Latest news with #KarenStevens
RNZ News
24-05-2025
- Health
- RNZ News
Modifications, Uber, not reading the terms: Common reasons why your insurance claim might be declined
A woman cancelled an overseas holiday when her mother became ill and was shocked to discover she was not eligible for reimbursement. Photo: 123RF Insurers can pay billions of claims each year, but many people are still disappointed, when they have a claim turned down or receive less than they expected. Insurance and Financial Services Ombudsman Karen Stevens says her office is dealing with more complaints than ever before from people for whom the process has not gone as expected. "For years and years, we would do around 3000 complaints a year and 300 investigations," she said. "By the end of this financial year, we'll be over 500 investigations - it's gone way up. "Last year, we had just on 5000 complaints into the office." She said part of the rise was due to increasing public awareness about what the scheme offered, but there were also misunderstandings about what insurance could be expected to provide. "The biggest consumer issue that we've got most of the time is a lack of understanding on scope of cover. Because they pay their premiums, they think that they're covered for basically every contingency." Here are some of the things that might seem small, but could affect your ability to make a claim. Stevens said insurance policy exclusions were something that caught people out frequently. Many policies include things that will not be covered and it's important to check what these are, so you know what to expect. "One that immediately springs to mind that I was looking at last night was in a travel context, where a woman and her husband and family were going on holiday. "They had travel insurance. She found out that her mother was very unwell and not likely to last the time that they were going to be away, so she cancelled her trip. "The problem was that there was an exclusion in the policy that quite clearly said that they wouldn't have unlimited cover, if the person who was unwell had been in a rest home of any sort in the 12 months prior to becoming seriously unwell or dying." That meant they had limited cover of up to $1000 per adult, which did not cover the costs of the trip. "She said, 'Oh, but there was nothing wrong with her, until she got pneumonia in hospital'. Well, that's fine, but the policy had an exclusion that actually had nothing to do with her wellness or anything else at the time." Stevens said modifications made to cars could be a problem. "If an insurer is unaware of the modifications, there's a specific exclusion, if they haven't been told about them and priced accordingly. They're likely to find out, when they go to claim, that not only are they not covered, but of course, our draconian laws on non-disclosure, which still stand, mean that they probably won't have any cover going forward either. "You know, vehicle modifications are still a big one in New Zealand." Consumer NZ insurance specialist Rebecca Styles said insurers could have a broad definition of what would count as modification. Styles said, if someone had been given lower premiums or a lower excess based on where a car would be parked, and then parked elsewhere, that could be a problem. "The insurer will have the ability, under the policy, to say, 'Well, terribly sorry, but we're either not paying your claim, because you're in breach of a condition or will avoid the policy', again, depending on the policy wording." Styles said State, for example, had a list of broad examples of when someone should notify it about a change to where a car was kept. "Where you park your car is considered a 'risk factor', so that would be taken into account, when pricing your policy - you usually park in a garage, but moved house and now park on the street. "While I haven't come across instances of an insurer declining a claim because of this, in the policy, there is a requirement to let the insurer know." If you're paying your insurance on a monthly basis and miss some, you could find your policy is cancelled. Styles pointed to a State policy that said people who missed a payment would get a notice and, if it remained unpaid, the policy could be cancelled. Insurers want to be notified before you start using your car for something like Uber or DeliverEasy, and some don't offer cover for these activities. Taking "reasonable care" is a standard requirement for most insurance policies. That means, if you leave your car unlocked with the keys in it, you might not have cover if someone steals it. This can be an issue in situations, such as where people leave their keys on the beach, while they go for a swim. Stevens' office said many travel insurance policies also had a requirement that people not leave items unattended, even for very short periods of time. Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday. h] Related
Scoop
01-05-2025
- Automotive
- Scoop
Severe Winds And Flooding – IFSO Scheme Urges Careful Action During Clean Up
Press Release – Insurance and Financial Services Ombudsman The first thing to remember is to only start dealing with the clean up when its safe to do so. Then, when its safe, make sure you document everything before starting on the clean up. With flooding in the South Island and damaging winds battering the Capital, the Insurance & Financial Services Ombudsman Scheme (IFSO Scheme) is reminding homeowners to take the right steps in the aftermath, to avoid issues with their insurance later on. 'The first thing to remember is to only start dealing with the clean up when it's safe to do so. Then, when it's safe, make sure you document everything before starting on the clean up. Take photos or videos of the damage and make a detailed list of affected items. Without proof – like photos or receipts – insurers can decline claims. A list on its own often won't be enough,' says Karen Stevens, Insurance & Financial Services Ombudsman. Making contact with your insurer before carrying out repairs is important too. 'You are expected to do essential repairs to prevent further loss, but you should only do this after talking to your insurer, as insurers and homeowners don't always agree on what counts as essential,' Stevens warns. 'For example, getting rid of carpets or disposing of wind-damaged furniture may seem obvious, but always check with your insurer first. If in doubt – check it out.' Stevens also says that acting early can make a difference. 'Make your claim as soon as possible, and ask questions. There's no such thing as a silly question when it comes to understanding your insurance. Check exactly what you need to do to make a claim,' she says. Knowing your cover can help manage expectations during this high-stress time. 'You need to understand whether your home is insured for full replacement or just a set amount (sum insured), and whether your contents are covered for replacement value or indemnity value – which factors in depreciation.' 'With vehicles, it's important to know whether your car is insured for market value or agreed value,' says Stevens. 'That will determine the amount you may receive if your vehicle is damaged by flooding or flying debris during a storm.' The IFSO Scheme recommends the following steps after severe weather: Document damage thoroughly before discarding anything. Take photos or videos of all affected items. Locate receipts and any proof of ownership where possible. Contact your insurer early and ask questions. Check with your insurer before making non-essential repairs, and only carry out urgent repairs needed to prevent further loss. For those dealing with the aftermath, Stevens says a little knowledge can go a long way. 'Understanding your cover and documenting damage properly can reduce stress and help get your claim sorted sooner, and avoid issues down the track,' she says. The IFSO Scheme resolves complaints about insurance and financial services, and is independent, fair, and free for consumers. People can make a complaint to the IFSO Scheme at or by calling 0800 888 202.
