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Patrick H.
Patrick H., Lawyer
Category: Australia Law
Satisfied Customers: 5403
Experience:  Dip Law LPAB - Sydney based lawyer
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My son had testicle cancer back 18 months ago and has

Customer Question

Hi,My son had testicle cancer back 18 months ago and has insurance,There is a trauma part to the insurance.The officer looking after his case said he could be paid out,up to $250,000 due to his condition.He never heard anything for months and then he found out he officer handling his case had left and the insurance company ran one day and said we have found you case which had been lost.they then said we need 3 month to update the history to this claim.Its now almost 2 yrs since since the illness has happened and the insurance company keep dragging things out,Just wondering if this is worth pursuing,Im his father and Im concerned as this has totally stressed my son out for almost the last 2yrs and still nothing has happened.
Submitted: 1 year ago.
Category: Australia Law
Expert:  Patrick H. replied 1 year ago.

You need to write a firm letter to the insurer pressing them for resolution of the claim, advising them that the previous claims officer had indicated they appeared to be liable, and advising them that you will refer the matter to the Financial Services Ombudsman if they do not respond ASAP as it has been an unreasonably long wait.

If they deny the claim they should explain why. If they offer an inadequate explanation or fail to respond in a reasonable further time frame (say a couple of weeks) you should make a complaint to the Financial Services Ombudsman which is an inexpensive alternative to going to court and can generally resolve cases like this.

https://www.fos.org.au/resolving-disputes/

Indeed if you have any doubt about the decision the insurer has made you should seek further advice.

I have considerable insurance experience and would be happy to review your insurance policy terms if they do deny your claim.

I trust the above assists.

Please rate my answer.

Patrick

Expert:  Patrick H. replied 1 year ago.

I note you have reviewed but not rated my answer.

Please rate my answer so I can be paid for my time and effort.

I am paid out of the funds you previously deposited, there is no further charge for rating my answer.

Thanks,

Patrick