The crux of the dispute arose when the salon's laser machine broke down in February, and repair costs were estimated at $18,069. The salon owner had insured the machine for $50,000 in December of the previous year, following its second-hand purchase and refurbishment in 2012 for $66,000.
Despite acknowledging the damage, QBE Insurance reduced its compensation to $7,286, citing an underinsurance clause. QBE claimed that due to the model being discontinued, a replacement would necessitate insuring at $155,000.
The insurer's clause stipulated that if the sum insured was less than 80% of the "total new replacement value," the liability could be adjusted accordingly. However, the salon owner challenged this assessment, arguing that a comparable refurbished machine was valued between $30,000 and $45,000.
The Australian Financial Complaints Authority (AFCA) intervened, siding with the salon owner. AFCA declared that policy wording began ambiguous, noting discrepancies in terms such as "full value" and "total new replacement value", creating confusion about the clause's intent.
AFCA clarified: "When the policy is read as a whole, it indicates the laser should be insured for its full value, or what it would cost to replace with a similar laser in a similar condition." They refuted QBE's expectation that the salon owner should have insured the laser for $155,000, indicating she would never recoup more than $50,000 under policy terms.
This ruling mandates QBE to cover the repair costs, less the policy’s deductible. The case emphasizes the importance of clarity in insurance contracts and equitable treatment of claims.
Published:Wednesday, 27th Nov 2024
Source: Paige Estritori
| Budget Direct Triumphs as Australia's Top Insurer in 2026 17 Feb 2026: Paige Estritori In a remarkable achievement, Budget Direct has been honoured as the inaugural 'Insurer of the Year' at the 2026 Finder Provider of the Year Awards. This prestigious recognition underscores the company's unwavering commitment to delivering exceptional value and service to Australian policyholders. - read more |
| Australian General Insurers Report Record Profits Following Premium Increases 17 Feb 2026: Paige Estritori In 2024, Australia's insurance industry reported an after-tax profit of $6.1 billion, a figure that is three times higher than the five-year average of $2 billion. This substantial increase is attributed to a combination of factors, including significant premium hikes and a reduction in severe weather events. - read more |
| Treasury's Initiative to Bolster Professional Indemnity Insurance and CSLR 17 Feb 2026: Paige Estritori The Australian Treasury has commenced a consultation process aimed at improving the effectiveness of professional indemnity (PI) insurance, with the goal of strengthening the Compensation Scheme of Last Resort (CSLR). This initiative seeks to gather stakeholder feedback on the current operation of PI insurance and explore opportunities for enhancement. - read more |
| Sterling Insurance's New Lloyd's Binder: A Boost for Professional Indemnity Offerings 17 Feb 2026: Paige Estritori Sterling Insurance has announced the acquisition of a new professional indemnity (PI) binding authority with Lloyd's, a move set to provide Australian brokers with greater control over product offerings and pricing structures. This development is part of Sterling's ongoing commitment to delivering tailored insurance solutions that meet the specific needs of niche and complex risk sectors. - read more |
| How to Compare Income Protection Insurance for Self-Employed Australians For self-employed Australians, the financial stability provided by consistent income is the backbone of both personal and business success. Unlike traditional employees, who might have access to sick leave or employer-sponsored disability benefits, self-employed individuals are solely responsible for their financial security in the event of illness or injury. This is where income protection insurance steps in as a crucial safeguard. - read more
|
| Tackling Unexpected Illness: How Income Insurance Can Help Maintain Your Standard of Living Illness limps in unannounced, derailing both physical health and financial stability without warning. When you're sideswiped by unexpected medical conditions, the uncertainty can compound, leading to a precarious balance of meeting health needs and financial commitments. Many are left pondering how to maintain their lifestyle amidst this turmoil. - read more
|
| Why Income Protection Insurance Matters for Every Australian Earner The unpredictable nature of life can often leave us vulnerable to financial uncertainty, especially when it comes to our ability to earn an income. Whether due to illness, injury, or unexpected job loss, the loss of income can have a devastating impact on our financial stability and quality of life. This is where the importance of insurance in financial planning becomes evident. - read more
|
| Income Safety Net: How to Choose the Right Income Protection for Your Lifestyle In the face of life's unpredictable twists and turns, few things are as disconcerting as the possibility of suddenly losing your ability to earn an income due to illness. Such events are often unexpected and can have significant financial repercussions that interrupt not only your flow of daily life but also compromise your future plans. - read more
|