Hacked Company Loses Insurance Battle Over Customer Payment Scam

2

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.

The company, holding a management liability insurance policy, sought to claim under its third-party crime coverage to recover the outstanding bills from the customers. However, AIG Australia denied the claim, stating that the policy only addressed "direct financial loss" from theft or fraud by a third party, and argued that since the stolen money belonged to customers, the business itself did not suffer a direct loss.

The Australian Financial Complaints Authority (AFCA) reviewed the case and acknowledged the company's loss. However, it determined that the loss did not align with the policy's specific terms. The ruling emphasized that only the company's customers faced direct financial loss, whereas the company experienced an indirect one due to subsequent non-payments.

The AFCA explained that the hack did not meet the company's policy definition of theft, as the stolen funds belonged to the customers, not the business. This discrepancy meant that the policy's electronic and computer crime coverage was not applicable. Additionally, the policy's criteria for "fraudulent act," which required acts of forgery or counterfeiting the insured had acted upon, were not met since the company was unaware of the false invoices.

This case highlights the critical distinction between direct and indirect financial losses in insurance claims, emphasizing the importance of understanding policy terms. For businesses, particularly those prone to cyber threats, it underscores the significance of having insurance coverage that appropriately addresses loss scenarios stemming from such events. It also serves as a cautionary tale of the complexities involved in recovering from cybercrime attacks without adequate protection.

Moving forward, businesses should ensure robust cybersecurity measures to prevent similar email hacks, coupled with clarifying insurance policies for adequate coverage against indirect financial losses as a result of customer fraud. This scenario may lead insurance providers to reevaluate their product offerings, potentially driving the development of more comprehensive cybercrime coverages. Additionally, the financial sector might witness increased discussions on how to formulate clearer policy definitions that align with the evolving nature of cyber threats.

Published:Tuesday, 11th Mar 2025
Source: Paige Estritori

Please Note: If this information affects you, seek advice from a licensed professional.

Share this news item:

Insurance News

Clear

IAG CEO Predicts Ongoing Insurance Premium Rises

31 Jan 2026: Paige Estritori

Insurance Australia Group (IAG) has reported a significant 91% increase in net profit for the first half of the 2024-2025 financial year, reaching $778 million. Despite this profit surge, IAG's CEO, Nick Hawkins, has indicated that insurance premiums are expected to continue rising, though at a more moderate pace compared to previous years. ([abc.net.au](https://www.abc.net.au/news/2025-02-14/iag-ceo-nick-hawkins-warns-of-further-premium-increases/104931074?utm_source=openai)) - read more

Rising Insurance Costs Challenge Australian Hospitality Sector

31 Jan 2026: Paige Estritori

The Australian hospitality industry is currently facing significant challenges due to escalating insurance premiums. Business owners report substantial increases in their insurance costs, which are becoming one of the largest expenses alongside wages, rent, and the rising cost of goods. ([au.finance.yahoo.com](https://au.finance.yahoo.com/news/aussie-hotel-owner-reveals-insane-48000-cost-behind-alarming-small-businesses-trend-040048130.html?utm_source=openai)) - read more

ACT Businesses Confront Higher Insurance Premiums Compared to NSW

31 Jan 2026: Paige Estritori

The Australian Capital Territory (ACT) Legislative Assembly has initiated an inquiry into the rising costs of insurance premiums within the territory, particularly focusing on the hospitality sector. Recent data indicates that businesses in the ACT are paying significantly higher insurance premiums compared to their counterparts in New South Wales (NSW). ([region.com.au](https://region.com.au/why-are-act-business-insurance-costs-much-higher-than-in-nsw-inquiry-to-seek-answers/841410/?utm_source=openai)) - read more

Australian Insurers Under Fire for Steep Premium Increases

30 Jan 2026: Paige Estritori

In recent times, Australian insurance companies have come under intense scrutiny due to substantial increases in premiums, even as they report record profits. This trend has raised concerns among consumers and policymakers alike, prompting calls for enhanced transparency and competition within the industry. - read more

Rising Insurance Costs in Northern Australia Despite Reinsurance Efforts

30 Jan 2026: Paige Estritori

Homeowners in Northern Australia are confronting significant increases in insurance premiums, even after the implementation of the federal government's cyclone reinsurance pool aimed at reducing costs in cyclone-prone regions. This development raises questions about the effectiveness of current measures and the ongoing challenges in making insurance affordable for residents in high-risk areas. - read more

Lack of Transparency in Insurance Premium Increases Concerns Consumers

30 Jan 2026: Paige Estritori

Australian consumers are increasingly facing substantial hikes in their insurance premiums, often with little to no explanation from their providers. This lack of transparency has led to growing frustration and calls for greater accountability within the insurance industry. - read more

AIA Australia's New Partnerships to Encourage Cycling Among Members

30 Jan 2026: Paige Estritori

AIA Australia, a prominent life, health, and wellbeing insurer, has announced strategic partnerships with global fitness company Peloton and premium cycling brand Specialized. These collaborations aim to motivate AIA Vitality members to adopt more active lifestyles by providing significant discounts on cycling equipment. - read more

Bupa's Strategic Expansion into Mental Health Services

29 Jan 2026: Paige Estritori

Bupa, a leading health insurer in Australia, has unveiled plans to significantly enhance mental health services by establishing a network of clinics named Mindplace. This initiative aims to open 60 clinics nationwide by 2027, aligning closely with the government's objective of operating 61 walk-in Medicare Mental Health Centres by mid-2026. - read more

Federal Support Secures Cohealth's GP Services Amid Financial Strain

29 Jan 2026: Paige Estritori

In response to financial challenges faced by Cohealth, a non-profit community health service, the federal government has allocated $1.5 million to maintain its GP services in Melbourne's inner north and west. This funding ensures that clinics in Collingwood, Fitzroy, and Kensington will remain operational until 31 July 2026, providing essential care to approximately 12,500 patients who were at risk of losing access to their GPs. - read more

Rising Out-of-Pocket Costs Challenge Australia's Universal Healthcare

29 Jan 2026: Paige Estritori

Patients Australia, in collaboration with La Trobe University, has released the 2025 Patient View Report, shedding light on the increasing financial burden faced by Australians seeking healthcare services. The report indicates that 62% of patients incur out-of-pocket expenses when visiting their GP, with nearly half of these individuals paying an average gap fee of $51 or more. - read more

Click for more Insurance News