Jewellery owner who ‘forgot’ to read policy loses missing valuables dispute

A home and contents policyholder, who initially stated she forgot to read her policy booklet and later claimed she read it but didn’t understand what the documents meant, has lost a dispute over some sentimental jewellery pieces that went missing during a hotel stay.

Suncorp had denied her claim on grounds that she had not taken out the optional extra cover for portable valuables, which would apply for loss away from the insured address.

The customer took her dispute to the Australian Financial Complaints Authority (AFCA), insisting her claim should be accepted since she had specified to the insurer the jewellery items that she wanted covered before taking up the policy.

She says she believed she had the cover she needed and that she was entitled to rely on the “verbal agreement taken out over the phone” with the insurer consultant who had attended to her call.

AFCA upheld Suncorp’s decision to deny her claim, ruling the insurer cannot be held responsible for any misunderstanding on the complainant’s part, if she either did not read the documents, or did not understand them.

AFCA says it would not be fair, in the circumstances, to require the insurer to pay the claim when the complainant had not taken out the optional cover that would have applied for valuables outside the home.

The external financial dispute ombudsman says the policy documents “clearly showed” that portable valuables cover did not apply, and points out that for the initial period, and again at renewal, the complainant was reminded to check her policy and to ask the insurer about any concerns.

“It is her responsibility to do that. She had the opportunity to check and ask the insurer about any concerns before the loss occurred, but she did not do so,” AFCA says in the ruling.

When she lodged her complaint, the Suncorp customer stated she “forgot to read the [policy] booklet” and later clarified she did review or read the documents.

She says she did not understand what the “portable valuable” options were and that the insurer’s consultant had not explained to her what the terms meant during the call.

AFCA did not accept her reasons, saying it is “not reasonable” to expect that every individual term, condition, limitation and exclusion under the policy would be addressed in the inception phone call.

“The full terms and conditions are set out in the policy documents which were provided at the time (and again at renewal),” AFCA says.

Click here for the ruling.