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#1

Just thought I would alert the site of Comsure accident insurance fine print. My son injured his foot riding his trail motorcycle. And had to have 10 weeks off work to recover and his foot to heal.
No problem he had accident insurance he actually had 2 policies with Comsure he thought would cove him with financial assistance. How wrong he was we have just had his claim turned down because the fine print said he had to be bed ridden.
My point is check your policy details, you may not be covered for what you think you are. I have not given up there is always the Insurance ombudsman.


#2

Sorry to hear about the trouble @archer_bryan. In my experience, accident insurance policies can be very restrictive in what they cover, as can similar income protection insurance policies. Thanks for sharing your story, it will no doubt help others.

Hope your son feels better soon too.


#3

Thanks for your Concern Brendon, the accident happened in 2015,we had trouble getting the medical records and all the other proof the insurance needed to eventually turn down my sons claim, the problem is that the insurance policy title makes you think you are covered for any situation but in reality the policies arn’t worth the paper they are written on.


#4

Hi
What was the insurance product actually called and is it part of scheme? I am an insurance broker and interested to see an accident policy that defines cover only applies if bedridden. Happy to help if possible.


#5

Comsure seems to keep their docs close to their vest, but I found an example.

Not sure if this CAN Bank 2012 brochure reflects a current product, but search for ‘bed’ and you have one. Just googled and there it was. Other Cominsure products with PDS available on the web appear to have similar clauses

“Pays a benefit if you are totally and temporarily disabled by an accidental injury or illness that confines you to bed.”


#6

Hi thanks for your response to help. My son took these policies on over the phone in good faith while he was working away at the mines. The policies by description would have to believe he was covered for any eventuality but apparently not. The names of the two policies are Injury cash protection policy and Accident Protection policy. It’s hard for me to believe that he was not covered. Unfortunately because he was initially turned down over the phone a long period of time has elapsed before we were able to lodge the claim. Regards Bryan


#7

Hi my son has received a offer for compensation for his injuries and Cominsure have agreed to refund him the whole amount he paid for these policies. Do you think he should pursue it all the way or settle for the refund, I estimate he lost $10000 dollars in lost income, Cominsure have offered him a refund of payments he made that amount to around $3000. Do you think if we perused it further with the Insurance Ombudsman he or she would rule in my sons favour? regards Bryan


#8

I suggest you seek that advice from a (probably personal injury) lawyer, not an internet forum, always remembering many lawyers will defend your rights to your last dollar so keep perspective.


#9

This policy document is here - Commonwealth Bank Injury Cash Protection Policy and Injury Cash Protection Policy Change Summary.

This policy document is here - Commonwealth Bank Accident Protection.

The wording which is specifically relevant is that relating to Daily Bed Confinement benefit (page 18 and 6 of the Injury Cash policy document and page 10 and 20 of the Accident Protection Policy).


I agree with @TheBBG, that it may be appropriate to gain advice from a specialist lawyer and that such lawyers are likely to have significant costs to recoup any benefit, if it is found to be payable. I would suggest that if you do go down the path of speaking to a lawyer, see if you can have a fee free initial consultation whereby you can explain your circumstance and also gain a fee schedule/estimate of fee from them.

It is likely that an estimate is needed to review and provide advice on your circumstances, which could include sending letter of claim to the bank from the lawyer. Additional estimates should also be given for follow up action such as making a claim through a tribunal or court.

Both these can can quite expensive as it is likely that the bank will entertain a process where a number of letters are sent requiring response. Each response and subsequent response will be at your cost.

With a small claim of say $10,000 which you outlined, you have to think whether you pursue the claim as a matter of principle (where costs are not relevant), whether your claim is likely to be successful and financially better than the current offer or whether the amount offered by the Commonwealth Bank is accepted based on the costs of pursing for a more modest amount.

Not withstanding this, it may be worth making a submission into the Financial Services Royal Commission, The link to public submission for an information on how to lodge can be found on this page - Royal Commission into Misconduct in the Banking, Superannuation and Financial Services Industry Homepage.

This is possibly of an example of a financial institution offering services without the purchaser being fully aware of or understands the limitations associated with the purchased product. I am for one to purchase such products, but the purchase decisions should be made by the purchaser knowing all about the product being sold. The purchaser should also be able to explore alternative products from other providers to see which product best suits ones needs.

The hard sell by many financial institutions, leads to the sale of products to individuals which is either unwanted or unsuitable based on the circumstances. Even going to any bank one is offered "would you like fries with that’ type questions from the bank teller, such as ‘do you have a home loan’, ‘do you have house, car or content’s insurance’ to ‘do you need a personal injury insurance’… Such is possibly driven by banking employee KPIs to achieve bonuses rather than what is in the best interests of the customer.


#10

Thanks for the advice, I have provisionally through Choice submitted my Son case to the Royal Commission, at least I have let people know buyer beware when shopping for accident cover. Regards Bryan


#11

Hi @archer_bryan, in addition to the above tips, you might also benefit from contacting our CHOICE Help service that is provided to members.