Broker did fair job during complex claim, ombudsman finds
A small business has failed to show its broker’s poor claim handling caused it to incur $16,000 in legal and accounting fees.
The claim was lodged in January 2023 under a business pack policy arranged by Great Wall Insurance Services for property damage, contents damage and business interruption losses after a fire.
It took several rounds of negotiations and requests for information before a settlement was finalised.
The business told the Australian Financial Complaints Authority the broker failed to provide guidance and support during the claim process, resulting in financial loss and unreasonable delays.
It alleged Great Wall’s “poor level of service” left it seeking help from solicitors and accountants, and their $16,000 fees should be reimbursed.
However, AFCA has rejected the business’ complaint. It says the legal and accounting professionals were engaged to help with information sought by the insurer; to support a dispute over the insurer’s claim assessment; and to assist with dissatisfaction at the insurer’s claim processing time frame.
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“I accept the exchanged information shows the claim took quite some time to finalise and that the complainant had to fight for what it believed was a fair settlement under the claim,” AFCA said.
“However, I note the negotiations were not simple or straightforward.”
AFCA says the claim involved several parties including a landlord; calculation of losses; profit and loss information; language barriers; and insurer policies and procedures that were not always appreciated by the complainant.
While there were minor delays or periods of inactivity by the broker, “these are few and far apart, with no evidence showing these may have caused the complainant any financial prejudice.
“The duration of such delays or inactivity were between a week and two weeks at most. Given the overall time the claim remained on foot and the nature of the claim, I accept it is not unreasonable to expect such minor delays may occur.”
AFCA says the broker provided “a timeline and evidence in support of each entry to the timeline. I am satisfied the broker acted appropriately, followed the complainant’s instructions and acted in the complainant’s best interests based on the instructions given.”
See the ruling here.