| Insurance Guide: Bushfire Insurance |
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Warning: This factsheet only provides information and should not be relied on as legal advice.
This guide covers the following topics:
PART 1 How are bushfires and insurance related? Bushfires have the capacity to wreak great havoc and can be responsible for devastating losses. In the case study, the fires tragically took Barb’s husband as well. All Barb has left are her insurance policies. If you have insurance, the damages and losses resulting from bushfires may be recoverable depending on what type of insurance you have and the extent of that cover. If you have:
If you are in any doubt about whether or not you have insurance, contact your insurer or the Insurance Council of Australia on 1300 728 228 or even your superannuation fund (for life insurance).
PART 2 Does my insurance policy cover me for bushfires? Depending on your actual policy, damage caused by bushfires may be covered as part of fire damage (if this cover is unqualified in any way). For example, your policy wording might read: “Fire damage is an insured event” and there is no mention of whether bushfires are excluded. There may also be specific references in your Policy dedicated to bushfires or this may be a clarification on whether or not fire damage includes bushfire damage and to what extent. For example, your policy might say: “Fire, including bushfire, is an insured event.” Some common clarifications dealt with in such clauses might include:
NOTE: Some policies will specifically state that you won’t be covered for the first 48 (or 72 hours etc) of the Policy if your new insurance is for a greater amount than the insurance that just expired. Be aware that exclusions for fire related damage may also apply. Some common exclusions include: No cover for loss or damage as a result of Scorching, melting, heat, smoke, ash or soot where there was no flame, or your home/contents did not catch fire. The extent of your cover will ultimately depend on the wording of your particular Policy. Some policies may state that your insurer: Will pay for damage to your home/contents caused by a burning building within 10 metres of your home. In addition to very specific wording in your Policy, you should also be aware that your Policy may place a general obligation on you to take precautionary measures to prevent loss. The wording may not specifically refer to fire damage or bushfires, but will equally apply to those scenarios. An example of this could be where you may have left your gutter uncleaned and filled with leaves. These leaves could possibly catch fire from embers carried by the wind. This however is arguable if the fire was of a sudden or even unavoidable ferocity. It is also arguable whether cutting/burning trees surrounding your property to prevent the likelihood and impact of bushfires might fall within such precautionary measures as permission for such actions require local council approval. Taking such measures may comply with your obligations under your insurance contract but be in breach of local planning laws and regulations. An example of a precautionary clause is: You must at all times, and at your expense, take all reasonable precautions:
If you do not, we may reduce or refuse to pay any claim you may make. GOLDEN RULE: It can be difficult to work out what is covered by your policy so if you are unsure get advice from the Insurance Law Service (1300 663 464) or your private solicitor. THINGS TO CHECK FOR IN YOUR POLICY: In relation to the extent of bushfire cover, some insurance policies:
(Above research conducted by Legal Aid NSW)
If you have insurance, you should contact your insurer to make a claim as soon as possible. It does not matter that your policy documents have been burnt/lost as your insurer can easily verify any cover you have with them. If you do not know the name of your insurer you can ask for assistance from the Insurance Council of Australia on 1300 728 228. For information on how to make a claim on your home and/or contents insurance, please see: Making a claim on car insurance For information on how to make a claim on your motor vehicle insurance, please see: Making a claim on home and contents insurance
PART 4 What are typical issues to consider in bushfire insurance claims?
