A complainant whose jewellery claim was declined after he refused to provide phone records to his insurer has lost a challenge to overturn the decision.

The man lodged the claim on behalf of his mother, who has dementia, after she lost a bag containing jewellery as well as other items during a walk on the beach on September 6 last year. He reported the loss to the police the next day and lodged the claim with Suncorp on September 14.

As part of its investigation into the claim, the insurer requested information from the insured, including valuation certificates for the lost jewellery, bank statements and phone records from August 20 to September 20. 

The complainant agreed to some of the requests but refused to provide the phone records, saying it was a breach of his privacy and not required for the investigation. 

Suncorp says it was relevant to confirm the circumstances of the loss and his movements during this time. After the insurer sent multiple letters to the claimant following up on the request, it declined the claim, saying it could not complete its investigation due to the man’s failure to cooperate.

The Australian Financial Complaints Authority (AFCA) said the phone records had been relevant to the claim.

AFCA's ombudsman said it is "not unusual" for insurers to request phone records and "while I acknowledge the complainant’s privacy concerns, the insurer is bound by the terms of
the Privacy Act 1988 (Cth).

"The Privacy Act regulates the insurer’s use and disclosure of the complainant’s personal information."

AFCA agreed the insurer was entitled to decline the claim due to the complainant’s unwillingness to provide the information and said it would only be required to re-open its investigation if the records were given.

“Because the complainant did not provide the records and they were reasonably requested by the insurer, I am satisfied he has not cooperated as he is obliged to under the policy,” AFCA said.

“I am satisfied that until the complainant provides the phone records and bank statement the insurer is entitled to decline the claim for non-cooperation.

“The insurer is not required to take any further action until the complainant makes the phone records and bank statement available to complete the assessment.”

The ruling also shot down the claimant’s allegations that Suncorp’s investigator had acted improperly after they had asked questions relating to the health and cognitive ability of the man’s mother.

“The investigator made inquiries about the complainant’s mother, who is the policy holder,” AFCA said. “The questions were general and not intrusive.

“He explained that he was trying to ascertain whether the complainant’s mother had the capacity to participate in an interview.

“The investigator accepted her dementia was too advanced to allow her to be interviewed and moved on to other topics.”

Click here for the ruling.