Overturning an insurance cop-out

Freya’s husband took out a life insurance policy with a significant death benefit. When sadly he passed away from cancer last year, Freya made a claim as the beneficiary under the policy. The insurer refused to pay Freya, on the basis that her husband had allegedly failed in his duty to disclose and fraudulently did not disclose certain aspects of his medical history and condition.

We assisted Freya to dispute the insurer’s decision, firstly through its internal dispute resolution process and then at the Australian Financial Complaints Authority.  We argued that not only did Freya’s husband make all relevant disclosures when he first became aware of his cancer diagnosis, he immediately informed the insurer of his diagnosis and sought to increase the coverage under his policy.  It had been open to the insurer at that time to avoid or renegotiate his policy, but the company did nothing.  It only sought to avoid the policy after the policy holder’s death.  Before Freya’s complaint reached a final hearing, the insurer agreed to pay Freya half a million dollars under the policy.

When Freya heard the good news, she told us that she was overwhelmed, in absolute tears and shaking with shock: "THANK YOU THANK YOU THANK YOU. Honestly you guys are the absolute BEST !!! and this means everything I’m truly grateful to you all".