Husband loses insurance dispute over wife's death

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.

Legislation that started in March 2019 would have ceased the woman's default cover, unless she responded to a notice saying she wanted it to continue. The trustee said it complied with legislation by emailing the notice, but the complainant said she never received it.

The life insurance policy ceased on July 1 2019. On March 5 2020, the member asked for a replacement of the policy and was covered again. The member died on February 12 2021, and the complainant made a claim for the death benefit.

But AIA declined to pay, after determining that she had died from a preexisting medical condition. The complainant argued that he should be paid the death benefit but the trustee rejected the claim.

The complainant stated that it was never their intention to cancel the death benefit and in fact were relying on the benefit payout as part of her final estate for the family.

He went on to say that the trustee had failed to appropriately notify them that the death benefit would be cancelled.

He said that they had not been initially made aware that the death benefit had ceased. "When we did become aware, via online account, that the death benefit had ceased, we contacted [the trustee] to have it reinstated immediately.” he said.

He said the trustee also did not mention that the new cover excludes pre-existing conditions.

However, the Australian Financial Complaints Authority said it was satisfied and that new cover was explained in the Product Disclosure Statement. The decision to decline the claim is fair and reasonable, it added.

Published:Tuesday, 17th May 2022
Source: Paige Estritori

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

Share this news item:

Insurance News

Clear

The Financial Perils of Travelling Uninsured: A Wake-Up Call for Australians

12 Mar 2026: Paige Estritori

Recent research has unveiled a concerning trend: 14% of Australian travellers embark on international journeys without any form of travel insurance. This statistic is even more alarming among younger travellers under 30, with nearly one in four opting to travel uninsured. Such decisions expose individuals to significant financial risks, especially when unforeseen events occur abroad. - read more

IAG CEO Predicts Ongoing Insurance Premium Rises

12 Mar 2026: Paige Estritori

Insurance Australia Group (IAG) has reported a significant 91% increase in net profit for the first half of the 2025 financial year, reaching $778 million. This surge is largely attributed to favourable weather conditions and a reduction in claims. Despite this positive financial performance, IAG's CEO, Nick Hawkins, has indicated that insurance premiums are expected to continue rising, albeit at a slower pace than in previous years. - read more

ICA Unveils Strategy to Combat Rising Motor Insurance Costs

12 Mar 2026: Paige Estritori

The Insurance Council of Australia (ICA) has released a comprehensive report titled 'Motor Insurance Policy Paper - A Roadmap for Reducing Rising Premiums,' calling for urgent and coordinated action to address the systemic cost drivers behind escalating motor insurance premiums. The report highlights that comprehensive motor insurance premiums have increased by 42% since 2019, reaching an average of $1,052 per year in 2024. - read more

APRA Data Reveals Steady Performance in General Insurance Intermediaries

12 Mar 2026: Paige Estritori

The Australian Prudential Regulation Authority (APRA) has released its latest bi-annual report on intermediated general insurance, providing insights into market activity for the six months ending June 2025. The data indicates a stable performance among general insurance intermediaries, with total premiums invoiced through intermediaries reaching $21.5 billion. Of this, $17.6 billion was placed with APRA-authorized general insurers, $2.6 billion with Lloyd’s underwriters, and $1.3 billion with unauthorized foreign insurers. - read more

ICA Advocates for Overhaul of Civil Liability Laws Amid Rising Insurance Premiums

12 Mar 2026: Paige Estritori

The Insurance Council of Australia (ICA) has recently released a white paper highlighting the urgent need for reforms to state and territory civil liability laws, which have remained largely unchanged for nearly 25 years. These outdated laws are contributing to significant increases in public liability insurance premiums, affecting a wide range of businesses across the nation. - read more

Rising Public Liability Insurance Premiums Challenge Australian Businesses

12 Mar 2026: Paige Estritori

Australian businesses are grappling with a significant rise in public liability insurance premiums, a trend attributed to outdated civil liability laws and escalating legal expenses. The Insurance Council of Australia (ICA) has highlighted that some businesses have experienced premium increases of up to 60% since 2019, placing additional financial strain on various sectors. - read more

ICA Calls for National Review of Civil Liability Laws Amid Rising Insurance Costs

12 Mar 2026: Paige Estritori

The Insurance Council of Australia (ICA) is advocating for a national review of civil liability laws to address the escalating costs of public liability insurance premiums affecting businesses nationwide. The ICA's recent white paper underscores the need to modernise state and territory laws that have remained largely unchanged for nearly a quarter of a century. - read more

Café's Storm Damage Claim Reduced Due to Underinsurance

12 Mar 2026: Paige Estritori

In a recent case, a café and catering business faced significant financial challenges after a storm forced its closure. The establishment ceased operations on August 28, 2024, and resumed on January 24, 2025, following repairs approved by their insurer, Suncorp. The insurer compensated the business with $280,570 for a year's gross profit loss and an additional $26,863 for increased operational costs. - read more

Insurer Ordered to Pay Arson Claim Despite Director's Past Convictions

12 Mar 2026: Paige Estritori

A recent ruling by the Australian Financial Complaints Authority (AFCA) has significant implications for restaurant owners and their insurance policies. An insurer was ordered to pay an arson claim it had initially denied, citing the restaurant's sole director's failure to disclose his criminal history during the policy's inception. - read more

Undisclosed Tenant Changes Result in Denied Insurance Claim for Landlord

12 Mar 2026: Paige Estritori

A recent decision by the Australian Financial Complaints Authority (AFCA) highlights the importance of landlords accurately disclosing tenant activities to their insurers. In this case, a landlord's failure to inform their insurer, AIG, about a tenant's change from operating a restaurant to hosting religious meetings led to the denial of a substantial theft claim. - read more

Click for more Insurance News

Insuring your most valuable asset

While many people would consider their home or their car to be their most valuable asset, it's your ability to earn an income that is most important in shaping your financial future. Statistically, two thirds of working Australians will suffer an injury or illness that will sideline them for 90 days or more. The majority of these people would not be able to pay their mortgage or meet car finance and other loan commitments without adequate income insurance.

... compare rates & options ...