Insurance dispute - after contacting the company, what next?

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Batman

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#173689 2-Jun-2015 09:54

Hi someone we know have been paying for a product that does not exist, without going into too much detail. A broker sold them a product, and after all these years it doesn't seem like what they paid is what was sold. THe broker is retired now.

They have written a letter to the insurance company, if they brush them off, who are the higher powers?

Insurance ombudsman? Commerce commission?

Thanks

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#1315918 2-Jun-2015 09:55

That sounds like a fraud?

Btw, was the product exist before and has been recently discontinued?

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#1315922 2-Jun-2015 10:01

I think they have documents of the original policy, and then the policy changed to exclude half of their cover, so I guess it is a dispute that is a bit complex. No idea what the wordings are in them, but just asking about someone higher that regulates these guys to get a fair solution.

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#1315925 2-Jun-2015 10:01

They are "elderly" and while not illiterate, has no ability to challenge.

nathan

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#1315973 2-Jun-2015 10:22

https://www.consumer.org.nz/articles/letters-about-insurance

http://www.iombudsman.org.nz/

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#1315978 2-Jun-2015 10:27

cheers peeps

Fred99

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#1315983 2-Jun-2015 10:36

A problem with the Insurance and Saving Ombudsman (ISO) scheme is that you have to exhaust options offered by the insurer under their disputes resolution process, then be issued with a formal notification from the insurer that the dispute has reached "deadlock" before the dispute can be handed over to the ISO. The ball is in their court.
I'm very cynical about the real value of the scheme. Insurers can use their normal tactic of "delay/defer/deny", but might issue prompt notification of "deadlock" by cherry-picking cases which suit their overall agenda (which is to make money for their shareholders).
Consulting a lawyer who specialises in insurance matters should be a priority. It's amazing how Insurance Company standard behaviour changes when they know that the client is receiving good legal advice.

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#1315991 2-Jun-2015 10:48

I don't think it's worth lawyer fees ... no claim's been made. Just money down the drain over a decade.

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linw

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#1316191 2-Jun-2015 13:41

joker97: I don't think it's worth lawyer fees ... no claim's been made. Just money down the drain over a decade.

Bit like most insurance policies, really.

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#1316197 2-Jun-2015 13:53

Not my house contents and car insurance :)

linw

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#1316290 2-Jun-2015 16:13

Had a friend who made sure she claimed her premiums back each year!

DaveB

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#1316335 2-Jun-2015 16:51

linw: Had a friend who made sure she claimed her premiums back each year!

Oh .... Made sure of it then? A leecher?

They should be lined up and shot! But there again, it is human nature that there will always be those that seem to think that insurance companies are bottomless pits of money. And then there are those that try to get insurance after the event. And there again, there are those that think insurers are just in the business to rip people off.

And then again, there are many people that think "Thank God I was insured".

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#1316337 2-Jun-2015 16:53

it's a way of making sure you don't lose your life if something really bad happens. a small price to pay really. health insurance is slightly different - the govt provides "free" healthcare ... ... ...

ajobbins

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#1316345 2-Jun-2015 17:06

linw:
joker97: I don't think it's worth lawyer fees ... no claim's been made. Just money down the drain over a decade.

Bit like most insurance policies, really.

Insurance is one of those necessary evils you hope you don't need, but are effectively "wasted money" if you don't. But that's exactly what insurance is, it's about pay someone else to take the risk instead of taking the risk on personally.

To the OP, does the insurance policy in question actually indemnify the policy holder in some way? If they have been sold insurance that they could never claim on (I.e. there was nothing they actually had or did to indemnify), they may be entitled to a refund of premiums paid. IANAL, but that is my basic understanding from working for an insurance underwriter many years ago now.

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#1316349 2-Jun-2015 17:13

i think it's got something to do with health exclusions. apparently they were told the exclusions can be removed but later told the exclusions can't be removed. something like that ...

ajobbins

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#1316352 2-Jun-2015 17:16

If it was just verbal advise from the broker it could be hard to prove and progress without a paper trail. Otherwise, who is to say they aren't trying it on or they misunderstood? (Not to say they are, but that's what the insurance company would suggest of course)

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