AFCA Ruling: Trucking Firm's Claim Invalid Due to Misrepresentation

1

The issue arose when the firm, led by a sole director identified as "B," sought insurance through a broker. The truck, valued at $82,500, was purchased from "C," the director of another company called "CT". The insurance application falsely stated the company had two years of prior operational and insurance history. Additionally, the declared operational radius was less than 600 km, despite the truck operating interstate.

NTI, upon reviewing the claim, refunded the premiums and rejected the coverage, citing misrepresentation. AFCA supported NTI's decision, reinforcing that no previous insurance was held by the complainant, who had operated for only 19 months. AFCA highlighted that while the business relationship with CT may have confused the broker, a reasonable person wouldn't have provided such misleading information.

This case underscores the critical nature of transparency and accuracy in insurance applications. Misrepresentations, whether inadvertent or deliberate, can lead to denied claims and significant financial repercussions. For businesses, particularly those engaging in partnerships or involving third-party brokers, this ruling serves as a reminder of the due diligence required when disclosing insurance history and operational specifics.

The decision also illustrates the strict adherence to policy stipulations regarding insurance history—a key criterion for coverage eligibility. For consumers, it highlights the importance of understanding the details of insurance applications and the potential impact of inaccurate disclosures.

The ruling may prompt businesses to review their insurance policies and application processes, ensuring alignment with operational realities and disclosure requirements. It serves as a cautionary tale for companies relying on brokers or partners to manage insurance applications, emphasizing the need for oversight to prevent costly mistakes.

For insurers, this case could lead to more rigorous checks during the application assessment to verify client information, reducing the risk of similar occurrences. As the financial services landscape evolves, such cases might influence further regulatory updates to safeguard both insurers and policyholders.

Published:Thursday, 10th Apr 2025
Source: Paige Estritori

Share this news item:

Insurance News

Clear

Potential AI Errors: A Looming Challenge for Insurers 24 Apr 2025: Paige Estritori Industry experts are signaling a potential risk for underwriters due to claims arising from inaccuracies produced by artificial intelligence (AI), likening it to the 'silent cyber' phenomenon of the past. Clyde & Co partner, Darryl Smith, highlights the issue, emphasizing how AI inaccuracies could impact various insurance policies, sometimes without immediate detection. - read more

AFCA Supports RAA Insurance in Vehicle Location Dispute 24 Apr 2025: Paige Estritori An insurance dispute over the location of a vehicle culminated in the Australian Financial Complaints Authority (AFCA) backing RAA Insurance in their decision to deny a claim. The issue surrounded the policyholder's claim that her son’s car was stored in South Australia, while the vehicle was allegedly used and registered in Victoria. - read more

AFCA Sides with Homeowners in Landmark Insurance Dispute Over Property Cracks 22 Apr 2025: Paige Estritori Homeowners recently secured a favourable ruling against their insurer after a water leak led to significant structural damage. After large cracks emerged on their property, Youi initially denied the insurance claim, attributing the damage to pre-existing issues like earth movement and tree root intrusion, both of which are exclusions in their policy. - read more

Climate Change Threatens Australian Suburbs with Unaffordable Insurance 17 Apr 2025: Paige Estritori More than 4% of Australian properties are currently facing heightened risks from natural hazards exacerbated by climate change, rendering insurance coverage often unaffordable or unavailable, according to recent findings by Climate Valuation. An analysis of over 15 million properties across 15,000 suburbs also highlights that an additional 10% are at moderate risk from disasters such as floods, bushfires, tropical cyclones, coastal inundation, and extreme winds. - read more

Insurer Rejects Claim Over Diesel Fluid Mix-Up 16 Apr 2025: Paige Estritori A contentious insurance claim has ended unfavourably for a motor policyholder after her husband mistakenly poured diesel exhaust fluid into her car's fuel tank. Although the policyholder initially received assurances from a Suncorp representative that the use of AdBlue fluid wouldn't be considered improper fuelling – supposedly an excluded scenario under her policy – the claim was later denied. This decision has sparked debate around policy definitions and customer service communication. - read more