Insurance Lawyers

It’s a great question and one that you may not think about too often when things are going well. However, insurance is important as it provides peace of mind that there is financial security available for you and your loved ones should an unforeseen event happen. What could happen tomorrow is rarely something a person can predict, and so it’s important to know that you have financial security.

When unforeseen events occur, they can leave devastating financial burdens behind. This is where insurance is of the utmost importance, as your insurance policy and provider will ensure that there is proper coverage for you and your family.

Essentially, an insurance claim is submitted to a person or business’ insurance provider when seeking reimbursement for losses that are covered under the insurance policy selected. An insurance claim has to be filed if an event occurs that is covered under your insurance policy.

By filing an insurance claim, you are thereby notifying your insurer that an event has happened that is covered by your insurance policy. After this, your insurer should then pay you the claim amount.

The three main categories of insurance that are found in Australia are as follows: life, health and general insurance. For life insurance, this includes a range of products that, upon passing away or injury, will provide payments.

General insurance extends to cover what has been bought by people for a variety of reasons, such as travel insurance for individuals. For businesses that have purchased general insurance, this usually includes public liability and product liability, and professional indemnity insurance.

Within Australia, there are three key regulators. These are: the Australian Financial Complaints Authority (AFCA – formerly the Financial Ombudsman Service); the Australian Prudential Regulation Authority (APRA); and the Australian Securities and Investments Commission (ASIC). Our insurance lawyers can represent you in front of such regulatory bodies, helping you to have your claim heard and resolved.

The Australian Financial Complaints Authority (AFCA) is the main dispute resolution body for the Australian financial system and provides an external dispute resolution service for members of the scheme. It deals with complaints by individual insureds against insurers or their brokers, which are within its terms of reference. The decisions of AFCA are binding on insurers.

The Australian Prudential Regulation Authority (APRA) is the prudential regulator, which essentially means that it is responsible for the general administration of the current Insurance Act. They have the authority to set prudential standards for the entire general insurance industry. There has also been a framework developed that holds all of the prudential standards and practice guidelines. APRA deals with systemic matters at an institutional level and licenses insurance businesses to operate in Australia.

The Australian Securities and Investments Commission (ASIC) is the corporate regulator. They are in charge of the general administration of the Insurance Contracts Act and are also responsible for overseeing and promoting the integrity of the market. They are also responsible for ensuring that consumers are protected properly.

As the insured, you have several duties in making your claim. These responsibilities can include disclosing material information, reporting the loss or damage that has occurred to the authorities, providing notice of an event to their insurer and providing proof of loss to the insurer as well. The insured must also make sure that no information is actively concealed or misrepresented. The insured should also gather a list of the stolen or damaged goods/property.

It’s vital for the insured person to abide by these duties as failing to do so could result in a contract breach, losing the premiums paid or policy cancellation.

The insurer is known as the company that provides and sells insurance policies and deals with claims. If an event occurs that has been detailed in the policy, the insurer is the one in charge of ensuring appropriate financial coverage has been provided in the form of the sum assured.
The insured is the person or company that is actively being covered by that policy. What’s important to note is that we never work with insurers – only the insured people or businesses.

Should there be information that is crucial to a contract that is only held by one party, the principle of good faith would be employed. This duty ensures that a party possessing vital information has a duty to the other party involved in the contract to disclose all relevant knowledge. This then allows the other party to come to an accurate understanding of what they are accepting.

This duty of good faith has now become a term that is found in every general insurance contract in Australia. The insured and the insurer must act with the utmost good faith towards each other in all dealings. There can even be damages awarded to an innocent party should there be a breach.

Yes, we can offer a no-win, no-fee payment model. We will always give you the most cost-effective options for legal support, including ‘no win no fee’ arrangements for our personal injury legal services. If your case is not successful, you will not be required to pay any legal fees to us at all.