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.

No ambulance cover for pre-existing conditions image
Pre-existing conditions are excluded, unless your insurer has accepted them in writing and charged an extra premium.
Mae's daughter Eva collapsed at a restaurant in Australia. Mae later made a claim for the cost of an ambulance ride.
Travel Insurance
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No insurance for man who skipped flight to make cruise image
If you choose to change travel plans, when you don't need to, this won't be covered.
Charles decided he couldn't run the risk of missing the cruise due to a cancelled flight. Instead, h...
Travel Insurance
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Fair Insurance Code Breach image
Insurers bound by the Fair Insurance Code must provide agreed minimum standards of service to customers.
After Kim's claim, for cracking walls, was initially accepted, it was later declined.
House and Contents Insurance
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Coffee-stained carpet, dining room only image
Check your policy limitations and exclusions.
After Viv's Nespresso coffee stained a patch of dining-room carpet, she wanted most of the carpet in the house replaced.
House and Contents Insurance
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Stolen car, no cover image
Disclose past criminal convictions when you apply for insurance.
Tim's claim, for his stolen car, was declined because he hadn’t mentioned his criminal convictions. Tim said he wasn’t asked.
Vehicle Insurance
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The van, the can and the boom image
Don’t tell tall tales – your claim will be checked.
Jean Paul claimed his van caught fire because a petrol can was knocked over during “sort of a romantic meeting”.
Vehicle Insurance
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A car bumped into me - no it didn’t image
False statements can’t be retracted, and all policy holders are implicated.
Mr Green tried to withdraw a claim as he had told a “bit of a lie”. But it was too late.
Vehicle Insurance
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Teenage son flips parents’ car image
It’s unlikely you’ll have cover if an accident occurs when you’re in breach of licence.
Simon, on a restricted licence, flipped his parents’ car while his sister was in the passenger seat.
Vehicle Insurance
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No cover for learner driver with passengers image
Don’t expect to be covered if an accident occurs when you’re in breach of licence.
When Karl, with a learner driver’s licence, crashed on the Rimutaka ranges, he had 3 passengers. His claim was declined.
Vehicle Insurance
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No tyre tread, no cover image
Check your car is roadworthy, including the tyre tread, even if it has a warrant.
Jeremy wrote off his car in wet weather. His claim was declined because of a "smooth tyre".
Vehicle Insurance
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Paying excess when it’s not your fault image
You will have to pay an excess, even if you're not at fault. Some policies have limited exceptions.
Mia’s car was stolen and then found, but damaged. She wanted the excess to be refunded as she wasn’t at fault.
Vehicle Insurance
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Car written-off, pay out less than expected image
Check your policy for how much you will be paid out if your car is a write-off. It may be less than you expect.
Katie thought she would get $10,500 for her written-off car, but the insurer offered the market value of $7,500.
Vehicle Insurance
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