Cover-More Insurance denied claim while contradicting earlier advice

[MikeG]

In Bali recently I was bumbling around on the beach at night and didn't notice my iPhone 15 Pro Max slip out of my pocket onto the wet sand, and by the time I noticed, there was no signal from FindMy and I suspect it was buried under the sand/water so there would be no signal. There has been no signal ever since.

Thank goodness I have travel insurance right? Well...

I raised a new claim online and the status was updated to "awaiting additional documentation". So I rang (via Skype on my laptop) and asked "what do I need to supply you with, as I'm leaving Bali soon." The cheery lady said, nothing at this stage, someone will be in touch from the claims team in 10 days time.

So I got an email about 10 days later asking for a police report from Bali police, so I responded explaining I had advice from someone that said, I didn't need to supply anything before leaving Bali, and I gave them the time I called.

a few more days later, I got a claim denied letter by email. So I've responded by asking to raise a complaint, as this is duplicitous and unfair.

Has anyone else had insurance companies outright lie to you? Has anyone had luck with the complaint/ombudsman process?

Should I give up and just claim through my AppleCare+ policy? Noting I've bought a replacement phone in Singapore (I run a business) and AppleCare+ now just sends a replacement, nothing else is an option. Its a hassle, but I really do want to hold Cover-More to account.

M

 

[Pushka]

In Bali recently I was bumbling around on the beach at night and didn't notice my iPhone 15 Pro Max slip out of my pocket onto the wet sand, and by the time I noticed, there was no signal from FindMy and I suspect it was buried under the sand/water so there would be no signal. There has been no signal ever since.

Thank goodness I have travel insurance right? Well...

I raised a new claim online and the status was updated to "awaiting additional documentation". So I rang (via Skype on my laptop) and asked "what do I need to supply you with, as I'm leaving Bali soon." The cheery lady said, nothing at this stage, someone will be in touch from the claims team in 10 days time.

So I got an email about 10 days later asking for a police report from Bali police, so I responded explaining I had advice from someone that said, I didn't need to supply anything before leaving Bali, and I gave them the time I called.

a few more days later, I got a claim denied letter by email. So I've responded by asking to raise a complaint, as this is duplicitous and unfair.

Has anyone else had insurance companies outright lie to you? Has anyone had luck with the complaint/ombudsman process?

Should I give up and just claim through my AppleCare+ policy? Noting I've bought a replacement phone in Singapore (I run a business) and AppleCare+ now just sends a replacement, nothing else is an option. Its a hassle, but I really do want to hold Cover-More to account.

M

It's worth another claim but try to provide more specific details about discussions. Insurance companies frequently refuse a first time claim. Also check your contents insurance. Portables. You may have cover outside the home.

 

[MEL_Traveller]

In Bali recently I was bumbling around on the beach at night and didn't notice my iPhone 15 Pro Max slip out of my pocket onto the wet sand, and by the time I noticed, there was no signal from FindMy and I suspect it was buried under the sand/water so there would be no signal. There has been no signal ever since.

Thank goodness I have travel insurance right? Well...

I raised a new claim online and the status was updated to "awaiting additional documentation". So I rang (via Skype on my laptop) and asked "what do I need to supply you with, as I'm leaving Bali soon." The cheery lady said, nothing at this stage, someone will be in touch from the claims team in 10 days time.

So I got an email about 10 days later asking for a police report from Bali police, so I responded explaining I had advice from someone that said, I didn't need to supply anything before leaving Bali, and I gave them the time I called.

a few more days later, I got a claim denied letter by email. So I've responded by asking to raise a complaint, as this is duplicitous and unfair.

Has anyone else had insurance companies outright lie to you? Has anyone had luck with the complaint/ombudsman process?

Should I give up and just claim through my AppleCare+ policy? Noting I've bought a replacement phone in Singapore (I run a business) and AppleCare+ now just sends a replacement, nothing else is an option. Its a hassle, but I really do want to hold Cover-More to account.

M

It’s a shame you weren’t provided with better advice on the original call.

It’s a pretty standard requirement in cases of loss or theft to have to get a police report. And have it translated to English in some cases if it’s not already.

When I had my passport stolen in India a couple months ago I decided not to file a report and claim on insurance exactly because I didn’t want to spend a whole day in a police station!

It might be worthwhile calling back to ask if (a) a statutory declaration will suffice, or, failing that, if (b) whether they would accept a police report filed in Australia. I know the latter sounds strange, but I’m sure I read somewhere once that someone did just that, and their claim was successful.

 

[Flyfrequently]

Others here may be more knowledgeable @MikeG but do agree with @Pushka about initial claim denial.

I do know with many TI covers, reports from police are required - takes time I know as we found out many years ago with loss of valuables on a beach.

PDS should clarify if that is required - if not stated, then try again with further information.

Certainly with medical, they want everything before approval.

Good luck and let us know how you go.

 

[TheRealTMA]

In Bali recently I was bumbling around on the beach at night and didn't notice my iPhone 15 Pro Max slip out of my pocket onto the wet sand, and by the time I noticed, there was no signal from FindMy and I suspect it was buried under the sand/water so there would be no signal. There has been no signal ever since.

