Octogenarian in poor health wins extra claim compensation

Report proposes 'self-funding' insurance model for export industries

An 84-year-old with severe arthritis and a heart condition who said she was forced to sleep on the floor during a claim for storm damage has won additional compensation in a second dispute hearing.

The Suncorp policyholder, who also told the Australian Financial Complaints Authority (AFCA) she had to put up with rude and hostile tradesmen, was awarded $2500. The insurer had earlier offered $1500 five months after her March 2019 claim.

Suncorp acknowledged its elderly customer was inconvenienced by service issues, particularly while her special electric fitted bed that managed her medical condition was being assessed, but said it attempted to minimise the impact and it was difficult at times to contact the complainant.

It offered accommodation, a temporary bed and payment for contents items, and when clothes were damaged after its repairer removed a ceiling it arranged for the area to be tested for asbestos and clothes to be cleaned.

It also offered to reimburse temporary accommodation and paid $400 as an emergency payment to cover clothes, and later settled the claim which was resolved, with the only aspect still in dispute the level of compensation.

AFCA ruled additional compensation was warranted, noting she had endured poor quality repairs and extra damage to her contents.

“The complainant was in a vulnerable position given her age and health issues. The insurer was aware of this fact early in the claims process. The reports provided show there were several issues with the repairs the insurer arranged,” the ombudsman said.

“These issues led to delays, stress and inconvenience.”

See also  Guy Carpenter acquires Re Solutions

Suncorp had provided incorrect information to the elderly homeowner in an email about an earlier complaint and an amount to pay for compensation, and AFCA said this erroneous advice had led to confusion.

“The insurer accepts it incorrectly referred to a prior AFCA determination. It confirmed this was an ex-gratia offer for the complainant’s claim experience,” the ruling said.

The homeowner complained to Suncorp about dealing with several claims managers and repeating scenarios, communication on repair specifications, the times of trades attending, poor quality workmanship, safety risks, exposure to health hazards, lack of care of interior furnishings, irreparable damage to her wardrobe, clothes and linen, and time spent communicating with the insurer.

It took several complaints for her specialty bed to be replaced, causing stress and anxiety and leaving her feeling traumatised.

Gyprock hit the floor and fibreglass went everywhere when the main bedroom ceiling was being replaced, spreading dust throughout the house, causing damage to furniture and clothing, and Suncorp did not provide replacement clothing for the duration of the repairs, she said.

She also raised numerous concerns over trades’ conduct, including an electrician disconnecting the power to the house which caused her to trip over when returning home, and that building material and waste was not removed, causing a safety hazard.

Suncorp’s repairer confirmed several issues with the repairs, including additional water damage inside the wardrobe, and defects in the plastering and painting, and that the ceiling removal damaged clothing and caused dust to enter the home.

Suncorp said there were delays that could have been avoided but it had offered $1500 compensation and made efforts to address concerns throughout the claim.

See also  Marsh D&O Echo facility launches enhanced coverage amid market volatility

See the full ruling here.