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.

Full medical history needed image
Tell your insurer your full medical history, even if it's old news.
When Rose arranged insurance, she didn’t mention her depression, skin, sinuses, spine, liver, cholesterol or ear issues.
Life Insurance Non-disclosure
See the case summary
35 unauthorised credit card transactions image
Failing to safeguard your credit card PIN could mean you are liable for unauthorised transactions.
Sharee complained that 35 unauthorised transactions were made with her credit card in NZ during the month she was overseas.
Loans & Credit
See the case summary
Financial hardship, no evidence provided image
The CCFA has rules for lenders about hardship applications and fees.
After Dan took out a loan, he said money had been stolen from his bank, and he’d lost his job. But he had no proof.
Loans & Credit
See the case summary
Three loans, no redundancy cover image
Lenders must ask for up-to-date evidence about a borrower’s ability to repay a loan
When Bev borrowed $17K for a car, she purchased payment waiver, but later discovered it didn’t cover redundancy.
Loans & Credit
See the case summary
$4,000 vacuum debt written off image
Lenders must ask for information about the borrower’s ability to repay the loan under the CCCFA
Mrs B entered into a loan agreement to buy a $4,000 vacuum cleaner, sold to her by a door-to-door salesperson.
Loans & Credit
See the case summary
Overseas treatment – no specialist letter, no cover image
If you’re making a claim for overseas treatment, contact your insurer well in advance.
The day before Ms B took her daughter to Australia for thyroid treatment, she phoned her health insurer to check the cover.
Health Insurance
See the case summary
Excluding tonsils, not adenoids image
Provide medical details for everyone under the policy.
Dougal's insurer declined to pay for his daughter Sally’s adenotonsillectomy, because she'd had enlarged tonsils.
Health Insurance
See the case summary
Weight loss surgery excluded image
Check your policy for exclusions.
Penny’s insurer declined to pay for weight loss surgery (a sleeve gastrectomy), recommended by her doctor.
Health Insurance
See the case summary
Tooth extraction excluded from cover image
Check your policy for exclusions.
Fiona's claim, for the surgical removal of her son’s tooth, was declined. The policy only covered wisdom tooth extraction.
Health Insurance
See the case summary
Roger’s trip ends in tragedy, waiver applies image
Pre-existing condition exclusions also apply to family members who aren’t travelling. Sometimes a waiver can apply, if there is proof the condition is stable
Just before he left on holiday, Vinnie's father died. Vinnie postponed his trip and made a claim.
Travel Insurance
See the case summary
Mr M’s trip to NZ ends in tragedy image
Pre-existing condition exclusions apply even if indirectly related.
Mr M’s heart attack was indirectly related to his hypertension and diabetes. His son’s claim for the...
Travel Insurance
See the case summary
No cover for anxiety, loss of enjoyment image
If a pre-existing condition is the cause of cancellation, the exclusion applies to all policy holders.
Louise’s daughter's anxiety prevented her from leaving the hotel, or participating in any activities, during their holiday.
Travel Insurance
See the case summary