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A contentious insurance claim has ended unfavourably for a motor policyholder after her husband mistakenly poured diesel exhaust fluid into her car's fuel tank.
Although the policyholder initially received assurances from a Suncorp representative that the use of AdBlue fluid wouldn't be considered improper fuelling - supposedly an excluded scenario under her policy - the claim was later denied.
This decision has sparked debate around policy definitions and customer service communication.
The policyholder argued that according to the product disclosure statement (PDS), only "incorrect fuel usage" was excluded, and as AdBlue is technically not a fuel, her claim should be valid. Additional grievances arose after alleging the insurer’s tow service inflicted further damage to her car, necessitating a new steering rack and wheel realignment.
Suncorp acknowledged the issue with its initial claim rejection, where the decision was based solely on the original PDS. However, the insurer pointed to a supplementary product disclosure statement (SPDS), which explicitly excludes coverage for damage resulting from using fluids not recommended by the vehicle's manufacturer. This key differentiation was reportedly communicated to the policyholder during her policy renewal.
The Australian Financial Complaints Authority (AFCA) sided with Suncorp, determining that the insurer did not mislead the customer about her claim status. While Suncorp admitted to referencing outdated PDS wording initially, AFCA deemed their reliance on the updated SPDS appropriate and found no obligation for the insurer to cover the incident. Additionally, AFCA found limited evidence to support the policyholder's accusations regarding damage caused by the towing service, reinforcing Suncorp's account of a winched, non-dragged vehicle recovery.
Despite these rulings, AFCA ordered Suncorp to compensate the policyholder $3000 for delay-induced inconveniences during the claim process, which left her without her vehicle for an extended period, citing the resulting undue stress and hassle.
This case highlights the importance of clear communication and understanding of policy amendments, emphasizing the role supplemental documents play during insurance assessments. Consumers are reminded to review documentation thoroughly during renewals to grasp the full scope of their insurance protections and exclusions.
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Copayment: A fixed amount you pay for a covered healthcare service, usually when you receive the service.