ASIC takes insurer TAL to court after it denied cancer claim over client’s depression history


ASIC alleges that the woman made a claim in 2014 after being diagnosed with cervical cancer for income protection under her TAL policy.

Loading

TAL then allegedly told the woman her claim had been accepted. At the same time, ASIC alleges TAL launched a secret investigation into all of the woman’s possible previously existing conditions to see whether it could deny the claim because the woman had made a false representation about her health.

ASIC alleges TAL’s review went well beyond an investigation into the woman’s gynaecological health and delved into all areas of her medical history. During its investigation TAL obtained a letter from the woman’s GP which stated she had seen a psychologist between early 2008 and mid 2009 after the break up of a long-term relationship.

ASIC alleges TAL then denied her claim based on this previous medical condition and stopped payments. It allegedly told the woman it would never have issued the policy had it had known about her unrelated depressive symptoms.

The regulator alleges that along with the denial of the claim, TAL did not allow the woman to respond to the investigation or to explain her situation.

ASIC also alleges that in sending a letter to the consumer, TAL accused the consumer of breaching her duty of disclosure and her duty of utmost good faith under the Insurance Contracts Act.

The regulator is seeking fines and declarations from the court.



Business

Related posts

Make a comment