The Australian Financial Complaints Authority (AFCA) has backed a decision by Suncorp to refuse a repair quote of $11,221.08 from a claimant whose vehicle was damaged after eggs were thrown at it.

Suncorp accepted the claim, which was lodged last June but a dispute later arose between the two parties over the required scope of claims and appropriate repair cost.

The claimant had submitted the quote from his nominated repairer, as was allowed under the motor policy. While the policy states he has the “choice of repairer” benefit, it also made clear the insurer did not have to necessarily accept the quote that had been provided.

An extract of the policy contract reproduced in the AFCA ruling says Suncorp “will pay the amount we assess to be reasonable by considering your repairer’s quote with any adjustments made by our assessor” and that it reserves the right to determine the method of repair used by the workshop.

Suncorp says the quote is not fair and reasonable and that it had not been allowed access to the vehicle for further assessment. It subsequently decided to offer the claimant a cash settlement of $2,445.76, which was based on a report from its own assessor, who had earlier inspected the vehicle at the nominated repairer’s workshop.

The claimant rejected the cash offer, arguing the amount is not enough to cover the required repairs and was represented by his nominated repairer in the dispute.

“The insurer is entitled to organise a further assessment and obtain an actionable quote from its preferred repairer,” AFCA ruled.

“This is because the insurer has identified concerns with the scope of works and quote and the complainant has not complied with their policy obligations requiring the complainant’s assistance and cooperation.”

Details of the case contained in the AFCA ruling says the insurer has tried to discuss adjustments to the quote, specifically about repair items it did not think were necessary.

But the claimant’s nominated repairer was not willing to engage with the insurer. According to notes taken by the insurer, the repairer said he would take the matter to AFCA unless Suncorp paid him at least $8500 to carry out the repairs.

The repairer disputes the insurer’s version of the event. He says he was willing to negotiate and therefore agreed to drop the repairs cost to $8500.

AFCA says Suncorp has raised and adequately explained its “reasonable concerns” with the quoted scope of works and repair methods while the complainant has not complied with his policy obligations by providing the insurer access to the vehicle to enable it to provide its own comparative quote.

The insurer’s initial assessment report listed several areas of damage not believed to be necessary but were included the nominated repairer’s quote. It lists the door aperture as an example, saying the egg residue had been washed off and there was no damage. But the nominated repairer included this section of the vehicle in his repair quote.

While the claimant did engage his own independent assessor, AFCA notes the assessor’s report is based on the nominated repairer’s quote. Furthermore it does not allow the insurer to verify the appropriate and necessary repair method with its own assessor and repairer.

AFCA also dismissed the claimant’s bid to have Suncorp pay for the report prepared by his independent assessor. It says the report did not assist the claimant’s position in the dispute and that he had consistently refused the insurer access to the vehicle.

If the claimant does not accept AFCA’s decision to allow Suncorp to arrange for an assessment of the vehicle to decide on the scope of repairs, then the insurer is entitled to rely on its cash settlement offer, less any applicable deductions under the policy.

Click here for the ruling.