The company, holding a management liability insurance policy, sought to claim under its third-party crime coverage to recover the outstanding bills from the customers. However, AIG Australia denied the claim, stating that the policy only addressed "direct financial loss" from theft or fraud by a third party, and argued that since the stolen money belonged to customers, the business itself did not suffer a direct loss.
The Australian Financial Complaints Authority (AFCA) reviewed the case and acknowledged the company's loss. However, it determined that the loss did not align with the policy's specific terms. The ruling emphasized that only the company's customers faced direct financial loss, whereas the company experienced an indirect one due to subsequent non-payments.
The AFCA explained that the hack did not meet the company's policy definition of theft, as the stolen funds belonged to the customers, not the business. This discrepancy meant that the policy's electronic and computer crime coverage was not applicable. Additionally, the policy's criteria for "fraudulent act," which required acts of forgery or counterfeiting the insured had acted upon, were not met since the company was unaware of the false invoices.
This case highlights the critical distinction between direct and indirect financial losses in insurance claims, emphasizing the importance of understanding policy terms. For businesses, particularly those prone to cyber threats, it underscores the significance of having insurance coverage that appropriately addresses loss scenarios stemming from such events. It also serves as a cautionary tale of the complexities involved in recovering from cybercrime attacks without adequate protection.
Moving forward, businesses should ensure robust cybersecurity measures to prevent similar email hacks, coupled with clarifying insurance policies for adequate coverage against indirect financial losses as a result of customer fraud. This scenario may lead insurance providers to reevaluate their product offerings, potentially driving the development of more comprehensive cybercrime coverages. Additionally, the financial sector might witness increased discussions on how to formulate clearer policy definitions that align with the evolving nature of cyber threats.
Published:Tuesday, 11th Mar 2025
Source: Paige Estritori
![]() | Call for Stricter Timelines on Insurance Claims and Renewals 06 May 2025: Paige Estritori The Insurance Brokers Code Compliance Committee is advocating for significant changes to improve transparency and clarity in their industry standards, amidst ongoing reviews of the National Insurance Brokers Association (NIBA) code. This call to action coincides with the recent closure of feedback collection from stakeholders, setting the stage for a draft report expected next month. - read more |
![]() | Insurers Under Scrutiny for Response to Alfred Flood Claims 05 May 2025: Paige Estritori In a recent development, Queensland MP David Lee has raised concerns about how insurance companies are addressing claims following the devastating floods caused by Ex-Tropical Cyclone Alfred. Businesses in Hervey Bay, a region heavily impacted by the floods, report facing significant hurdles in having their damage claims recognized. - read more |
![]() | AFCA Rules Against Engine Theft Coverage in Motor Policy Dispute 04 May 2025: Paige Estritori An applicant's attempt to claim insurance coverage after the theft of an engine designated for his 1993 Nissan Skyline has been denied. Despite holding a comprehensive motor policy with IAG, the insured's claim was rejected after multiple engines were stolen in a brazen ram-raid at his vehicle repairer's workshop in November 2023, prompting an appeal to the Australian Financial Complaints Authority (AFCA). - read more |
![]() | ACCC Strengthens Position Against Broker Commissions 02 May 2025: Paige Estritori In a recent submission to the professional code of practice review, the Australian Competition and Consumer Commission (ACCC) has reiterated its position against broker commissions. Echoing findings from its 2020 Northern Australia Insurance Inquiry, the ACCC advocates for extending the ban on conflicted remuneration to include brokers. - read more |
![]() | Partial Settlement Reached in Homeowner's 'Slow Leak' Insurance Dispute 01 May 2025: Paige Estritori A recent ruling by the Australian Financial Complaints Authority (AFCA) has determined that Auto & General Services must cover a portion of a homeowner's insurance claim related to long-term water damage caused by a leaking pipe. The decision comes after a protracted dispute regarding the coverage of damages arising from a leak that reportedly developed over 12 months, spanning both before and during the insurance policy period. - read more |
