The son, who initially filed the claim following an accident in April of the previous year, saw his claim denied by RAA Insurance. The insurance provider, based in South Australia, concluded that the vehicle was a total loss but rejected the claim after discovering the car's purchase and registration in Victoria despite frequent visits to South Australia.
During the claims process, the son portrayed himself as the primary driver, asserting minimal use by his mother, the policyholder. However, he later altered his statements to AFCA, stating that the car was never his and was unregistered in Victoria. AFCA found these new assertions unconvincing due to the lack of documentation supporting his position.
The ombudsman involved in the dispute stated that evidence indicated the vehicle was mainly used, registered, and stored in Victoria at the time the policy was taken out. Consequently, it was determined that the policyholder misrepresented the car's usual location and storage when securing insurance coverage.
RAA Insurance referenced their underwriting standards, emphasizing that they do not extend coverage to vehicles registered outside South Australia or the Broken Hill postcode. A declaration from an RAA employee supported this position, confirming that the vehicle’s Victorian registration would have led to denial of coverage initiation.
AFCA observed that such misrepresentation compromised RAA's risk assessment capabilities, justifying the insurer's decision to decline the claim. The omission of accurate information about the vehicle's storage location led to the policy being issued under false pretenses. AFCA concluded that compelling the insurer to honor the claim would be unjust, given the circumstances.
