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

Allianz Australia Penalised for Misleading Travel Insurance Information

30 Dec 2025: Paige Estritori

In a significant ruling, Allianz Australia Insurance and its subsidiary, AWP Australia, have been fined a total of $16.8 million for providing misleading information about their travel insurance products. The Supreme Court of New South Wales found that between 2016 and 2018, the companies misrepresented the extent of coverage available to consumers, leading to potential misunderstandings about policy benefits. - read more

Allianz Partners Highlights Risks of Travelling Uninsured

30 Dec 2025: Paige Estritori

Recent research conducted by the Insurance Council of Australia (ICA) and the Department of Foreign Affairs and Trade (DFAT) has unveiled a concerning trend: approximately 14% of Australian travellers embark on international journeys without any form of travel insurance. This statistic has prompted Allianz Partners to urge Australians to reconsider the importance of securing adequate coverage before travelling abroad. - read more

Surge in Medical Claims Among Australian Travellers Highlights Importance of Comprehensive Insurance

30 Dec 2025: Paige Estritori

In 2024, medical incidents emerged as the leading cause of travel insurance claims among Australian travellers, accounting for more than 40% of all claims handled by nib Travel. This trend underscores the critical importance of securing comprehensive travel insurance to mitigate the financial risks associated with medical emergencies abroad. - read more

Allianz Australia Penalised $16.8 Million for Misleading Conduct

30 Dec 2025: Paige Estritori

In a significant regulatory action, Allianz Australia and its subsidiary, AWP Australia, have been fined $16.8 million for making false and misleading statements. This penalty was imposed following an investigation by the Australian Securities and Investments Commission (ASIC), underscoring the critical need for transparency and honesty in the insurance sector. - read more

New Legislation Prohibits Use of Genetic Test Results in Life Insurance Underwriting

30 Dec 2025: Paige Estritori

The Australian government has announced plans to introduce legislation that will ban life insurers from using adverse genetic test results in their underwriting processes. This move aims to eliminate genetic discrimination and encourage individuals to undergo genetic testing without fear of insurance repercussions. - read more

Bupa Penalised $35 Million for Misleading Conduct Towards Customers

30 Dec 2025: Paige Estritori

In a landmark decision, health insurer Bupa has been fined $35 million for misleading customers about the benefits they were entitled to under their policies. This penalty, imposed by the Australian Competition and Consumer Commission (ACCC), underscores the necessity for transparency and accuracy in the health insurance sector. - read more

ICA Advocates for Overhaul of Civil Liability Laws to Curb Rising Insurance Premiums

30 Dec 2025: 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

APRA Data Shows Significant Rise in Public Liability Insurance Premiums

30 Dec 2025: Paige Estritori

The Australian Prudential Regulation Authority (APRA) has released its latest National Claims and Policies Database (NCPD) statistics, revealing a substantial increase in public liability insurance premiums over recent years. According to the data, premiums have risen by 40% since 2015, a rate that surpasses general inflation and places additional financial strain on businesses across the country. - read more

AFCA Ruling: Insurer Must Honour Arson Claim Despite Director's Past

30 Dec 2025: Paige Estritori

In a significant decision, the Australian Financial Complaints Authority (AFCA) has directed an insurer to honour an arson claim for a restaurant, despite the director's failure to disclose his criminal history during the policy's inception. This ruling underscores the complexities surrounding disclosure obligations and the insurer's duty to assess risk appropriately. - read more

Navigating Insurance Challenges: A Call to Action for Perth's Hospitality Sector

30 Dec 2025: Paige Estritori

Perth's hospitality industry is currently grappling with escalating operational costs, prompting many businesses to reassess their insurance coverage to ensure both adequacy and affordability. Rising wages, tighter profit margins, and complex compliance requirements are compelling restaurants, cafes, and bars to scrutinize their insurance policies more closely. - 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 ...