The PNP Group was engaged to support a small family business in Western Sydney with their insurance claim after being impacted by the June 2016 major storms. PNP assisted the family business financially and with litigation measures to achieve the desired outcome.
The requirements for the Small Family Business
A local tomato farm in Western Sydney experienced major infrastructure disruptions from the storm, leading to monetary loss for the business. The tomato farm approached their insurance company claiming compensation and help under their insurance policy. The insurance claim was denied by the company claiming the damages from the storm weren’t covered based on their “Flood” clause.
PNP was later approached in September 2016 by the family business, asking for assistance in reaffirming their claim. The family business wanted PNP’s support in:
- demonstrating and relating the key facts within their case,
- expert testimony to support the grounds on which they were filing their claims and,
- support against the validity of the insurer’s position and their “Flood” clause exemption.
The support & expertise provided
Within the insurer’s policy, there was a “Storm” coverage policy under which any claims filed would be covered by the insurer. The flood policy under which the insurer claimed their coverage wasn’t valid differed from the storm policy in terms of factors of event and level of damage.
The PNP Group worked with the family business listening to and analysing all key factors surrounding the flood event and further damage. When assessing the key details of the case it became apparent that there was a crucial overlooked factor, that showcased that the tomato farms claim was in fact covered by their insurance policy.
In April 2021 the PNP team demonstrated that the insurer had missed key evidence that the tomato farm had been impacted by storm water, prior to the flood event. Although the “Flood” clause meant the farm was exempt from coverage by the insurer, the discovery about the storm water damage in the first instance meant that the insurer must cover any damage under this specific policy.
The Outcome
Although the case was long and drawn out over five years, with the financial and legal assistance of PNP, this local, family business was able to continue their fight and achieve the desired outcome. Within due cause, the following was decided “The panel has reviewed the matter in full and accepts that the policy covers damage caused by storm water, which based on the expert advice was to a maximum water level height of 7.5cm. Your claim has now been referred to the claims department to commence the process of settlement for the above coverable damages.”
How PNP Can Help
It is through our commitment to the insured and understanding the policy wording and terms, the insured rights under the insurance contracts act, that the PNP Group can effectively help policy holders to achieve a successful outcome.
We take pride in understanding individual and business needs whilst dealing with an insurance event and as an organisation we have available resources and experts to support you during that period.
For a free 15min consultation call 1300 767 462 or email info@pnpgroup.co.
Click here for more information on our Insurance Claims Management services.