QUESTION 2

Five years ago, Mr Lamb (the insured) entered into a contract by which he insured both his house and contents with ABC Insurance Ltd (ABN 11 2jj 333 xxx) (the insurer). At that time his house, which was located in an exclusive Melbourne suburb, was valued at $6.5 million. After his children grew up and moved away, he realised the house was too big for his wife and him to live in alone. Thus, two years ago, he set up a company, Glamourous Getaways Pty Ltd in which he rented out his home for weddings, events and to movie production companies.

Insurance Contract entered into by Wally Lamb and ABC Insurance Ltd

Clause 19

We Cover

Loss or damage caused by thieves or burglars.

We Do Not Cover

Loss or damage:

(a) caused by you or someone who lives at the insured address;

(b) caused by someone who entered the insured address with:

(i) your consent;

(ii) the consent of someone who had your authority to allow them access to the insured address.

(iii) caused by thieves or burglars entering your insured address from common property, shared clothes line areas, garages, storage areas or a car parking lot at the insured address without signs of forced entry.

Part (c)

Following the denial of the claim for theft of the contents of the house, Mr Lamb has asked for your advice on how to appeal the decision of the insurance company.

Advise Mr Lamb on both internal and external dispute resolution of insurance claims.

[10 marks]

Thank you for your help :)