Underinsurance refers to the situation where an insured has undervalued their home and or contents policy. This means that they will not have sufficient insurance to cover their loss or damage, even if their claim is approved. Underinsurance is a major problem particularly in times of natural disasters such as floods or bushfires, as the cost to rebuild can easily rise due to the increased demand for builders and building materials. Statistics obtained from the Insurance Council of Australia in 2007 showed that “up to 81% of those who are insured will be more than 10% shy of true rebuilding costs.” (http://www.insurancenews.com.au/analysis/bushfire-underinsurance-a-threat-and-maybe-an-opportunity, accessed 20/02/09). Some insurers offer options on your Policy to increase the safety net of protection, in return for you paying additional premiums. You will know this when you see clauses such as: “Safety net home protection – 25% extra of the home sum insured” Insurers may also offer complete replacement cover. This is where regardless of the extent of your losses, what you have lost is replaced. For example, if your home was completely destroyed by bushfires, the insurer will pay for the cost of completely rebuilding your home. Insurers cannot be expected to pay for more than the amount that you are covered for. However, your insurer has a duty to clearly inform you in writing that their liability is limited to a particular amount before the contract is entered into. (Section 35 of the Insurance Contracts Act 1984( Cth))
Is my insurer responsible for the sum my home is insured for?
“Each renewal, we increase your sum insured to help keep pace with inflation and consequently your premium will increase. As always, you are free to choose a sum insured level which best suits your needs and we recommend you review the amount of your cover periodically, particularly if you have made changes to your assets.”
Replacement v Indemnity Cover Recent experience with the ACT January 2003 and the 2009 Victorian Black Saturday bushfires has shown that you will need to read your policy very carefully to determine whether you have indemnity cover or replacement cover (i.e. new for old replacement). This is particularly important as it may result in you not being able to recover the full value of your insurance cover. If you have indemnity cover, your insurance policy might allow for the rebuilding of your property up to the sum you insured it for. However, there will likely be clarifications on this cover where you do not rebuild and choose instead to sell the land. In such cases, your policy could say that your insurer will only repay the indemnity value of the property (its value taking into account depreciation). If you have a replacement cover, your insurer should compensate you for the amount it would cost to replace (or rebuild for buildings) your damaged or destroyed building/contents to the condition it was in just prior to the fires. Any settlement agreements to pay you a certain amount must be qualified by this requirement to fully compensate you for the amount it would cost you to replace your buildings. For example, if the rebuilding amount for your destroyed property has been underestimated, you have a right to seek whatever additional amounts would be necessary to bring the rebuilt property to the condition it was in prior to the fires. On this point, see also the discussion below on Additional Benefits in relation to compliance with new regulations.
2. Cash Settlement or Repair/Replacement Often the decision as to whether to repair, replace or cash settle a claim is that of the insurer’s. Look for something like the following clause in your policy, “We will decide how we settle your claim If your contents or valuable items suffer loss or damage, we will decide whether to
If you are offered and decide to accept a cash settlement, see the section below entitled “Additional Benefits” before you sign any deeds of releases or otherwise finalise your claim.
Fences are typically part of a specific cover that you would need to pay extra for. For example, you can ask for fence cover in relation to:
If you do not have specific cover for fencing, depending on your type of policy or whether your sum insured is not already exhausted, there may be a general basic cover for fence up to a limited amount (e.g., up to $2,500 for all fences). Contact your insurer to find out the extent of your cover for repairing or replacing fences.
4. Cancellation of policy due to failure to pay insurance premiums There are two main scenarios when non payment of premiums can result in your insurer cancelling your policy. Many bushfire victims have only discovered after the fires that their insurance has been cancelled due to their failure to make the premium payments.
A. Can my insurer cancel my insurance contract if I don’t pay my premiums? i. If you pay your insurance premiums in instalmentsThe short answer is yes. Under section 60(1) of the Insurance Contracts Act, if you fail to comply with a provision in your insurance contract (such as a provision requiring you to pay premiums) your insurer can legitimately cancel your policy. However, conditions will apply. An example of instalment contracts of insurance is when you pay premiums on a monthly basis. Under section 62 of the Insurance Contracts Act, an insurer can cancel your policy without giving you notice of the cancellation under the Act, if:
What all this means is that as soon as one instalment of premium payment is overdue, your insurer can:
If your insurer did not give you anything in writing (before you entered into the contract) telling you about their right to cancel your policy without notice if you fail to pay premiums for at least one month, and did not also comply with section 59, then they cannot cancel unless they have followed notice requirements under section 59. If they didn’t cancel correctly, your policy will still continue until expiry. For what happens after expiry see “Cancellation of policy due to failure to renew.”
ii. If you pay your insurance premiums in yearly payments In order to cancel your policy, your insurer must give you notice complying with section 59 (that is, for non life insurance contracts, your insurer must give you written notice of any proposed cancellation at least 14 days before they cancel.)
