FSCL said $10,000 and an apology was "more than fair" to resolve her complaint. Photo: 123rf
A business owner who changed an insurer's statement to say it would pay her $100,000 to resolve her complaint - rather than the $10,000 it had offered - has been told by a complaints service that she was being unreasonable.
The woman's business was affected by Cyclone Gabrielle last year and was closed for several weeks.
She made an insurance claim for material damage and business interruption, as well as a claims preparation costs claim.
Three months later, the insurer paid her $58,000 for the material damage and business interruption claim.
But Financial Services Complaints Ltd (FSCL) said she was "most unhappy" with the way the insurer had communicated with her and dealt with her claims.
She said the $1230 she was offered for the claims preparation claim was not an accurate reflection of the time she spent putting it together.
She complained that the insurer had not met its obligations under the Fair Insurance Code to pay her claim in a reasonable amount of time, to provide information about the process and provide regular updates. She said it did not give her information from her file, did not answer specific questions and the special investigations team "bullied" her.
FSCL said the insurer acknowledged there were shortcomings in its process and offered her $10,000 to resolve the complaint. But she did not accept that and changed it to $100,000, which she said was designed to catch out the insurer and see whether it was paying attention to detail.
FSCL said $10,000 and an apology was "more than fair" to resolve the complaint.
It said the three-month timeframe to pay the claim was reasonable given the volume of claims after the weather events of last year.
"We saw that most of the communication between [the claimant] and the insurer was via the loss adjusters. Some of this communication did not clearly set out what was happening with the claim process, and we encouraged the insurer to ensure loss adjusters (their agents) communicate clearly with clients."
It said $1230 was reasonable for the claims preparation claim and the $10,000 would cover any shortfall, anyway.
FSCL told the business owner it would not continue with her complaint because the insurer had made a reasonable offer and it was more than FSCL could award if it made a decision.
She did not accept this "and continued to drip feed further claims to the insurer and raise further complaint issues", FSCL said.
"We told [her] it appeared she was not pursuing her complaint in a reasonable way, and did not want to resolve her complaint. [She] did not accept this, and we closed our file."
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