Case Studies

The following case summaries highlight common issues and consumer tips. Cases can be filtered by subject below and names have been changed to protect confidentiality. Access to the full case study database is available for IFSO Scheme Participants in the Participant Area.

Request to reduce life cover image
Insurers and financial advisers must act with reasonable care and skill.
Shortly before he died, Sam asked his financial adviser to reduce his life insurance cover from $268,000 to $100,000.
Life Insurance Financial Advisers
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No home, 4 loans, responsible lending? image
Lender responsibilities aim to protect consumers against substantial hardship.
Ann's house was demolished and she told her lender she couldn't repay her 4 loans. She later received a repossession notice.
Loans & Credit
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Stress after the storm image
Independent evidence can help to progress insurance claims.
After a claim for flooding and storm damage was accepted, issues and delays continued for a stressful year.
House and Contents Insurance
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$189K romance scam image
Financial Advisers must exercise reasonable care and skill.
When Andre, a quadriplegic, requested 5 withdrawals from the family investment, his adviser followed instructions.
Financial Advisers
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$43K loan, ute repossessed image
The CCCFA sets out lender responsibilities for consumer protection.
Charlie, who had terminal cancer, couldn't work or pay off a $43,000 loan. Charlie’s ute was reposessed.
Loans & Credit
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Cancer, non-disclosure image
Your full medical history must be disclosed when you apply for insurance.
Jin had life and trauma insurance. After his stage 4 colon cancer diagnosis at age 31, he made a claim.
Life Insurance Non-disclosure
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Covid-19: cancelled travel image
Check your exclusions. Most travel policies exclude global pandemics.
Barry cancelled his Bali trip due to Covid-19. His insurance claim was declined due to the pandemic exclusion.
Travel Insurance Travel Covid
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Excess dog damage image
An excess is paid when claims are accepted. If there is more than one event, more than one excess can be applied.
Viv’s claim, for carpet damaged by dog vomit and diarrhoea, was accepted. But three policy excesses were applied.
House and Contents Insurance pets
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Son crashes car, no cover image
Check your policy for exclusions. Insurers must act with reasonable care and skill.
Cora's car insurance claim was declined because her son was excluded as a driver. But Cora said he was covered.
Vehicle Insurance
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Skin surgery benefit changed image
Check your policy to see if your insurer can change your policy cover.
Kaia’s health insurer wrote to inform her it was changing the limits for skin surgery under her policy.
Health Insurance
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Bad knee, no cover image
Health insurance won’t pay claims for pre-existing conditions, unless the insurer has agreed.
Kate needed a knee replacement but her insurer wouldn’t pay, as she'd had knee pain 16 years earlier.
Health Insurance
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Leaving out medical details is a problem image
Tell your insurer your full medical history, even if you don’t think it's relevant.
Yasmin didn’t mention her two spinal injuries when she applied for insurance. Her claim for a spinal cyst was declined.
Health Insurance Non-disclosure
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