We produce a Newsletter each quarter of helpful tips and hints, news articles and worthwhile insurance claim information.

Our latest newsletter is below and an Archive of our past newsletters is also provided. You can search for articles on specific topics, using the search feature at the top right of this site.





Level 8, 350 Collins Street
Melbourne  Vic 3000
03 9642 8578



  1. Welcome
  2. Spice Up Your Life - Changes in 20 Years
  3. Move Over - FOS is now AFCA
  4. Tell My Why - Under Insurance
  5. Viva Forever - The ISR
  6. Never Give Up on The Good Times
    - Odd Spot



20 years' providing commercial claims services; a cause for celebration.



Welcome to our Summer 2019 Edition and 57th Claim Solutions' Newsletter.

Claim Solutions is celebrating 20 years' providing commercial claims services. Our experts' insurance and claim preparation experience exceeds this milestone, however, in Australia where the national average tenure is 3 jobs in a decade, our stability supporting businesses and brokers following losses is unwavering.  We look forward to continuing this support to you or your clients.

To put this longevity in perspective The Spice Girls were top of the music charts with Goodbye in January 1999 and now all things old are seemingly renewed.  In this vein we launch our new website and logo including a news section with our latest Tweets.

This newsletter brings a reflection of changes in commercial insurance over 20 years including technology and the external dispute resolution body, and an exclusive interview with the unwavering ISR policy.

If you, or your clients, have suffered loss or damage we wish you a speedy recovery.
If you have experience a loss and have an insurance claim we are available to assist you.  We welcome your enquiries.

All our newsletters over the past 20 years have been indexed to provide you with an online compendium of our claims experience.  Browse our index here to find articles which interest you.


Spice Up Your Life - Changes in 20 Years

On first reflection of being asked what has changed in claims in 20 years it was easy to say, nothing.  Let's face it the Industrial Special Risks Policy Mark IV wording, the preferred commercial property cover for businesses, has been around since 1989.  The Insurance Contracts Act 1984 (ICA) continues to apply to insurance contracts in Australia and was enhanced by the Insurance Contracts Amendment Act 2013 (Cth) (ICAA).  And "Riley" remains the leading text on Business Interruption after more than 60 years and 10 editions.

Indeed there is very litigation around Business Interruption claims.  However, the ICAA did include developments in technology and the insurance industry.  For instance, Product Disclosure Statements and other notices, that previously had to be delivered by mail or hand, can be delivered electronically.  It is not surprising then that the majority of changes that we considered tended to relate to changes in technology.


"Riley" remains the leading text on Business Interruption after more than 60 years.



Our observed changes in commercial claims processes:

  1. Claim documentation is largely received by email.  Gone are the days of couriers or faxes.
  2. Claims are submitted electronically including all supporting documentation.
  3. Offsite storage such as e-rooms and dropboxes are utilised where there are many parties to a claim or the documentation is large.
  4. Forms of Release are never seen for partial progress payments and rarely for final payments.
  5. Insurer payments are by direct deposit.  This has been a very great change in the provision of loss adjuster reports and timely payment to Insureds to enable expedited reinstatement.



Move Over - FOS is now AFCA

APRA reported General Insurers paid $3.5b in claims under Fire and ISR policies in the year to March 2019. That's an average of $67m a week. Accordingly to the Insurance Council of Australia (ICA) 95.7% of claims, that weren't withdrawn, were accepted.

While the statistics are seemingly very good for claimants, disagreements do arise. Claimants have to access an Insurer's Internal Dispute Resolution (IDR) system before escalating to an ASIC-approved External Dispute Resolution (EDR) body which was, until recently, the Financial Ombudsman Service (FOS).

FOS was established in 2008 to hear financial complaints by consumers or small businesses up to $500,000 lodged within 6 years of a loss. A small business is now defined as less than 100 employees.

From 1 November 2018 FOS was replaced by the Australian Financial Complaints Authority (AFCA) to hear insurance claim disputes after following the Insurer's internal dispute resolution process.  AFCA will be able to hear legacy complaints from 1 January 2008.

As we go to print we await any changes by ASIC following feedback from the Hayne Royal Commission as it pertains to insurance claims.


