Tuesday, Oct 22, 2013 at 16:58
Hi Chris
For sure, insurance companies have the right to question any claim, but what is black and white is the policy exclusions, and if it isn’t excluded, it is included by default.
If poor judgement and duty of care was worded into a policy insurance companies would go out of business tomorrow, nobody would take one out if it was that easy for them to refuse a claim.
The instance you cite may indicate the driver had poor judgement and that lead to an accidental “drowning” of the vehicle, but that doesn’t mean the insurance company can reject the claim on those grounds.
Unless the policy prohibits the crossing of creeks, and I would be surprised to find a comprehensive policy that does, then I can’t see any reason this person is not covered. Comprehensive insurance is specifically to cover accidental damage.
The reason there is a clear and concise PDS accompanying an insurance policy is so it sets out in full detail the obligations and responsibilities of all parties. Insurance companies don’t get to pick and choose what they may or may not pay out on after the event. Unless of course it potentially falls into one of the following categories, and these are the most common reasons insurance companies do not pay out.
Non disclosure – You didn’t disclose all the information required prior to buying policy
Exclusion clauses – The policy doesn’t cover the loss (policy must state this)
Fraud – An obvious one
Policy cancelled – Premium not paid etc, or the insurer cancelled policy under advice to you
And a word on exclusion clauses, the insurer must demonstrate that the exclusion clause is relevant to the claim...
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