Scoop
01-05-2025
- Automotive
- Scoop
Severe Winds And Flooding - IFSO Scheme Urges Careful Action During Clean Up
With flooding in the South Island and damaging winds battering the Capital, the Insurance & Financial Services Ombudsman Scheme (IFSO Scheme) is reminding homeowners to take the right steps in the aftermath, to avoid issues with their insurance later on. 'The first thing to remember is to only start dealing with the clean up when it's safe to do so. Then, when it's safe, make sure you document everything before starting on the clean up. Take photos or videos of the damage and make a detailed list of affected items. Without proof – like photos or receipts – insurers can decline claims. A list on its own often won't be enough,' says Karen Stevens, Insurance & Financial Services Ombudsman. Making contact with your insurer before carrying out repairs is important too. 'You are expected to do essential repairs to prevent further loss, but you should only do this after talking to your insurer, as insurers and homeowners don't always agree on what counts as essential,' Stevens warns. 'For example, getting rid of carpets or disposing of wind-damaged furniture may seem obvious, but always check with your insurer first. If in doubt – check it out.' Stevens also says that acting early can make a difference. 'Make your claim as soon as possible, and ask questions. There's no such thing as a silly question when it comes to understanding your insurance. Check exactly what you need to do to make a claim,' she says. Knowing your cover can help manage expectations during this high-stress time. 'You need to understand whether your home is insured for full replacement or just a set amount (sum insured), and whether your contents are covered for replacement value or indemnity value – which factors in depreciation.' 'With vehicles, it's important to know whether your car is insured for market value or agreed value,' says Stevens. 'That will determine the amount you may receive if your vehicle is damaged by flooding or flying debris during a storm.' The IFSO Scheme recommends the following steps after severe weather: Document damage thoroughly before discarding anything. Take photos or videos of all affected items. Locate receipts and any proof of ownership where possible. Contact your insurer early and ask questions. Check with your insurer before making non-essential repairs, and only carry out urgent repairs needed to prevent further loss. For those dealing with the aftermath, Stevens says a little knowledge can go a long way. 'Understanding your cover and documenting damage properly can reduce stress and help get your claim sorted sooner, and avoid issues down the track,' she says. The IFSO Scheme resolves complaints about insurance and financial services, and is independent, fair, and free for consumers. People can make a complaint to the IFSO Scheme at or by calling 0800 888 202.
Yahoo
29-01-2025
- Climate
- Yahoo
‘Depending on FEMA': St. Augustine family still waiting for federal help months after Hurricane Milton
It's been months since Hurricane Milton tore through the St. Augustine area, but Karen Stevens is still dealing with its impacts. Action News Jax told you months ago when her driveway was completely washed out by Milton, leaving her and her family trapped inside their home. >>> STREAM ACTION NEWS JAX LIVE <<< 'If we had an emergency, we couldn't get in,' Stevens explained to Action News Jax on Wednesday. Stevens said the county did come out and fill part of the driveway with asphalt just to be able to get vehicles in and out, but they've been told the remainder of the repairs are FEMA's responsibility. Stevens tells Action News Jax the federal agency hasn't been easy to get a hold of. When she last spoke to FEMA on Jan. 21, Stevens said she was met with no updates to her case. 'They tell me it had not been looked at since November 1st, it is still on the [supervisor's] desk,' Stevens explained. 'I said 'Okay well can we at least try to get an inspection?' He said, 'You haven't had an inspection yet?' I said, 'No.' He said he would talk with a supervisor, try to get an inspection, and I would get an email within 24-48 hours, and I've gotten nothing.' [DOWNLOAD: Free Action News Jax app for alerts as news breaks] Meanwhile, if her family were to just do the repairs themselves, Stevens said estimates have it costing around $7,000-$10,000 out of pocket. 'I know our family doesn't have that type of money to do, so that's why we're depending on FEMA to help out,' Stevens said. Now, with their driveway significantly weakened while awaiting repairs, Stevens explained the driveway is unable to support the weight of first responder vehicles like an ambulance, providing safety concerns with her 78-year-old mother at home. [SIGN UP: Action News Jax Daily Headlines Newsletter] 'I do sympathize with everybody in North Carolina and now the people in California, but I just feel like the little people, like I consider our problem little to what they're going through, but we need just as much help as anyone else I would think,' Stevens added. Action News Jax also reached out to FEMA directly for an update. While they said they're unable to discuss the details of the case due to privacy laws, they have escalated it to their case management team. Click here to download the free Action News Jax news and weather apps, click here to download the Action News Jax Now app for your smart TV and click here to stream Action News Jax live.
