Mix and match: claimant loses appeal over partially damaged bedroom suite – Daily – Insurance News

A complainant who sought to have his entire five-piece bedroom suite replaced after parts of it was damaged has lost his claims dispute after his insurer refused to cover the non-damaged items.

The insured lodged a claim on November 28 last year after two bedside tables and a bed frame that formed part of the five-piece suite were damaged by water and deemed irreparable. The claimant argued that the bedroom suite was a single contents item and wanted it to be replaced entirely.

Insurance Manufacturers of Australia (IMA) accepted the claim for the affected pieces but declined to replace the undamaged parts of the set.

The insurer referred to the policy’s Product Disclosure Statement (PDS), which defined a “set” as a “group of items that belong together” based on appearance, size, shape, colours and materials.

It said the PDS states that in events where damage has occurred, only the affected parts of the set will be covered.

The complainant said he expected the entire bedroom suite to be replaced, disputing that “a reasonable person would not be happy with a ‘mishmash’ bedroom suite as a replacement for a matching suite”.

The Australian Financial Complaints Authority (AFCA) acknowledged that it was not possible to replace the damaged parts of the set with “an exact match” but said the policy stipulated that it would not cover undamaged parts of the set unless it were required for mechanical or electronic operation to function.

The decision rejected the claimant’s argument that the 110-page PDS was unreasonably long, saying it was up to him to “ensure the product was suitable for his needs and circumstances”.

“I appreciate 110 pages is a significant amount however, the claim was lodged on November 28 2021 while the policy renewed on April 22 2021,” AFCA said.

“This means the complainant had more than seven months to read the PDS, confirm it was suitable for his needs, and if not, find alternative insurance.”

AFCA accepted the insurer’s decision not to replace the undamaged parts of the set and was satisfied with the covered amount, totalling $4800. It also required the insurer to pay delivery fees amounting to $150.

Click here for the ruling.



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