![]() | AFCA Supports Insurer's Decision in Ex-Spouse Death Dispute 30 Apr 2025: Paige Estritori In an intriguing case involving travel insurance and familial ties, a woman's claim for travel costs upon the death of her ex-husband has been rejected. While she returned abruptly from her vacation to support her family, Nib Travel Services (Australia) deemed her claim outside of coverage parameters. - read more |
![]() | Customizing Your Farm Insurance: Tailoring Policies to Fit Unique Agricultural Needs Those who work the land know that every farm has its own heartbeat - its unique rhythm defined by the crops it yields, the livestock it nurtures, and the natural environment it exists within. Recognizing this individuality is crucial, especially when it comes to safeguarding your agricultural investment with the right insurance policy. - read more
|
![]() | Natural Disaster Preparedness: Insurance Tips for Farmers Facing Adversity In the heart of New Zealand's pastoral verdure, the significance of preparedness for natural disasters is paramount for the farming industry. The distinct landscape, while providing an idyllic backdrop for agricultural pursuits, is not without its challenges. Farmers are often at the mercy of nature's unpredictability, making disaster preparedness not just prudent but essential for the continuity of their livelihood. - read more
|
![]() | Securing Your Farm's Future: Top Estate Planning Tips for New Zealand Farmers New Zealand's farming community forms the backbone of its thriving agricultural sector, yet many overlook the critical importance of proactive estate planning. With farmland often being held within families for generations, securing its future is not just a financial concern, but a deeply personal one as well. - read more
|
![]() | Protecting Your Farming Future: Why Machinery Breakdown Coverage is Essential Farming is a vital part of New Zealand's economy and cultural heritage, representing a way of life for thousands across the country. With its unique landscapes and diverse climate, New Zealand farmers are renowned for producing a wide array of high-quality products that serve not only the nation's needs but also supply a multitude of international markets. - read more
|
![]() | Navigating Farm Succession: A Step-by-Step Guide for Rural Australian Families Welcome to our comprehensive guide on navigating farm succession for rural Australian families. The journey of passing on a family farm from one generation to the next is both a critical and challenging milestone. Recognizing that every farm has its unique story and set of circumstances is fundamental to the process. - read more
|
![]() | Proven Strategies for Australian Farmers to Reduce Farm Insurance Premiums Welcome to our comprehensive guide on navigating the complexities of farm insurance for Australian farmers. As an integral part of the agricultural industry, insurance provides a safety net that helps secure the livelihood of farmers against unpredictable events that can lead to financial hardship. From property damage due to natural disasters to loss of livestock or crops, having adequate farm insurance can make all the difference in keeping a farming operation afloat in times of crisis. - read more
|
![]() |
Customizing Your Farm Insurance: Tailoring Policies to Fit Unique Agricultural Needs Those who work the land know that every farm has its own heartbeat - its unique rhythm defined by the crops it yields, the livestock it nurtures, and the natural environment it exists within. Recognizing this individuality is crucial, especially when it comes to safeguarding your agricultural investment with the right insurance policy. - read more
|
![]() |
Natural Disaster Preparedness: Insurance Tips for Farmers Facing Adversity In the heart of New Zealand's pastoral verdure, the significance of preparedness for natural disasters is paramount for the farming industry. The distinct landscape, while providing an idyllic backdrop for agricultural pursuits, is not without its challenges. Farmers are often at the mercy of nature's unpredictability, making disaster preparedness not just prudent but essential for the continuity of their livelihood. - read more
|
![]() |
Protecting Your Farming Future: Why Machinery Breakdown Coverage is Essential Farming is a vital part of New Zealand's economy and cultural heritage, representing a way of life for thousands across the country. With its unique landscapes and diverse climate, New Zealand farmers are renowned for producing a wide array of high-quality products that serve not only the nation's needs but also supply a multitude of international markets. - read more
|