I win: Insurance claimed reversed.


This is a follow on from the above thread.

Was originally informed that most damage was wear and tear.

Insurance company accept claim for doors and graffiti but applied an excess of $500 to each one which didnt help much as both were about $700.

After inspecting the property and damage with pm immediately rang insurance company and asked for the assessor to come back and explain his findings to me in person as there is no way this is general wear and tear.

After a 30 minute discussion insurance company agreed to contact assessor and send to reinspect.

3 days later insurance assessor arrives and after telling me he didn't know why he had to come back I asked him two simple questions.

1) Does your place look like this?

2) Do you throw bottles and knives at your walls?

He was far from impressed with my questions and 3 hours later he left after I made him look at every bottle mark, knife or machette mark, chip, gouge and hole. One wall had 119 chip, holes and marks.

After numerous discussions and having him return a few times he has reversed his decision and now all has been accepted.

So if you have a claim and you don't agree with the decision appeal and stick to your guns.
Good for you Y33.

Makes you wonder how many people just accept the assessors view/opinions/reports and end up footing the bills.


Yes, it does make you wonder. This is the second claim different IP I have had to challenge in 5 years. The first one worth about 20K took about 2 years to settle with compensation for the wait and delays.

The key is documentation. Document every time you have contact and make sure you include, persons name, position, date, time, reference number and brief notes of conversation. You can even ask them to read back to you what they are putting on your file, for clarification.
Another tip for claims.

Always ask tradesmen for the top price with quality repairs fittings etc. The insurance companies will always try to reduce the amount to pay out. When obtaining quotes I normally try to get 3 or 4 and give them the top 2. This allows you to receive enough money to pay the lesser quotes to do the work when the insurance company starts reducing the pay out amount.
Well done.

We recently had a win with Workcover - they initially refused a worker claim and then, weeks later and after taped interviews etc finally came back with an acceptance of the claim. It was a major injury that required surgery, prosthetic implant, bone grafts etc. Will save us thousands in medical costs and there will be a 'permanent injury' settlement for the injured person as well. I reckon Insurance companies refuse most claims on a first basis and then most people back off; but it really pays to hang in there!