Insurance is a contract and contains terms and conditions placing obligations on both parties. There is legislation and a code that limit the terms insurance companies can include in the contract. There are also limits to what they can rely on when considering your claim. For example:
Property policies may have provisions as to whether the company must settle in cash, or reinstate or replace the damaged item.
Under a business interruption policy, the contract will define the circumstances and period of disruption to the business for you to be paid. But what about situations where your business suffers no physical damage but cannot operate due to prevention of access, due to a neighbour's property damage?
The wording of your insurance contract is important, along with the record of your application and claim.
Typically claims we assist with fall into the following categories:
Commercial insurance claims of all classes:
If you have purchased your insurance cover through an authorised broker, you may find they can assist you in managing your policy, including claims, completing forms and liaising with underwriters and claims personnel on your behalf.
However, many brokers do not have a fully resourced and specialist claims service, acting only as a postbox between you and the insurer. We will, if instructed by you, the policyholder, cooperate fully with your broker and view our expertise and services as an extension of the normal service offered by your broker.
Or, if you feel your broker has not provided the claims service you expect, you are unhappy with the insurance company decision and would like an independent second opinion, we will assist you on a direct basis and your enquiry will remain confidential. Once we determine you have a valid, payable claim, we recommend you authorise Claim Assist to liaise with your broker.
Many domestic insurances may be sold direct by the insurer, often through online or telephone applications. Companies such as Vero, Tower and NZI may have multiple brand names with slightly differing products.
Vero Insurance is Australian owned by Suncorp and operates as
- Vero Insurance NZ Ltd
- AA Insurance
- Mariner Marine Insurance
- AMP General Insurance
IAG insurance is Australian owned and operates in New Zealand as
- NZI Insurance
- State Insurance
- AMI Insurance
- Lumley General Insurance
Tower Insurance is a public listed New Zealand company, brands include
- Tower Insurance
- Fin Tel
Youi Insurance is a South African-based domestic risk insurer. Policies issued have some restrictions not highlighted by their consultants. In 2015 Youi was fined $320,000 after pleading guilty to misleading sales techniques. If you have a claim declined by Youi, please contact us immediately for assistance.
sell products underwritten by New Zealand companies and branded by the bank. Your claim will be handled by the insurance company, however frontline claims staff may have limited technical knowledge. We can assist by communicating your circumstances to them in a form they will understand and, where appropriate, we will access senior claim administrators to finalise your claim.
Travel Insurance is one of the most significant areas of dispute in New Zealand. Statistics are difficult to verify, particularly for declined claims. In Australia, industry data showed 31,000 travellers had their travel insurance claims declined in 2015-2016, up from 24,200 the previous year.
It is estimated some 15% of all travel claims are exaggerated or fraudulent. As a result, travel insurers are highly vigilant and scrutinise carefully all claims.
Article: The definitive list of why travel insurance claims are denied >
Consumer Finance Insurance is commonly added to any retail purchases involving hire purchase or a loan – for example revolving credit at a major retailer or motor vehicle loans. This includes extended warranty insurance and vehicle warranty insurance. These classes of insurance can be a minefield for the uninitiated. Call Claim Assist for advice – we have experience in both the underwriting and claims management of this insurance.
Article: Money for nothing? Consumer watchdog concerned Kiwis are buying insurance they can't claim on >
ASIC's Moneysmart advice: Think twice before you buy consumer credit insurance >
We will discuss your loss and understand your position and then, with your consent (normally with a letter of authority) contact your insurance company. Our goal is to have a declination reversed or the dispute resolved amicably. If this is not possible, we will recommend the next course of action through more formal means – the Disputes Tribunal, an appropriate court, or the Insurance Ombudsman.
If your insurance claim has been denied, please do not give up straightaway. Just because an insurer has made a decision, it does not necessarily mean that it is the right decision. We can advise you of your options, and can help you obtain the claims payout to which you are rightfully entitled. There will be time limitations contained in the contract of insurance that you are dealing with. We recommend you contact Claim Assist immediately and request our advice as soon as you encounter a problem with the insurer. There is no obligation and the initial call is free.