B. Can my insurer limit or deny my claim if I don’t make an instalment of premium? i. If you pay your insurance premiums in instalmentsThe answer to this question is yes but only if:
(Section 39 of the Insurance Contracts Act) ii. If you pay your insurance premiums in yearly payments The answer to this question is yes. If you pay premiums yearly and you do not pay those premiums, you will not obtain cover. See below also on “Cancellation of policy due to failure to renew.”
5. Cancellation of policy due to failure to renew This scenario is different to when you don’t pay premiums and your policy is subsequently cancelled. The crucial difference in renewal cases is that you have failed to renew your policy when your policy lapsed/expired. Under section 58(2) of the Insurance Contracts Act, your insurer must give you written notice no later than 14 days before the day your policy expires informing you:
Under section 58(3),
before the previous contract expires, there will exist a statutory contract of insurance (insurance created under the Act) that will provide you with insurance cover to the same extent as the previous contract commencing from the expiry of the previous contract and for the same period as your previous contract or until you get another insurance cover. This essentially means if your insurer failed to comply with section 58, the policy will continue as if you had renewed it and for the same period as the previous policy.
PART 5 Additional Benefits under your policy There may be additional benefits under your home building and/or contents policy which may cover you for emergency/alternative accommodation, removal of debris and demolition, architects, surveyor and legal fees etc. These additional benefits can be in addition to your sum insured. Therefore, before agreeing to any settlement of your claim, it is important that you check to see if you are entitled to more than your sum insured through the existence of additional benefits cover. Some of these additional benefits are discussed in more detail below.
1. Emergency/Temporary Accommodation If as a result of the bushfires, your house was completely destroyed or rendered uninhabitable, you should contact your insurer to find out:
An example of a clause to look out for to determine whether or not you are covered for temporary accommodation is: “We [the insurer] will pay the reasonable costs incurred by you for comparable accommodation for up to 12 months while your building is being rebuilt or repaired.” If you have been relocated to emergency “community” accommodation, it is also worth contacting your insurer to determine whether you are eligible for emergency “private” accommodation. If you live in a remote area, there may be no private accommodation available. Contact your insurer to determine what is likely to happen in such cases. THINGS TO CHECK FOR IN YOUR POLICY: In relation to temporary/emergency accommodation, some insurance policies:
2. Demolition and/or Removal of Debris During bushfires, not only can whole buildings be damaged and destroyed, but you may experience the problem of debris scattered across your property. The costs to remove such debris from your property and clear your land can be significant. You will need to review your policy carefully to determine whether your insurer will cover you for the demolition and/or removal of debris associated with bushfire damage. One example of such a clause could be: “We will pay the reasonable costs of demolition and removal of debris and of anything which caused the loss, destruction or damage.” You, as the insured, have to establish that the cost of removal of debris is fair and reasonable and applies to the damaged property insured under your policy. This means that:
So what is “debris” exactly? “Debris” is something that will be defined in your insurance contract. Some insurance policies are worded in such a way that trees, shrubs and plants are not considered debris. This exclusion may be done through a series of clauses. Make sure you look out for these. You might think you are covered for all types of debris when you read a clause such as the following: “When the buildings and/or contents have been destroyed or damaged by any of the insured events covered by your policy, we will pay the reasonable cost of: Demolition and Removing buildings and contents debris from your risk address” However, if you see any clauses in your contact such as the following you will know you are not covered for trees and shrubs debris. “What are not buildings: The following items are not buildings: Landscaping, trees, shrubs and plants; What are not contents: The following items are not covered by this policy: Trees, shrubs, plants growing outdoors in the ground” As you can see, if you contracted to this insurance policy, because your policy is only limited to the removal of debris to “buildings or its contents”, and because “trees, shrubs and plants” aren’t considered buildings or its contents, the removal of fire damaged trees and plants are not covered by the policy. The result may sound strange to suggest that damaged trees and shrubs aren’t debris, but in most cases and except in standard contracts, insurers have the discretion to determine what risks they are willing to accept. Also note that with the above example, “contents” only excluded those plants “growing outdoors in the ground.” Therefore, you may claim on your damaged flowers or herb gardens grown indoors. If you are unsure as to whether your Policy covers you for the demolition and/or removal of debris or even if your claim for demolition and/or removal of debris increases the rebuilding or repair costs for your property to above what you are covered for, you may want to argue that given the ferocity of the fires, your insurer under the duty to act with utmost good faith, should cover the reasonable costs of the removal of debris. This argument however should only be used as a final resort as insurance contracts are typically read and interpreted clause for clause and word for word.
