An apartment owner has won a dispute over malicious damage to her property, overturning her insurer’s decision to only partially accept her claim.

Chubb agreed to cover damage to fire equipment and flooring, amounting to $2431, but said other repairs were for pre-existing damage and were not covered under its policy.

The Australian Financial Complaints Authority has dismissed the insurer’s assessment and criticised its response to the adjudication process, saying it caused unnecessary delays by failing to provide evidence to support its contention. 

The complainant filed the claim in December 2022 after finding damage to her apartment caused by a tenant who had moved out. She provided quotes and tax invoices for repairs totalling $15,873. 

The insurer agreed to cover two items but said damage to the home’s door was caused by an unrelated event and other claimed items were covered by a separate contents policy.

The authority disagrees that the contents policy covers these items, but it has acknowledged information showing the complainant knew the door damage occurred before she lodged the claim. The insured said the tenant caused the damage and it was relevant to the claim, but the authority has ruled she will have to file a separate claim for this.

Chubb asserted that a condition report on the damaged items pointed to wear and tear, which was not covered under its policy. But the insurer failed to supply the report. 

The ruling says the insurer “had sufficient opportunity” to respond to requests for the document. 

“The insurer has not submitted any assessment reports, expert evidence or anything else to support the exclusions it is relying on,” the authority said. 

“On July 25 2023, the insurer was informed that it was at risk of an adverse inference being drawn if it did not provide the information it had been asked for by July 28 2023.

“The insurer did not respond by the due date. The only condition report available is the complainant’s pre-tenancy condition report, which I am satisfied does not demonstrate that the claimed damage is pre-existing or of the type excluded by the policy.” 

The decision requires Chubb to pay the complainant $12,628, minus policy excess. It awards an additional $3500 for non-financial losses caused by the insurer’s actions, including delays, poor claims handling and failure to engage with the claimant.  

“Having considered all the circumstances, I am satisfied the insurer’s poor conduct had a significant effect on the complainant and her reasonable expectations for the claim,” the authority said.

“This caused considerable delays, unusual inconvenience and interference with the complainant’s enjoyment and peace of mind.” 

Click here for the ruling.