My claim was refused - Car crashes
My claim has been refused
Most insurance policies have special rules about when they will refuse to pay a claim. It is important to read your policy carefully to understand when this is likely.
You should get legal advice if your insurer refuses to pay your claim.
Insurers may not pay if:
- The insurer was not given relevant information when the policy was taken out or renewed, for example, a driving conviction was not revealed.
- The crash wasn’t reported to the police or to the insurer.
- The driver was under the influence of alcohol or drugs.
- The driver was unlicensed.
- The car was poorly maintained. For example, it was not roadworthy.
- False details were given about a claim or driving history.
What are my options if my claim is refused?
Your options are:
- complain in writing to your insurer’s internal dispute resolution department
- complain to the Australian Financial Complaints Authority (AFCA)
- go to court, or
- do nothing.
You should get legal advice before deciding to go to court, or to do nothing.
Going through the Australian Financial Complaints Authority
If your complaint to your insurer’s internal dispute resolution department is rejected, you can take the dispute to AFCA.
- is a free and independent dispute resolution service for insurance matters
- can make a decision that is binding on the insurer.
You don’t have to accept the decision if you don’t want to. You can still go to court to resolve the matter.
Time limits apply
Your complaint must be lodged with AFCA:
- within 2 years from the date you receive the final letter rejecting your claim from your insurer’s internal dispute resolution department, AND
- within 6 years from the date of the car crash (or whenever you first became aware or should reasonably have become aware of your loss).
If in doubt about the time limit, it is best to lodge your dispute and see what happens.
If you are outside of those time limits, AFCA may consider accepting the complaint if AFCA considers special circumstances apply.
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