3. Architects, surveyors and legal fees Most home building insurance policies these days provide additional cover for the costs of the services of architects, surveyors and legal fees in rebuilding and/or repairing damage to buildings. If you are unsure whether you are covered for these, check to see if you have a clause in your policy similar to the following: “We will pay the reasonable costs of architects, surveyors and legal fees when damage or loss occurs. We will pay up to 10% of your buildings sum insured.”
4. Compliance with new regulations Many insureds are concerned about whether their insurers are required to pay for the additional amounts required to ensure that a rebuilt property complies with new fire safety standards that only came into existence after the fires. The experience of the 2009 Victorian Black Saturday bushfires has highlighted this as an area of major concern to some insureds on covers such as replacement cover. The answer to this question is that it will depend on what you are entitled to under your policy. An example of a clause to look out for is: “We will also pay any additional costs required for your buildings to comply with government or local authority by-laws.” If your policy has a clause with the same or a similar wording, it is very likely that your insurer will cover you for the costs for additional compliance with new regulations including those about fire safety standards of properties in bushfire prone areas. It is also likely that you may be covered for additional compliance costs if your policy is to replace your property “as new.” If you cannot find this clause in your policy documents, it is unlikely that you are covered for these new compliance costs, but it is always worth checking with your insurer to see if they are willing to negotiate on this issue. For those seeking new cover to protect their bushfire prone properties, it may be useful to ask for this type of cover as an additional benefit of your policy.
PART 6 The General Insurance Code of practice The General Insurance Code of Practice contains some provisions that provide relief or protection to insureds who find themselves the victims of bushfires. Assistance under the Code is provided through the following avenues:
The General Insurance Code of Practice obliges your insurer to fast-track your claim if you are in urgent financial need (Clause 3.7a) and to make an advance payment within 5 business days of you satisfactorily demonstrating your urgent financial need (Clause 3.7b). Remember that any advance payment will be deducted from the total value of your claim.
For bushfire related damage, it is very likely that buildings will need to be either reconstructed or repaired. As with all repair workmanship and materials claims, be aware that: Under the General Insurance Code of Practice, where your insurer has selected and directly authorised a repairer, they will:
3. Responding to Catastrophes and Disasters, and Reopening Settlements The General Insurance Code of Practice contains clauses specifically designed to apply to disaster cases such as bushfires and floods. Two useful clauses are:
PART 7 Other Common Bushfire Insurance Issues
If, in the case study above, Barb and Leo had obtained their policy 24 hours before a bushfire engulfed their property and under their policy, there is a clause that reads: “Fire, including bushfire, is an insured event. However, We will not cover loss or damage caused by bushfires for the first 48 hours of this policy”
A. Can the insurer then refuse Barb’s claim for bushfire damage to her home on the basis that there is no cover for bushfire for the first 48 hours after inception of cover? The answer to this question can be complicated. If your claim has been rejected by a similar line of reasoning, you will want to consider the following issues:
B. Can the insurer deny your claim alleging that you failed to disclose that the property was under bushfire threat when the policy was arranged? The answer to this question will depend upon your answers to the following:
On these particular issues, the Insurance Ombudsman (FOS) has stated that “the insurer...is not obligated to be “omnipotent” in acquiring knowledge of natural or potential natural disasters. However, the Panel does expect major insurers who insure without question, properties in bushfire prone areas to make some enquiries to protect their position, rather than passively expect their policyholders to demonstrate the same level of “omnipotence.” (Determination No: 203 08 17947) It is also useful to note that had the telephone consultant appropriately questioned and verbally conveyed the 48 hour no bushfire cover clause, it may be more difficult to argue that cover should still be provided.