Tell My Why - Under Insurance

We have continually reported the non insurance and under insurance of Property and Business Interruption covers for as long as the ICA has been providing statistics.

The latest ICA report in July 2015 discussed that of the 85.7% of Small to Medium Enterprises (SME) that reported being insured in the first instance, 10% under insured assets. This had seemingly improved from their December 2008 report that 26% of businesses did not have an insurance but at that time 80% of SME's considered they were under insured.

Our anecdotal experience is that nothing has changed.  Far too many businesses don't take Business Interruption cover when they insure assets.  Those that have Business Interruption cover largely do not understand what they are insuring until a loss occurs.

In all the ICS report the most common reason for non and under insurance was affordability. The financial burden of maintaining fixed costs, incurring costs to resume trading, forgoing profits & director wages whilst trading has ceased can be devastating. As we enter a hard market of premium increases, it makes good sense for businesses to have Business Interruption cover from a risk management and business continuity planning perspective.


Viva Forever - The ISR

The Industrial Special Risks Policy is a clever piece of policy drafting which responds to a multitude of risks.  It is essential the guide book which governs whether a claim is covered and if so the amount that should be paid.

The ISR has become a standard on which many pack policies are based and has been the reference when a badly worded pack policy has been disputed.

A little bit of history.  There were numerous drafts of the ISR Policy.  The first was introduced by the Insurance Council of Australia (ICA) in the 1970's.  Today the most commonly used the Mark IV version which was introduced by the ICA as an advisory wording in 1987.  An updated wording, the Mark V Industrial Special Risks Policy was introduced in 1991 and which it did not gain popular appeal some of its more Insurer-favoured wordings can be seen in pack policies.

In an exclusive interview we asked the ISR Policy what you've always wanted to know.

What Are You?  I am often described as an "All Risks" policy i.e. insuring "All Risks" unless they are excluded.  This is in contrast to an "Insured Perils" policy which specifies the risks which are covered, for example fire, storm, tempest, theft, etc.  I contain 2 cover sections - Material Damage and Consequential Loss.

Where Are You Found?  I am an Australian policy wording suitable for medium to large enterprises from manufacturers to retailers and beyond.  I can provide cover across multiple situations/locations.

When Is Cover Provided?  The period of insurance is specified in the Schedule of Insurance and is generally 12 months.  The cover under Section 2 extends beyond this if a claim occurs depending on the length of the Indemnity Period.

Who Benefits From Your Cover?  Generally I am written for businesses with assets of more than $5m and/or Gross Profit of more than $3m.

Why Insure Under an ISR?  The breadth of the cover, along with the drafted endorsements that can be tailored to your business, is wider than any other cover available in the Australian market place.


Never Give Up on The Good Times - Odd Spot

Our original newsletters used to contain an odd spot.  There is much levity and learning in our industry so we bring you Yahoo Finance's six most bizarre insurance claims in Australia in 2018.

  1. A motor vehicle claim for Bessie the cow that sat on the car.
  2. The toilet that exploded without warning. We guess that makes it sudden and unforeseeable.
  3. A family made a claim following a Christmas thief who stole all their presents from under the tree. There generally has to be evidence of a break in and remember there is only one Santa who can squeeze down the chimney.
  4. The travel insurance claim for delayed luggage limited to the costs of personal hygiene items because they were travelling to a nudist camp.
  5. A traveller in New York bitten by a squirrel but stung by the $3,000 medical bill.
  6. The traveller’s injury claim for a blister that ended up with a $20,000 medical bill and a limp.

If you got through all those Spice Girl heading references, we are impressed.  If you have experienced a loss and have an insurance claim we are available to assist you.  We welcome your enquiries.



Claim Solutions Pty Ltd
ABN 31 091 028 072
Level 8, 350 Collins Street
Melbourne  Vic 3000
03 9642 8578
This email address is being protected from spambots. You need JavaScript enabled to view it.




The Articles which appear in this Newsletter are not intended to be a substitute for specific technical advice.

Let us find the Solution to your Claim, please contact us on +61 3 9642 8578 or email: info@claimsolutions.com.au