Case Studies

The following case summaries highlight common issues and consumer tips. Cases can be filtered by subject below and names have been changed to protect confidentiality. Access to the full case study database is available for IFSO Scheme Participants in the Participant Area.

When the policy pay-out is limited

Check your policy. Accident cover is not life insurance.

When Tim’s dad Roger died, Tim made a claim under Roger’s policy called the “$50,000 Plan”. The insurer paid out $500.
Life Insurance

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What is fair and reasonable conduct?

Educational, cultural and personal circumstances of customers are relevant.

When Lagi's claim was declined, the IFSO Scheme asked whether the sales process was fair and reasonable.
Life Insurance

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Life insurance, reduced payment

Don't leave medical information off an insurance application.

After Mary died, her life insurer discovered she'd had diabetes, cholesterol and blood pressure issues.
Life Insurance

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No cover for childbirth trauma

Trauma insurance cover is specific. Check the exclusions, and the conditions listed in your policy.

Carol sustained significant physical trauma during childbirth, but her trauma insurance claim was declined.
Life Insurance

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Income protection reinstated

Tell your insurer, or adviser, about your full medical history and write it down.

Robert didn’t mention his chronic headaches on his insurance application, but he did tell the bank adviser.
Life Insurance Non-disclosure

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Full medical history needed

Tell your insurer your full medical history, even if it's old news.

When Rose arranged insurance, she didn’t mention her depression, skin, sinuses, spine, liver, cholesterol or ear issues.
Life Insurance Non-disclosure

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35 unauthorised credit card transactions

Failing to safeguard your credit card PIN could mean you are liable for unauthorised transactions.

Sharee complained that 35 unauthorised transactions were made with her credit card in NZ during the month she was overseas.
Loans & Credit

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Financial hardship, no evidence provided

The CCFA has rules for lenders about hardship applications and fees.

After Dan took out a loan, he said money had been stolen from his bank, and he’d lost his job. But he had no proof.
Loans & Credit Lending

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Three loans, no redundancy cover

Lenders must ask for up-to-date evidence about a borrower’s ability to repay a loan

When Bev borrowed $17K for a car, she purchased payment waiver, but later discovered it didn’t cover redundancy.
Loans & Credit affordability Lending

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$4,000 vacuum debt written off

Lenders must ask for information about the borrower’s ability to repay the loan under the CCCFA

Mrs B entered into a loan agreement to buy a $4,000 vacuum cleaner, sold to her by a door-to-door salesperson.
Loans & Credit Lending affordability

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Overseas treatment – no specialist letter, no cover

If you’re making a claim for overseas treatment, contact your insurer well in advance.

The day before Ms B took her daughter to Australia for thyroid treatment, she phoned her health insurer to check the cover.
Health Insurance

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Excluding tonsils, not adenoids

Provide medical details for everyone under the policy.

Dougal's insurer declined to pay for his daughter Sally’s adenotonsillectomy, because she'd had enlarged tonsils.
Health Insurance

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