Initially, the camper owner noticed no damage during usage in early November 2023, only to uncover water damage in April the following year. The insurer, RAA Insurance, asserted that the seals of the camper had deteriorated over time, thereby excluding it from coverage under clauses related to "depreciation, wear and tear, rust, corrosion," as well as "deteriorated seals and joints over a number of incidents."
The AFCA reviewed evidence from the insurer's assessor, which included images showing gaps in the seals where they did not align perfectly with the camper body. Despite these submissions, the authority found that the images and other evidence failed to incontrovertibly establish the alleged deterioration. They identified a lack of definitive indicators, such as holes or cracking, that would typically signal such decline.
In the ruling, an AFCA ombudsman remarked that, while deterioration is indeed a gradual process, the insurer did not provide persuasive evidence establishing that deterioration was the primary cause of the damage. The decision placed the burden of proof on the insurer, requiring clear information detailing the condition of the seals and how it led to the damage.
Consequently, AFCA mandated the insurer to approve the claim and arrange for repairs. Should they opt for a cash settlement, a 15% increase over the repair quotation must be paid. This decision underscores the obligation of insurers to substantiate exclusions in policy claims with compelling evidence.
