Assessment
The document which details the decision of the IFSO Scheme Case Manager after a complaint has been investigated.
Avoidance
If a policy is avoided it means it is treated as though it never existed. This is a common law remedy available to the insurance company in certain circumstances. See the info sheet: Non-disclosure - what you need to tell your insurer.
Complaint
A complaint is a formal investigation by the IFSO Scheme. The issue must have gone through the financial service provider’s internal complaints process before it is accepted by the IFSO Scheme for investigation and resolution, by agreement where possible (through negotiation, conciliation and mediation) or by decision.
Complaint enquiry
A complaint enquiry is any question or issue that is brought to the IFSO Scheme.
Deadlock
This is when you have come to the end of the Participant's internal complaints procedure and the complaint cannot be resolved. It is at this stage that you can bring a complaint to the IFSO Scheme.
Disability
This depends on the policy wording. It is not a medical definition but a policy definition. Please read your policy for details.
Duty of disclosure
You have a duty to give the insurance company all the information it needs to know when deciding if it can offer you insurance. This duty arises when you take out the insurance and, for house, contents and vehicle insurance, at every renewal of your policy. If you do not disclose all material information, the insurance company is entitled to avoid the policy and decline to consider your claim. See the info sheet: What you need to tell your insurer.
Endorsement
An alteration to the standard terms and conditions of the policy, which forms part of the contract between you and your insurer.
Excess
A fixed amount you must pay when making a claim. It represents a portion of the loss which is not covered by the insurance company. The insurance company will pay the additional claim costs. See the info sheet: Excess
Ex gratia payment
A payment made by your insurer or financial service provider to you, when it does not have to do so under the terms of the policy or contract.
Financial Service Provider
A person or business providing a financial service, including: insurance, financial advice or planning (including brokers), loans and credit, superannuation (including KiwiSaver), investment management, foreign currency exchanges and money transfers, mortgages, savings and cheque accounts. For the legal definition see the Financial Service Providers (Registration and Dispute Resolution) Act 2008.
Indemnity value
This is the value of the item at the time of the loss. Payment of the indemnity value is designed to put you in the same financial position you were in immediately before the loss occurred. Also see Market value.
Insurable interest
This refers to the fact you must own or have some other interest in the property/item which is insured under the policy.
Insured
Someone who has an insurable interest in the property covered by the policy.
Insurer
The insurance company providing the insurance cover.
Locked-in period
The period in personal superannuation plans during which funds can only be accessed in limited circumstances.
Market value
The value of an item immediately before a loss occurs, taking into account wear and tear and depreciation. Also see Indemnity value.
Material information
This is any information which would affect the insurer's judgement about whether to accept a particular risk and, if so, on what terms. Examples of information an insurer regards as material include: details of traffic and criminal convictions; previous claims history; previous avoidance or cancellation of insurance by an insurer; and the applicant's medical history. See the info sheet: Non-disclosure - what you need to tell your insurer.
Maturity
The end of the term of an endowment insurance contract.
Modifications
Additions to a vehicle which alter it from the manufacturer's specifications e.g. mag wheels, bodykit.
Participant
A financial service provider which belongs to the IFSO Scheme. It may be a company or an individual.
Premium
The money paid by you to your insurer for the cover provided by the policy.
Proposal
The application you complete by telephone or in writing when you arrange the insurance. It contains questions designed to obtain full information about you and what you want insured. This information enables the insurer to assess the risk involved and calculate the premium.
Recommendation
If you or the Participant are not happy with the decision in an Assessment, then either of you can request a Recommendation. A Recommendation is a reconsideration of the matter by the IFSO. However, a Recommendation will only be permitted if new or relevant information is provided or there are proper grounds on which to do so.
Sum insured
This is the maximum amount the insurance company will pay in the event of a claim.
Surrender value
The amount payable to you when you surrender or cancel a life insurance policy.
Third party
Any person other than you and your insurer or financial service provider.