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The pattern I see most: a claim denied with a phrase rather than a reason. "Wear and tear." "Pre-existing." "Not covered."
A phrase isn't a reason. Ask them, in writing, to do three things:
- Name the specific clause of the policy they're relying on
- Explain how it applies to what actually happened
- Send you any report they relied on to reach that decision
Vague denials tend to either firm up into something you can argue with, or quietly fall over. Either result is better than the phrase.
Insurers have an internal dispute process, and it's a real one — a decent number of denials get changed there without going any further. If that gets you nowhere, AFCA is free for you to use and their decisions bind the insurer: 1800 931 678.
Put a date on your request. Not a threat, just a date, otherwise it sits in a queue forever.
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