Thank goodness I have travel insurance right? Well...

I raised a new claim online and the status was updated to "awaiting additional documentation". So I rang (via Skype on my laptop) and asked "what do I need to supply you with, as I'm leaving Bali soon." The cheery lady said, nothing at this stage, someone will be in touch from the claims team in 10 days time.

So I got an email about 10 days later asking for a police report from Bali police, so I responded explaining I had advice from someone that said, I didn't need to supply anything before leaving Bali, and I gave them the time I called.

a few more days later, I got a claim denied letter by email. So I've responded by asking to raise a complaint, as this is duplicitous and unfair.

Has anyone else had insurance companies outright lie to you? Has anyone had luck with the complaint/ombudsman process?

Should I give up and just claim through my AppleCare+ policy? Noting I've bought a replacement phone in Singapore (I run a business) and AppleCare+ now just sends a replacement, nothing else is an option. Its a hassle, but I really do want to hold Cover-More to account.

M

IOE Covermore are very reluctant to pay claims and quote requirements for extra details etc. You need to respond forcefully with documentation and quote their policy conditions back to them and you may be successful in your claim. In our case they refused a $1200 claim, paying only $500. After our rebuttal , they eventually paid out another $700.

 

[Flyfrequently]

It’s a shame you weren’t provided with better advice on the original call.

It’s a pretty standard requirement in cases of loss or theft to have to get a police report.

Very much agree @MEL_Traveller
All a nuisance to get reports but it is what they need to "tick the boxes"

Side note: Don't work in insurance but have had personal and professional experiences.

 

[MEL_Traveller]

Very much agree @MEL_Traveller
All a nuisance to get reports but it is what they need to "tick the boxes"

Side note: Don't work in insurance but have had personal and professional experiences.

Helps weed out fraudulent claims I guess? Plus the chance that by reporting it to police you may get your items back and save the insurance having to pay out.

 

[Daver6]

Could this possibly help? Bali Police is launching an app so you can file reports directly from your phone | Coconuts

 

[Jacques Vert]

I raised a new claim online and the status was updated to "awaiting additional documentation". So I rang (via Skype on my laptop) and asked "what do I need to supply you with, as I'm leaving Bali soon." The cheery lady said, nothing at this stage, someone will be in touch from the claims team in 10 days time.

This is why I never phone an insurance company; always send an email so you have their advice in writing! Can't remember the legal term for it but in a previous case against an insurance company, where they denied our claim, my solicitor stated that we were able to rely on the advice given by one of the company's agents. Fortunately, we had that advice in writing so we could prove exactly what advice had been given.

 

[MikeG]

They never replied to my emails. So I had to call them after a few days

 

[MEL_Traveller]

I suspect what the insurance company *thought* they were communicating was that you don’t need to send anything just now, wait until the claims department writes to you… but at that stage you would send your police report, which you would have got anyway (because the phone was lost). Probably not thinking or realising you might not have got one

The current cover-more PDS says under ‘claims’, first thing, that you must report any loss or theft to the police, transport provider or accommodation provider within 7 days and you should obtain a report confirming the incident to submit to covermore with your claim.

 

[MikeG]

Could this possibly help? Bali Police is launching an app so you can file reports directly from your phone | Coconuts

This was announced 5 years ago. Sadly, this still hasn't eventuated. They say there is an Android app available, but perhaps it is geolocked to the Bali region.

Post automatically merged: Jun 14, 2024

I suspect what the insurance company *thought* they were communicating was that you don’t need to send anything just now, wait until the claims department writes to you… but at that stage you would send your police report, which you would have got anyway (because the phone was lost). Probably not thinking or realising you might not have got one

I think her words were more like "nothing additional is required"... They should record their calls,should this get as far as a complaint to the Ombudsman.

 

[MEL_Traveller]

This was announced 5 years ago. Sadly, this still hasn't eventuated. They say there is an Android app available, but perhaps it is geolocked to the Bali region.

Post automatically merged: Jun 14, 2024

I think her words were more like "nothing additional is required"... They should record their calls,should this get as far as a complaint to the Ombudsman.

I was editing my post while you were replying.

The PDS says under ‘claims’, first thing, that you must report any loss or theft to the police, transport provider or accommodation provider within 7 days and you should obtain a report confirming the incident to submit to covermore with your claim.

Perhaps for completeness the operator could have confirmed with you that you had such a report!

Worth pursuing to see if a stat dec will fit the requirements.

 

[MikeG]

Hi everyone, I thought I'd update you all on the saga.

21st June: raised dispute with Cover-More, to have the claim reassessed, taking into account the bad advice given over the phone, and providing a police report made online with NSW Police.
24th July: called Cover-More and was told the dispute would take 30 working days, and there was no update. The tone was one that they really didn't give a rats about my customer experience
24th July: raised AFCA complaint against Cover-More outlining all the facts
25th July: Cover-More sent me a letter saying they will pay out the claim, referencing the AFCA complaint reference. LOL

I can't say enough about Australian Consumer Protection. Simply awesome!