2. Is my tractor/car or my All Terrain Vehicle/motor bike covered for damage under contents insurance? Many bushfires have left not only homes destroyed but have also damaged family tractors, farm bikes or other motor vehicles on the property. In the case study above, if Barb and Leo’s car didn’t have its own separate fire insurance policies, separate from their home contents insurance, would Barb be able to successfully claim on her home contents insurance for the damage to her car? Unless otherwise provided for in your policy, contents insurance will typically NOT cover motor vehicles, motorbikes, trailers and caravans. If you have separate fire insurance on these vehicles you should make a claim on those policies. Remember though that each policy has its own specific wording, you must read yours carefully to determine whether damage to your tractor in a bushfire is covered. You can find this in the section that defines what contents are covered or not covered. One example of this could be: “What contents are not covered: ... Motor bikes, trail bikes, mini-bikes... Motor vehicles, caravans, trailers and their attached accessories or spare parts”
PART 9 What can I do if my claim is refused and how do I raise a complaint? For information on what to do if your home and/or contents insurance is refused, please see: What can I do if my home and/or contents insurance claim is refused? For information on what to do if your motor vehicle insurance is refused, please see: What can I do if my car insurance claim is refused?
If you are a victim of the February 2009 Victorian Bushfires, please contact the Victorian Bushfire Legal Line on 1800 113 432 for all bushfire related enquiries including for legal advice. They also have a website which you can access at http://www.bushfirelegalhelp.org.au If you have a question about claiming on your insurance policy or you have a dispute with your insurance company further down the track, you can call the Insurance Law Service on 1300 663 464 or the Financial Ombudsman Service on 1300 780 808. If you are a tenant affected by the bushfires either from having your possessions burnt or your rental property damaged or destroyed, please contact a Tenants Union in your state or territory for tenancy advice. Alternatively you may contact Law Access on 1300 888 529 for a referral to your nearest Tenants Union.
PART 11 Do you have a bushfire enquiry but not really about the insurance side of things? Do you have a mortgage or other loans? If you are paying off your home, you will be legally obliged to meet your mortgage repayments, even if your home has been destroyed or damaged by fire. Not paying your loan pending the outcome of an insurance claim will result in additional interest and enforcement fees being added to your loan and may result in legal action. You should contact your lender immediately to ask for hardship assistance. Some lenders have already announced special measures being taken to assist customers affected by the fires including relief from repayments and other forms of assistance. The insurer is also obliged to notify your financial institution about the claim (for example, where there is a mortgage over your home) under the General Insurance Code of Practice, but you must let the insurer know about the financial institution’s interest. If you have other loans you cannot pay as a result of hardship you should also contact your lender. You may have a legal right to a hardship variation on your loan, or your lender could be obliged to work with you under an industry code of practice. However, special relief offered by some institutions may be more beneficial and you should explore that avenue first. For general information on hardship variations please click on the following links:
If you cannot pay your loan and you cannot reach an agreement with your lender contact
If you are after help with other areas of law, the Bushfire Legal Help Handbook published by Victoria Legal Aid provides a guide to the law for people affected by the February 2009 Victorian bushfires. This handbook can be accessed at http://www.bushfirelegalhelp.org.au/handbook.php or by contacting Victoria Legal Aid themselves. Need some more help? For a list of additional resources, click here .
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