Insurer wins dispute after denying cleaner thefts claim
A man whose cleaner confessed to stealing cash, jewellery and other items worth as much as $20,000 over many months has lost a claim dispute with Suncorp.
The policyholder, who held a home and contents policy, reported the theft to police and provided CCTV footage of the cleaner taking a handbag and rummaging through drawers. The cleaner admitted the crime and was charged.
Suncorp did not dispute the man’s version of events but denied the claim as the insurance policy terms excluded cover for theft by someone who entered the home with the policyholder’s consent.
The Australian Financial Complaints Authority (AFCA) determined that as the cleaner was welcomed into the insured address the thefts were excluded from cover and Suncorp was entitled to deny the claim.
The fact the theft was deceptive, premeditated, and occurred over a long period of time did not affect application of the policy exclusion, AFCA said, and nor did evidence other insurers with similar exclusions had accepted claims from other victims of the same cleaner.
“There is no dispute that whenever the cleaner entered the insured address, she did so with the complainant’s consent. Therefore, the cleaner’s thefts are excluded from cover under the policy, and the insurer is entitled to deny the claim.
“The insurer’s assessment of the claim was fair and reasonable,” AFCA ruled.
The terms set out in the product disclosure statement (PDS) stated: “We do not cover loss or damage caused by someone who entered the insured address with your consent.” AFCA said the exclusion was “clear and unambiguous".
See the full ruling here.