Australia: Insurance Laws and Products

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Article
# 7 Outdated Medical Definitions In Trauma Insurance: A Legal And Consumer Challenge In Australia
Trauma insurance, also known as critical illness insurance, provides a financial safety net for policyholders diagnosed with specific serious medical conditions. However, a significant issue undermining the efficacy of trauma insurance in Australia is the reliance on outdated medical definitions. Outdated medical definitions in Insurance policies can lead to denied claims and unmet expectations, creating substantial legal and consumer challenges.
Australia Insurance
CO
Carroll & O'Dea
Article
AFCA’S New Approach To General Insurance Claims Handling: GICOP Compliance May Not Be Enough
The Australian Financial Complaints Authority has published new guidance clarifying how insurers must handle claims, including strict timeframes and expanded compensation rules. Insurers now face potential liability beyond policy limits for unreasonable delays, and may be required to compensate claimants for non-financial losses. With storm season approaching and complaint volumes rising, these changes create significant operational and financial pressure on the insurance industry.
Australia Insurance
GC
Gilchrist Connell
Article
Motor Accident Update: E-Bikes, E-Scooters And Emerging Issues
E-bikes and e-scooters are transforming urban transport in Australia, but what happens when accidents occur? This article examines the complex compensation challenges facing injured riders and pedestrians, revealing significant gaps in insurance coverage and exploring recent legislative changes that may leave victims without the protections available in traditional motor vehicle accidents.
Australia Litigation
CO
Carroll & O'Dea
Article
Broker Negligence, Hypothetical Cover And Section 54
The Victorian Supreme Court has clarified the burden of proof in broker negligence claims, establishing that insureds must demonstrate a hypothetical insurance policy would have responded to their loss. This landmark decision examines the interplay between causation requirements, section 54 of the Insurance Contracts Act, alteration of use clauses, and broker renewal obligations in the context of a major warehouse fire claim.
Australia Insurance
GC
Gilchrist Connell
Article
Insurer’s Denial Upheld: Non-Disclosure Of Material Risk Changes Reduces Liability To Nil
The Supreme Court of New South Wales has ruled that insurers can deny indemnity and reduce liability to nil when an insured fails to disclose material changes in risk. This case examines how a pharmaceutical manufacturer's undisclosed pivot to hand sanitiser production during COVID-19, involving a fifteenfold increase in ethanol storage, led to a complete denial of coverage following a devastating fire.
Australia Insurance
GC
Gilchrist Connell
Article
#5 Financial Services Royal Commission Concerns Regarding Trauma Cover
The Financial Services Royal Commission uncovered serious deficiencies in Australia's trauma insurance sector, revealing how complex policy terms, problematic sales practices, and unfair claims handling have left many policyholders vulnerable. With eight out of ten life insurers admitting failures in updating medical definitions, the Commission's findings expose systemic issues that continue to affect claimants seeking critical illness coverage.
Australia Insurance
CO
Carroll & O'Dea
Article
“Exceptional Circumstances” And Surveillance Evidence – What Angileri Means For Your Personal Injury Claim
A recent Personal Injury Commission decision examines when surveillance footage can be admitted in psychiatric injury claims, potentially lowering the threshold for insurers to introduce evidence that may not fully capture the complex, fluctuating nature of psychological impairment. The ruling raises important questions about how claimants should document their limitations and whether ordinary daily activities will increasingly be characterized as inconsistencies warranting surveillance admission.
Australia Litigation
CO
Carroll & O'Dea
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