Think you've got the house covered?
 
(from Fairfax Media, 02/02/2014)
 
It may pay to check the small print of your house insurance policy, and learn a bit about exactly what damage your insurer will pay claims for because a review of the home cover cases handled by the insurance ombudsman in 2013 show the shocks some homeowners get when their insurer turns down a claim.
 
And, while it is up to people to read and understand the policy they are buying, the cases show how some policy wording can seem to say one thing, but insurers will argue they mean something quite different, and refuse to pay a claim, or only a part of it.
 
Or simple errors on the part of the homeowner, and sometimes even the insurer, can undermine the cover people would otherwise have had in place.
 
SUM ASSURED CATASTROPHE
 
This case confirms concerns that many people are picking too small a sum for their home insurance cover.
 
The vast majority of house insurance has switched to sum assured, where the homeowner takes on the risk of deciding the maximum amount the insurer is liable to pay if their house needs rebuilding. It has been a fundamental shift of risk from insurance company to homeowner. And where the homeowner gets it wrong, they can find the money they are paid by their insurer won't be enough to rebuild their home as it was.
 
In the case in question, a woman arranged house insurance with a sum assured of $967,000 (excluding GST). Her house was burnt down in an arson attack, but the cost of reinstating the home was just over $1.5 million. She tried to argue that the insurer should pay professional fees and demolition costs "in addition" to the sum insured - which would have enabled her to narrow the insurance gap she found herself with - but the ombudsman found the policy did not require it.
 
UP TO POLICYHOLDER TO GET IT RIGHT
 
There are still the old-style traditional "total replacement" house insurance policies on the market, offered by the likes of FMG and Medical Assurance Society. While there's been a big focus by media on people getting their sum assured wrong, it is also possible to mess up your total replacement cover.
 
That happened to one woman who, in 2000, insured her 146 square metre home. The policy was cancelled six years later because of unpaid premiums.
 
The woman complained and got a new policy. The insurer went through its fact find again with her. The woman did not know the floor area of her home, so the insurer accessed an independent website, which indicated the floor area of the house was 110sqm. When the Christchurch earthquakes ravaged the home, the insurer offered a settlement based on a 110sqm floor area. Despite the failings on both sides, the ombudsman found the onus is on the policyholder to provide the correct information about the risk to be insured.
 
FALLING THROUGH THE CRACKS
 
A man made a claim to his insurer after machinery being used for roadworks had shaken his house and he had noticed cracks to its exterior. The insurer believed the cracks to be historical and declined the claim under the exclusions for gradual damage and for damage caused by cracking resulting from earth movement. The ombudsman did not believe that the policyholder had proven the damage was "sudden". The evidence suggested that the damage had happened over a period of time, rather than being due to a sudden event, as required by the policy.
 
清楚你的房屋保险的受保范围吗？
檢查你的房屋保險政策, 你可能會有點驚訝, 方可知道你的保險公司會賠償什麼破壞造成的損失, 因為一個由保險申訴專員在2013年所做的房屋保險研究展現了一些屋主受到保險公司拒絕賠償的驚愕個案.
目前, 人們都应去閱讀和瞭解他們購買的保險政策, 而這些個案發現有些政策在用字上是一個意思, 但在保險公司口中卻是另一個很不同的意思, 因而被拒絕賠償，或只有部份赔偿.
或許是屋主在填写保险表格时的小錯誤, 有時甚至是保險公司解释上的一点点出入, 都削弱了人們本來應得的保障.
個案一: 總金額保證
這個案證實了人們選了太低總金額的房屋保險的风险是存在的.
从去年七月开始，主要的房屋保險都是總金額保證, 屋主需要自行決定當房子需重建時保險公司需要賠償的總金額, 這樣的話風險由保險公司轉化至屋主身上. 當屋主錯誤地提供最高金額, 他們就發覺獲得的賠償根本不夠用來重建房子到原本的狀態.
舉一個例子:
一個女士購買了值$967000 (不包括銷售稅)的房屋保險, 她的房子在一次縱火案中盡毀, 但把房子重建成原來的狀態需要$1500000. 她嘗試向保險公司追討專業人士費用, 拆卸費以及本來受保的金額 ， 因為她想縮短她受保金額 ($967000) 與實際需要 ($1500000) 之間的差距. 但最终上诉没有成功。
個案二: 由保单持有人來弄清楚投保细节
現今市場上仍有舊式的傳統 『完全更換』 房屋的保險政策, 由像FMG或Medical Assurance Society 等機構提供.
這發生在2000年一個女士身上, 她146平米的房子受保, 但她的保險政策在6年後因欠交保險費而被取消了.該女士投訴并得到了新的保險政策. 保險公司因而再跟她核查她的房子. 女士原來并不知道她房子的建筑面積, 所以保險公司透過網頁, 發現原來該房子只有110平米. 當2011年基督城地震摧毀了她的房屋, 保險公司只賠償了一套110平方公尺的房子給女士. 雖然雙方互指不是, 但申訴專員認為政策持有人有責任提供正確資料給保險公司來計算風險.
所以客人要自己清楚自己房屋在加保时的细节，不要完全依赖政府登记的信息。如以上案例，36平米的差别应该很明显的感觉到，这时应该找专业的估价师出报告，然后去更正政府登记的信息。
個案三: 裂痕的陷阱
有個男士家的外牆被修路機器發出的震盪震出了數條裂痕, 他向保險公司索償. 保險公司認為裂痕都是因歷史因素造成的, 并以日久的逐渐損壞和因地殼移動的損壞兩個原因來拒絕了賠償. 申訴專員認為該男士沒法證明裂痕是出於突發. 而當時證據都說明了裂痕其實出現了一段時間, 而并不是在保險政策中說明的突發事件而引起的。
所以如自家门口有大型施工或不寻常的活动时，应该注意自己的房子有没有受到影响，尽早发现提供有力索赔证据将减低你的损失。