Your Duty of Disclosure
In order to make an informed assessment of the risk and calculate the appropriate premium, your Insurer needs information about the risk you are asking to insure. For this reason, before you enter into a contract of insurance, you have a duty under the Insurance Contracts Act 1984 (Cth) to disclose to your insurer every matter that you know, or could reasonably be expected to know, is relevant to the insurer’s decision whether to accept this risk and, if so, on what terms. The duty continues after the proposal form has been completed up until the inception date of the policy and also applies when you renew, extend, vary or reinstate a contract of insurance.
You do not have to disclose anything that:
One important matter to be disclosed is the history of losses suffered by the person or entity seeking insurance and possibly also losses suffered by any related or associated person or entity sough to be covered by the relevant insurance policy. You are responsible for checking that you have made complete disclosure. We suggest that you keep an up to date record of all such losses and claims and that you make all reasonable enquiries of directors, officers, senior managers and any relevant employees in order to ensure that adequate disclosure has been made.
Claims Made Policies
Some policies or policy sections are issued on a ‘claims made’ basis. This means that the policy responds to:
You will not be entitled to indemnity under your new policy in respect of any claim resulting from an act, error or omission occurring or committed by you prior to the retroactive date, where one is specified in the policy terms offered to you.
Consequences of Non-Disclosure
If you do not comply with your duty of disclosure, your insurer may be entitled to reduce its liability in respect of a claim or may cancel your contract of insurance. If the non-disclosure was fraudulent, the insurer may be able to avoid (or cancel) the contract of insurance from its beginning. This would effectively mean that you were never insured.
You must also notify your insurer of any significant changes which occur during the period of insurance. If you do not, your insurances may be inadequate to fully cover you. We can assist you to do this and to ensure that your contract of insurance is altered to reflect those changes.
Contracts entered into by the Insured affecting Insurers’ rights
Some insurance contracts seek to limit or exclude claims where the insured person has limited their rights to recover a loss from the person who has responsibility for it eg: by signing an agreement which contains a disclaimer, indemnity or limitation of liability of the other party. Please tell us about any contracts of this type which you have entered into or propose to enter into.
As an Australian Financial Services licensee Coversure is required to have specific processes in place to handle complaints and disputes with clients.
These procedures have been designed to deal with a prospective or existing client's complaint effectively, efficiently and fairly.
We are committed to meeting if not exceeding our clients’ expectations whenever possible. We recognise that dissatisfied clients have a right to complain and to have their complaint handled.
Coversure Complaints Officer
The Coversure Complaints Officer can be contact via email to email@example.com or by address correspondence to Covers office at the address noted under contacts on this web site.
The Coversure Complaints Officer is responsible for:
What Happens after the Complaint is Lodged
After the complaint is passed to the Complaints Officer, other employees are no longer responsible for handling the complaint.
The Complaints Officer will take over the management of the complainant, and will attempt to resolve the complaint swiftly.
If the Complaints Officer cannot resolve the complaint, it may be referred to Lloyds or another agency for resolution.
What we will do if your complaint is about a Lloyds Policy?
Lloyd’s is the world’s specialist insurance and reinsurance market, bringing together an outstanding concentration of underwriting expertise and talent. Around 80 syndicates underwrite insurance at Lloyd’s, covering all classes of business. Together they interact with thousands of brokers daily to create insurance solutions for businesses in over 200 countries and territories around the world.
In Australia, Lloyd’s is proud to be a member of the Insurance Council of Australia, and strives to comply with the agreement it has made under the General Insurance Code of Practice.
Lloyds aim is to provide the highest service to its Australian policyholders and, to this end, they have developed the following procedures for the fair handling of complaints from Lloyd’s policyholders.
How Lloyds we help you?
There are established procedures for dealing with complaints and disputes regarding your policy or claim. All policyholders can take advantage of the complaints service.
Any enquiry or complaint relating to a Lloyd’s policy or claim should be addressed to either your Lloyd’s insurance intermediary, Coversure, (“the coverholder”) or to the administrator handling your claim in the first instance – in most cases this will resolve your grievance.
Coversure or the claims administrator will respond to your complaint within 15 business days provided they have all necessary information and have completed any investigation required to respond to your complaint.
Where further information, assessment or investigation is required, they will agree to reasonable alternative timeframes with you.
You will also be kept informed of the progress of your complaint.
In the unlikely event that this process does not resolve your complaint or you are not satisfied with the way your complaint has been dealt with, you should contact:
Lloyd’s Australia Limited
1 O’Connell Street
Sydney NSW 2000
Telephone: (02) 8298 0700
When a dispute is made to Lloyds they will usually require the following information:
Following receipt of your dispute, the person lodging the complaint will be advised whether the dispute will be handled by either Lloyd’s Australia or the Policyholder & Market Assistance Department at Lloyd’s in London:
Where they are a retail client and the dispute is eligible for referral to the Financial Ombudsman Service (FOS), the dispute will be reviewed by a person at Lloyd’s Australia with appropriate authority to deal with your dispute.
How long will the Lloyds Step 2 process take?
The dispute will be acknowledged in writing within 5 business days of receipt, and they will be kept informed of the progress of the Lloyds review of their dispute at least every 10 business days.
The length of time required to resolve a particular dispute will depend on the individual issues raised, however in most cases they will receive a full written response about the dispute within 15 business days of its receipt by Lloyds of all necessary information and Lloyds have completed any investigation required.
If the dispute is not resolved in a manner satisfactory to the person lodging the complaint then the following will occur.
Wholesale clients or retail clients not eligible for referral to the FOS may be eligible for referral to the Financial Ombudsman Service (UK).
Such referral must occur within 6 months of the final decision by the Policyholder & Market Assistance Department at Lloyd’s. Further details will be provided by the Policyholder & Market Assistance Department with their final decision about the complaint.
Lloyds will provide retail clients eligible for referral to the FOS with details of that body. FOS is an independent body that operates nationally in Australia and aims to resolve disputes between you and your insurer. Your dispute must be referred to the FOS within 2 years of the date of our final decision.
From 1st January 2018 an exemption is provided to small business for NSW stamp duty payable on certain types of insurance.
A small business is an entity within the meaning of section 152-10 (1AA) of the Income Tax Assessment Act 1997 of the Commonwealth for the income year in which the insurance is effected or renewed. At present, you are a small business entity if you are an individual, partnership, company or trust that:
Aggregated turnover is your annual turnover plus the annual turnovers of any business entities that are your affiliates or are connected with you.
The exemption applies to only certain products distributed by Coversure and includes Liability and Professional Liability