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
| TAL's Health Sense Plus Now Covers Income Protection Policies 19 Jan 2026: Paige Estritori In a significant development for policyholders, TAL has expanded its Health Sense Plus program to encompass income protection (IP) policies. This initiative, effective from August 8, 2025, aims to incentivise proactive health management by offering premium discounts to clients who engage in preventative health checks. - read more |
| New Legislation Prohibits Life Insurers from Using Genetic Test Results 19 Jan 2026: Paige Estritori The Australian government has enacted legislation prohibiting life insurers from using the results of genetic tests to refuse coverage or increase premiums. This landmark decision aims to eliminate genetic discrimination and encourage individuals to undergo potentially life-saving genetic testing without fear of financial repercussions. - read more |
| Markel Insurance Expands into Australian Marine Market with New Leadership 19 Jan 2026: Paige Estritori Markel Insurance has announced the appointment of Tim Wills as Head of Marine for Australia, marking a significant expansion into the country's marine insurance sector. Based in Sydney, Wills will spearhead the introduction of Markel's marine products, starting with marine cargo insurance. - read more |
| Pelagic Risk Services Strengthens Marina Support with Gold Sponsorship 19 Jan 2026: Paige Estritori Pelagic Risk Services, a specialist marine insurance broker, has elevated its commitment to the marina industry by upgrading from Silver to Gold Sponsorship with the Marina Industries Association (MIA). This move underscores Pelagic's dedication to supporting marinas across Australia through enhanced financial contributions and the provision of exclusive risk management resources. - read more |
| Income Protection vs. Life Insurance: Tax Differences You Should Consider Have you ever wondered how income protection insurance can affect your taxes? It's an often-overlooked aspect of managing your finances that could make a substantial difference. Understanding your insurance options is crucial in making informed decisions that benefit your long-term financial health. - read more
|
| Affordable Life Insurance: Finding the Right Fit for Your Family's Finances Life insurance is a crucial component in safeguarding your family's financial security. It offers peace of mind, knowing that your loved ones will be protected in the event of unexpected circumstances. Many Australians understand the value of having life insurance, but the task of finding a policy that fits within a family's budget can sometimes feel overwhelming. - read more
|
| Income Protection Insurance: Balancing Cost with Adequate Coverage Income protection insurance is a critical safety net for anyone who relies on a steady paycheck to meet their financial obligations and maintain their lifestyle. It offers a replacement income if you are unable to work due to illness or injury, ensuring that your financial responsibilities can be met even when you're not at your earning best. In today's fast-paced world, income protection has become an essential consideration for the modern working individual. - read more
|
| How to Choose the Right Income Protection Insurance as a Freelancer Income protection insurance is a type of coverage designed to replace a portion of your income if you're unable to work due to illness or injury. It's an incredibly vital form of insurance for freelancers, who may not have the same safety nets as traditional employees, such as paid sick leave or disability benefits. - read more
|