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

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

Australian Insurers Adapt Investment Strategies Amid Geopolitical and Economic Changes

29 Jan 2026: Paige Estritori

Australian insurers are actively revising their investment portfolios in response to evolving geopolitical events and a stabilizing economic environment. A recent report by Janus Henderson Investors reveals that 47% of insurers plan to increase their investment portfolio risk in the next 12 months, with a significant focus on private markets. - read more

Mandatory Professional Indemnity Insurance for NSW Builders by 2026

29 Jan 2026: Paige Estritori

Registered building practitioners in New South Wales are facing a critical deadline to secure professional indemnity (PI) insurance by July 1, 2026, in accordance with the Design and Building Practitioners Act 2021. This legislation, which originally set a 2025 enforcement date, has been extended by 12 months to allow the industry additional time for preparation. - read more

ICA Calls for Comprehensive Reforms in Queensland's Insurance and Building Sectors

29 Jan 2026: Paige Estritori

The Insurance Council of Australia (ICA) has recently submitted a series of recommendations to the Queensland Productivity Commission, aiming to reform the state's construction and insurance sectors. These proposals are designed to enhance the resilience of the built environment and improve the affordability of insurance for Queensland residents. - read more

Rising Mental Health Claims Impact Construction Insurance Costs

29 Jan 2026: Paige Estritori

Australia's construction industry is facing a significant challenge as mental health claims among workers continue to rise, leading to increased insurance costs and complex risk management issues. Recent data indicates that approximately 20% of construction workers have experienced mental health conditions, highlighting the urgency for industry stakeholders to address this growing concern. - read more

Inattention and Speed: Key Factors in Major Truck Crashes

28 Jan 2026: Paige Estritori

The National Truck Accident Research Centre (NTARC) has released its latest Major Incident Investigation Report, shedding light on the predominant causes of significant truck crashes across Australia. The findings reveal that human factors, particularly inattention, distraction, and inappropriate speed, continue to be the leading contributors to these incidents. - read more

TAL's Health Sense Plus Now Covers Income Protection Policies

27 Jan 2026: Paige Estritori

In a strategic move to enhance the value of its offerings, TAL has announced the expansion of its Health Sense Plus program to encompass income protection insurance. This initiative, effective from 8 August 2025, aims to incentivise proactive health management among policyholders by providing premium discounts. - read more

Rising Mental Health Claims Reshape Australia's Insurance Landscape

27 Jan 2026: Paige Estritori

Australia's insurance sector is experiencing a significant shift as mental health conditions become the predominant cause of total and permanent disability (TPD) claims. Recent data from the Council of Australian Life Insurers (CALI) indicates that mental health issues now account for nearly one-third of all TPD claims, marking a substantial change in the industry's claim patterns. - 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 ...