Basic Insurance Claims Process

Claims Process in New Zealand

  • Filing a Claim: A policyholder must first file a claim after an event triggers coverage (e.g., a car accident or property damage). The policyholder submits the claim to the insurer.

  • Investigation: The insurer will then investigate the claim, including determining the cause of the loss and the extent of damage.

  • Settlement: If the claim is accepted, the insurer will compensate the policyholder according to the policy’s terms. If the claim is denied, the policyholder may seek clarification or appeal the decision.

  • Disputes: If a policyholder disagrees with the insurer’s decision, the matter may be referred to the Insurance & Financial Services Ombudsman (IFSO) or, if necessary, taken to court.

Bad Faith Insurance Practices in New Zealand

  • Bad faith insurance practices occur when insurers unreasonably deny, delay, or underpay claims.

  • Policyholders in New Zealand who feel they have been mistreated can take action by lodging a complaint with the Insurance & Financial Services Ombudsman (IFSO) or seeking advice from an insurance lawyer to dispute the claim.

  • In some cases, policyholders may be entitled to compensation for emotional distress or additional damages due to bad faith actions.

Insurance Disputes and Litigation in New Zealand

Disputes: Common insurance disputes in New Zealand include disagreements over the amount of compensation, the interpretation of policy terms, and the scope of coverage. Disputes may arise after natural disasters, accidents, or property damage.

Litigation: If an insurer refuses to settle a claim fairly, a policyholder can pursue legal action, including filing a claim in court or seeking alternative dispute resolution (ADR), such as mediation or arbitration.

The Role of Insurance Lawyers in New Zealand

  • Insurance lawyers in New Zealand specialise in advising clients on their rights and obligations under insurance policies, representing policyholders in disputes, and assisting with claims processes.

  • They can help clients navigate the complexities of insurance law, including bad faith claims, and provide legal representation in disputes involving insurers.

Tim Gunn