Insured Value Disputes: A Closer Look at Claims Resolution

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.

Following the claim submission under his home and contents policy, QBE offered to arrange a replacement through a designated jeweler, referred to as Jeweler P. However, the claimant sought a cash settlement instead, prompting QBE to offer $15,048, which reflected the jeweler’s estimate for a suitable substitute.

Frustrated with the compensation amount, the claimant requested the full insured value, raising concerns about the jeweler's qualifications and output quality. This scenario highlights a crucial issue: the perceived mismatch between insured sums and actual claim settlements.

According to the ruling by the Australian Financial Complaints Authority (AFCA), the determination of the claimant's compensation was chiefly based on the actual replacement costs rather than the insured amount or premium that had been paid. “The relevant consideration for the purposes of the complainant’s claim is the actual cost the insurer would incur to replace the necklace,” stated AFCA’s ombudsman.

Adding to the complexity, the claimant expressed doubts regarding Jeweler P's capabilities, citing a negative review dated two years prior. Although AFCA acknowledged the claimant’s concerns about the jeweler's reputation and his belief that the suggested replacement was subpar, these factors did not adequately justify a demand for the full insured amount. The ombudsman concluded, “I am not satisfied these matters entitle the complainant to the outcome he seeks.”

In a further analysis, it was revealed that there were discrepancies in the valuation of the necklace. While the insured necklace weighed approximately 156 grams, Jeweler P’s quote was based on a 150-gram estimate. Following this, AFCA indicated that QBE should reassess the replacement cost to align with the revised details provided by the claimant.

AFCA also denied the claimant's request for additional compensation, emphasizing that many of the delays were predominantly due to his insistence on a resolution that was beyond the policy's provisions. This case underscores the importance of understanding both the terms of an insurance policy and the mechanisms of claims processes, especially when expectations revolve around the insured values of personal property.

This incident serves as a reminder for policyholders: the sum insured may not always equate to the cash settlement in the event of a loss, and insurers are likely to adhere strictly to the actual replacement costs as outlined in policy agreements. To navigate such disputes effectively, clear communication and precise documentation during the claims process are imperative.

Details of this case were shared by Insurance News Magazine, shedding light on the finer points of insurance claims involving high-value personal items.

Published:Monday, 6th Jan 2025
Source: Paige Estritori

Please Note: If this information affects you, seek advice from a licensed professional.

Share this news item:

Insurance News

Clear

ICA Advocates for Overhaul of Civil Liability Laws to Curb Rising Insurance Premiums

24 Feb 2026: Paige Estritori

The Insurance Council of Australia (ICA) has recently released a white paper highlighting the urgent need for reforms to state and territory civil liability laws, which have remained largely unchanged for nearly 25 years. These outdated laws are contributing to significant increases in public liability insurance premiums, affecting a wide range of businesses across the nation. - read more

Liberty Adds 'Safe Harbour' Insolvency Cover to D&O Policies

24 Feb 2026: Paige Estritori

Liberty Specialty Markets has announced the addition of a company insolvency extension to its Australian directors' and officers' (D&O) liability policies. This innovative feature is designed to support companies and their directors by covering reasonable costs incurred when engaging approved advisers under the 'safe harbour' insolvency regime. - read more

APRA Reports Significant Underwriting Gains in Short-Tail Insurance

24 Feb 2026: Paige Estritori

The Australian Prudential Regulation Authority (APRA) has released data indicating a substantial underwriting profit of $1.55 billion in short-tail insurance lines for the September quarter. This marks a notable improvement in the sector's performance, with householders insurance contributing $636 million to the overall profit. - read more

NSW Court Decision Escalates Liability Risks for Construction Industry

16 Feb 2026: Paige Estritori

A recent landmark ruling in New South Wales has significantly altered the liability landscape for the construction industry. The court's decision removes the ability for developers and builders to rely on proportionate liability defences under the Design and Building Practitioners Act 2020 (DBP Act), thereby increasing their exposure to claims related to building defects. - read more

Rising Public Liability Insurance Premiums Challenge Australian Businesses

16 Feb 2026: Paige Estritori

The Australian Prudential Regulation Authority (APRA) has released its latest National Claims and Policies Database (NCPD) statistics, revealing a substantial increase in public liability insurance premiums over recent years. According to the data, premiums have risen by 40% since 2015, a rate that surpasses general inflation and places additional financial strain on businesses across the country. - read more

Click for more Insurance News