What do I need to do before ringing the Insurance Ombudsman for legal advice on an insurance dispute?

If you seek legal advice about a dispute with us there are a few things you can do:

 

Obtain a copy of your Insurance Policy and your Certificate of Insurance if you do not already have a copy. These documents set out the extent of your insurance coverage so any decision on your claim will be made in reference to them.

 

If you are unhappy with our decision, request the reasons in writing. Where an insurance company rejects your claim they are required to provide you with written reasons

 

Ask for a copy of any expert reports, transcripts, recordings, statements or other information we are relying on as evidence to reject your claim. You have the right to ask for copies of information that we have relied upon in assessing your claim under clauses.  We may refuse to provide the requested information but we should not do so unreasonably.

 

If an insurance company refuses to provide information they are relying on it may be arguable that their refusal to provide the information is a breach of the Duty of Utmost Good Faith

 

In situations where we have refused to provide information you may lodge a complaint to the Managing Director of Gan Direct. Requests for written reasons, policy documents, and evidence we have relied on may be made by writing

We have 5 days to resolve your dispute. If we don’t resolve your dispute you can lodge a dispute with the Insurance Ombudsman Service.

 

Once you have all of the above information, you should read our written reasons to check whether or not you agree with our decision. Read any reports or other documents we rely on as evidence.

Tags: dispute, good faith, insurance ombudsman

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