Jewellery owner loses dispute over ‘missing zero’ on sum insured
The owner of a diamond ring and two valuable watches who says a bank employee skipped a zero when entering sums insured, resulting in a theft payout of $29,000 rather than $290,000, has lost a claim dispute.
She went to the Australian Financial Complaints Authority (AFCA) seeking an additional $261,000, alleging Westpac General Insurance took advantage of her limited English language skills, failing to inform her that the coverage for each of the specified items was significantly less than their replacement costs.
AFCA ruled she had not established Westpac made an error in insuring the specified items, or that it misled her.
“The complainant’s suggestion that (the insurer’s agent) made the same error three times in entering the individual amounts for the specified items - omitting a zero each time - seems unlikely,” AFCA said.
“There is no suggestion that the complainant is innumerate. It is reasonable to assume she could understand the numbers on the policy documents sent to her.”
AFCA also said that by providing policy documents in English, rather than her native language, Westpac had not acted unconscionably, noting the bank employee spoke the same native language when helping her buy the policy.
“The obligation was on the complainant to be satisfied the policy met her needs even if this meant obtaining assistance from others to confirm that was the case,” AFCA said. “The insurer was not under any duty to advise her on the amount of coverage she should put in place.”
The Westpac customer attended a branch requesting two watches and a ring be listed as Specified Personal Valuables, and a new policy commenced in July 2017 and renewed on existing terms a year later. Documents clearly stated the sums insured.
The month after renewal, her property was broken into and, among other things, the specified items were stolen. Westpac accepted her claim and paid the sums insured for the specified items: $29,000.
She told AFCA that while at the branch, she did some research on her mobile phone and wrote the brand name, model number and amount of cover she wanted for the two watches - $100,000 and $80,000 respectively. She says she gave the note to the Westpac employee to assist in completing the online home and contents policy application, and that the employee retained the note.
She asked that her diamond ring be covered for $110,000, she told AFCA, and explained to the employee her English was very poor and she was unable to read documents provided by the bank, and relied on advice and support during the entire application process.
AFCA said she had an obligation to check the policy and ensure it met her needs.
“She did not ask that the sums insured for the specified items be changed … or show the specified items sum insured was incorrect or that the insurer engaged in misleading or deceptive conduct, acted unconscionably or breached a duty of care owed to her,” AFCA said.
Westpac said that had she asked to specify items on the policy for a total value of $290,000 as she suggested, this would have triggered the agent to contact its underwriting department to determine if the risk could be covered.
There was no record of an underwriting referral being triggered, and AFCA said it was unlikely a bank employee regularly involved in the sale of insurance products would encourage a customer to not read policy documents - as the jewellery owner claimed - and it was reasonable to assume she could understand the numbers on the policy documents sent to her.
“The panel is satisfied that the insurer did not incorrectly record the sums insured for the specified items,” AFCA’s ombudsmen said. The panel considered it “most unlikely that the insurer made the alleged misrepresentation”.
Westpac provided a Key Facts Sheet in her native language, which warned: “You should read the PDS and all policy documentation for all the conditions, exclusions and limitations of this policy that limit or exclude cover”.
There was no evidence she asked for versions of the policy documents in her native language or of any agreement with the insurer that it would only communicate with her in that language. There were also no diary notes, correspondence or statements from anyone to corroborate that she asked for a total of $290,000 in cover.
AFCA also said the total value of the three specified items actually exceeded $290,000, and this suggested she was willing to underinsure her watches and ring.
“The panel is not satisfied that the complainant has established that the sums insured were incorrectly recorded,” it said.
“The complainant was obliged to check the policy and ensure it met her needs. It was not unconscionable for the insurer to supply English language versions of the policy documents to her or for it to expect that she would take steps to satisfy herself the policy provided her with the cover she wanted.”
See the full ruling here.