is facing potential eviction due to a dispute over public liability insurance requirements imposed by the Gympie Regional Council. - read more
Record Surge in Insurance Complaints Due to Claim Processing Delays
Record Surge in Insurance Complaints Due to Claim Processing Delays
23 Apr 2026: Paige Estritori
Recent data from the Australian Financial Complaints Authority (AFCA) reveals a significant increase in complaints against insurance companies, with an average of 100 complaints per day. This surge is primarily attributed to delays in processing everyday claims, affecting both home-building and motor vehicle insurance sectors. - read more
Click for more Insurance News
Life Insurance Articles

How Much Life Insurance Does Your Family Actually Need?
How Much Life Insurance Does Your Family Actually Need?
Financial security for families is an essential consideration in any household. Life can be unpredictable, and ensuring that your loved ones are protected from financial hardship in your absence is a critical part of financial planning. - read more
Single or Married: How Life Insurance Needs Vary Across Different Life Stages
Single or Married: How Life Insurance Needs Vary Across Different Life Stages
Life insurance is a financial product that provides a lump sum payment to your beneficiaries in the event of your death. It is designed to offer financial security by covering debts, daily living expenses, and future financial obligations. - read more
Understanding Your Insurance Needs at Every Life Stage
Understanding Your Insurance Needs at Every Life Stage
Navigating the complex world of insurance can often feel daunting, but understanding the importance of life stage consideration when choosing life insurance is essential. As we journey through the various chapters of our lives, our financial responsibilities, dependents, and personal circumstances evolve. These changes invariably have significant implications for our insurance needs. - read more
Understanding Various Life Insurance Types: Which One is Right for You?
Understanding Various Life Insurance Types: Which One is Right for You?
Financial security is one of the most important aspects of modern family life. Ensuring that loved ones are protected and well-supported in the event of an untimely death is a fundamental concern for many Australians. - read more
Life Insurance Audit: Regular Check-Ups for Your Policy's Health
Life Insurance Audit: Regular Check-Ups for Your Policy's Health
Life insurance serves as a crucial safety net, guarding your loved ones against the unforeseen. Just as you would take care of your health through regular check-ups, it is equally important to ensure that your life insurance policy remains in sound condition to provide the necessary protection. - read more

Knowledgebase
Waiting Period:
The time period that must pass after filing a claim before the insurance coverage becomes effective or benefits are paid.

Quick Links: | Life Insurance Australia | Compare Life Insurance | Best Life Insurance Australia | Life Insurance Quotes | Term Life Insurance | Life Insurance Policies | Affordable Life Insurance | Life Insurance Calculator | Independent Life Insurance Brokers | Life Insurance Benefits | Family Life Insurance
This website is owned and operated by Clark Family Pty Ltd (ACN 010 281 008) as Trustee for the Clark Family Trust (ABN 35 957 893 714), 43 Larch Street Tallebudgera QLD 4228. Clark Family Pty Ltd is an Authorised Representative (AR 1298860) of Unique Group Broker Services Pty Ltd (AFSL 509434) for financial product referrals and an Authorised Credit Representative (ACR 401491) of Saccasan Pty Ltd (ACL 386297). Check our licensing details on the ASIC registers: Clark Family Pty Ltd ACR, Clark Family Pty Ltd AR, Saccasan Pty Ltd, Unique Group Broker Services.
IMPORTANT: We act solely as an introducer and refer enquiries to licensed third-party brokers, insurers, and lenders. We do not provide financial product advice or credit assistance. We may receive a fee or commission from these third parties in consideration for the referral. Before any action is taken to obtain a product or service referred to by this website, advice should be obtained (from either the third party to whom we refer you or from another qualified intermediary) as to the appropriateness of obtaining those products having regard to your objectives, financial situation and needs. Whilst we have our own process for validating the legitimacy of our referral partners, you should independently verify the credentials and licensing of any adviser or provider you engage. Visit the ASIC website for further information.