Good news story: From heartbreak to hope
How Ausure broking & claims expertise turned around an insurance claim denial
Angela* was devastated when her house near Mackay burned to the ground. However, when she heard her insurance claim had been declined by the insurer, she realised: “I’d lost everything and was looking at being financially ruined, I was absolutely shocked.”
The insurer technically had grounds on which to decline the claim on the basis that the insurance policy states that if the house is insured as a rental property, it needs to be tenanted and not stand unoccupied for more than 60 days. The owner also has a responsibility to ensure the property is maintained in reasonable order.
Unfortunately, Angela’s tenants had long moved out and thus the house was untenanted at the time of the fire. Angela hadn’t thought to update her insurance broker or insurer that this was the case.
Thankfully, Angela had been astute in taking out her insurance policy through a professional broker. At the time, she didn’t realise just how valuable this would prove to be.
Insurance brokers act in the best interest of clients. This meant Angela had an ally to act on her behalf.
Ausure insurance broker Adelle Ripps assisted Angela in taking the claim to the insurer’s internal dispute service. But the decline was upheld. They then took it to FOS, now called AFCA (Australian Financial Complaints Authority). Adelle and the Ausure team thought there were reasons in this particular case to further pursue the claim. That’s when having Ausure’s specialist Claims Team to work together with can be extremely beneficial to broker’s clients.
The Ausure broking team has the professional experience and expertise to assist in tricky claims. They knew of precedent cases where insurers had turned over decisions on unoccupied houses in particular circumstances. The broking team could compile all the data and precedent cases, consult solicitors and evidence that was needed to put an expanded case to AFCA.
The Ausure broking team worked hard to get the very best possible result for Angela. It was a long and complicated process and the team kept Angela updated along the way.
The result exceeded all expectations: The insurer agreed to pay for the following:
– Paid out for full sum insured of the house.
– Paid out for contents cover on claim.
– Plus interest on that, dating back to when the claim was first submitted for review.
– Reimbursed for cost of temporary fencing which had to be installed for safety reasons to keep debris on property safe.
– Paid out for removal of debris from property so client could re-build her house.
“I was dumbfounded when Adelle called me with the good news,” recalls Angela. “I cried with relief when they said the insurer would pay. I’d been living in limbo.”
People often don’t realise the human role insurance brokers play in their client’s lives:
What has been learned from all this?
Angela has the following advice:
‘’I’d recommend to others to use a professional insurance broker. I was extremely glad to have Ausure on my side through all of this. The team did extremely well to get the result they achieved, especially considering the claim was denied. They have all the expertise to help at times like this.’’
‘’Take time to read your disclosure document. Although it was requested of me, I didn’t properly read my whole disclosure documents when I took out the insurance. It was all there and explained what I needed to do to ensure that the cover remained in place.“
“It’s also essential to keep your broker updated on any changes to your assets, so the correct insurance cover can be maintained.”
“I would like to say an enormous thank you to Adelle and the Ausure team for their efforts. Truly appreciate the result. I’ll continue to use Ausure in the future.”
About Adelle Ripps
Adelle is able to assist you in all of your general insurance requirements, including Home, Motor, Farm and Business. Being a local resident of Mackay, Adelle has a better understanding of the area and will take the time to understand your individual needs and potential risks you may be exposed to.
Adelle takes pride in helping her clients get results and taking the pressure of them if a claim arises.
Disclaimer: The nuances and details of each insurance claim are different. It takes exceptional skill and expertise to overturn an insurer decline and depends on a range of factors. Angela’s win might not necessarily have been possible, given a slightly different set of circumstances.
*Angela – A pseudonym has been used to protect client privacy.
This Good News story shows the value of having a trusted Ausure insurance broker on your side.
We all know bad things happen. Fires, theft, floods or cybercrime can destroy businesses and livelihoods. Having the right insurance cover in place to help protect your assets and minimise risks is vital. It is often when devastating events happen, that people realise just how valuable their insurance broker can be.
Excellence, innovation and family values are the essence of what Ausure has been about since the company started 25 years ago. Ausure is proud of our network of 233 insurance brokers situated in 112 locations across Australia.
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