Understanding the Implications of Non-Disclosure in Insurance Claims
0
The information on this website is general in nature and does not take into account your objectives, financial situation, or needs. Consider seeking personal advice from a licensed adviser before acting on any information.
In a significant ruling, the Australian Financial Complaints Authority (AFCA) has directed QBE Insurance to honour an arson claim from a restaurant, despite the director's failure to disclose his criminal history during the policy's inception.
This decision underscores the complexities surrounding disclosure obligations and the importance of clear communication between insurers and policyholders.
The case involved a restaurant and takeaway business that suffered extensive damage due to an arson attack on August 2, 2024. The insurer, QBE, declined the claim, citing the director's non-disclosure of prior criminal convictions. The director contended that the omission was unintentional and offered to pay any additional premiums that might have been applicable had his history been disclosed.
AFCA's investigation revealed that QBE could not provide concrete evidence of the specific questions asked during the policy's inception, as the process was conducted through an electronic platform managed by a broker. Without clear documentation of the disclosure requirements, AFCA determined that the insurer had not sufficiently established a failure in the duty of disclosure by the insured.
Clarity in Disclosure Requirements: Insurers must ensure that their disclosure questions are explicit and that records of these interactions are meticulously maintained.
Policyholder Vigilance: Business owners should proactively disclose any information that might be deemed material to the insurer, even if not explicitly requested, to avoid potential disputes.
Broker Communication: When policies are arranged through brokers, it's essential for all parties to have a clear understanding of the disclosure obligations and to document all communications thoroughly.
For restaurant owners, this case serves as a reminder of the importance of transparency and the need to understand the intricacies of their insurance policies. Ensuring that all relevant information is disclosed can prevent complications during the claims process and safeguard the business against unforeseen events.
Published:Wednesday, 7th Jan 2026 Source: Paige Estritori
Please Note: If this information affects you, seek advice from a licensed professional.
Health insurance premiums are set to experience a substantial increase in 2026, with projections indicating a global rise of 10.3%. This marks the third consecutive year of significant hikes, following increases of 10% in 2025 and 9.5% in 2024. These figures are highlighted in WTW's 2026 Global Medical Trends report, underscoring the persistent inflationary pressures affecting insurers and employer-sponsored health plans worldwide. - read more
Recent analyses have brought to light significant concerns regarding the profit margins of private health insurers in Australia, especially in the context of rising premiums. The Australia Institute has highlighted that major insurers are reporting substantial profits while simultaneously increasing premiums, a situation that has sparked criticism and calls for greater transparency within the industry. - read more
Health Minister Mark Butler has issued a stern warning to private health insurers in Australia, cautioning them against employing underhanded tactics to increase premiums. This comes in response to findings from the Commonwealth Ombudsman, which revealed that some insurers have been closing old policies and introducing more expensive new ones, effectively circumventing regulatory limits on premium hikes. - read more
AUSactive, Australia's leading body for the exercise and active health sector, has announced the launch of a new insurance product tailored specifically for fitness professionals. This initiative, developed in collaboration with global insurance broker Marsh, aims to provide enhanced protection while offering lower premiums compared to existing market options. - read more
This website is owned and operated by Clark Family Pty Ltd (ACN 010 281 008) as Trustee for the Clark Family Trust (ABN 35 957 893 714), 43 Larch Street Tallebudgera QLD 4228. Clark Family Pty Ltd is an Authorised Representative (AR 1298860) of Unique Group Broker Services Pty Ltd (AFSL 509434) for financial product referrals and an Authorised Credit Representative (ACR 401491) of Saccasan Pty Ltd (ACL 386297). Check our licensing details on the ASIC registers: Clark Family Pty Ltd ACR, Clark Family Pty Ltd AR, Saccasan Pty Ltd, Unique Group Broker Services.IMPORTANT: We do not provide financial product advice or credit assistance. We act solely as an introducer and refer enquiries to licensed third-party intermediaries, insurers, and lenders - with whom you can then deal directly. We may receive a fee or commission from these third parties in consideration for the referral. Before any action is taken to obtain a product or service referred to by this website, advice should be obtained (from either the third party to whom we refer you or from another qualified intermediary) as to the appropriateness of obtaining those products having regard to your objectives, financial situation and needs. Whilst we have our own process for validating the legitimacy of our referral partners, you should always verify the credentials of your financial adviser before proceeding with recommendations that they may present. Visit the ASIC website for further information.
Web design and construction by:
Clark Family Pty Ltd
A.C.N. 010 281 008 Copyright 2004 - all
rights reserved