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.

$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
See the case summary
$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
See the case summary
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
See the case summary
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
See the case summary
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
See the case summary
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
See the case summary
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
See the case summary
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
See the case summary
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
See the case summary
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
See the case summary
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
See the case summary
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
See the case summary