Accident, Health + Travel Claims
New technologies such as wearable devices are transforming accident and health insurance. Already some policies provide benefits to customers who use wearable devices to monitor their activity, such as providing premium reductions to those with proven exercise regimes.
Technology advances of this kind raises many unanswered legal questions that impact on the insurance industry. How accurate is data from wearable devices and what if it’s inaccurate? How secure is it? Should it be able to be subpoenaed and shared in litigation to demonstrate the wearer’s mobility?
Our team led by Sean O’Connor provides policy advice and claims management on a wide range of accident, health and travel policies, including group policies for businesses and sporting clubs, disability income protection, individual and corporate travel insurance, expatriate care policies and even pet insurance. We also provide advice on potential recovery opportunities where available.
As our working populations become more flexible, more global, and more technologically enabled, accident and health insurance law is in a fascinating period of transformation. Our team is working with our clients within the insurance industry to map out the risks in our fast-paced environment, and identify the opportunities arising from innovation.
The policies and claims on which we advise are rich and varied. Some examples include:
Significant corporate injury, sickness and travel policies
Advising on group injury, sickness and travel policies, in particular for several insurers relating to corporate and business travel insurance programs for Australian, New Zealand and international banks and financial institutions, manufacturers and producers.
Advice on pre-existing conditions and non-disclosure issues
Managing many claims arising out of South-East Asia and the United Kingdom, including acting for London accident and health underwriters in respect of disputes about pre-existing conditions, non-disclosure issues, claw-back provisions and disputes over the start date of policies and plans.
Coverage disputes before the Financial Ombudsman Service
Acting in a range of coverage disputes for insurers where complaints are lodged with the Financial Ombudsman Service by individuals challenging declinature.
Policy wordings and exclusion clauses
Advising on policy wordings and exclusion clauses in breach of anti-discrimination legislation and whether insurers can demonstrate that the exclusions fall within the actuarial/statistical data or unjustifiable hardship exceptions.