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Permalink Reply by Ray Morris on January 26, 2012 at 14:30

That is really good information and advice, Michael, I may need to draw on this as my on-going 'dispute' with CUNA re definition of sporting equipment in their PDS rolls on, now at the second level, the one prior to the Ombudsman. I reckon I will be heading there soon too. Cheers! ;-)

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Permalink Reply by Mike Andy on January 27, 2012 at 17:32

I'm unsure the issue you are having with CUNA but the information I have on the previous page is CGU specific and only to the CGU Accidental Damage policy.

I had a look at the CUNA Membercare plus PDS just then (http://www.cunamutual.com.au/cunamutual_approved/media/PDS/MC_HIP_P...) and unfortunately it would seem that if your claim is relating to damage to your bike whilst in use then you may have difficulty regarding whether a bicycle is defined as a content item or a sporting or recreational item.

The policy wording does provide coverage for Sporting and Recreational Goods and equipment, which is covered under the definition for "valuables" as per page 19 however it does go on to say on page 33;

"We will not pay for:

11. accidental loss or damage to sporting and recreational goods
and equipment whilst in use or play;"

I am assuming the difficulty you are having is that CUNA may be arguing that a bicycle is a pience of sporting or recreational equipment. Which is not entirely unreasonable - however.... you may be able to argue that the policy specifies on page 20 that your contents include:

"3. sporting and recreational goods and equipment;
4. clothing and other personal effects;

8. bicycles, surfboards, canoes, surf skis or other non-motorised
watercraft less than 3 metres in length;"

Given that the PDS contains separate definitions for "Sporting and recreational goods and equipment" and "bicycles" and there is no specific exclusion to "Bicycles" that are damaged in use, then you could argue that the policy is misleading, or at the very least creates confusion in relation to bicycle coverage that would prevent you from making an informed choice if this was an important consideration in your insurance.

If you don't get any joy explaining this to their Internal Dispute Resolution people (IDR) then take it to the ombudsman - 1300 780 808. It won't cost you anything, and at the very least you know that it will mean that your rights have been looked after.

Good Luck!

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Permalink Reply by Ray Morris on January 27, 2012 at 19:48

Many thanks for your reading of this CUNA PDS. I am currently at the second level of complaints, so with their IDR at present, so next step is the ombudsman, as you indicate. I am certainly basing my argument on the ambiguity of definitions in their PDS, and quoting other PDS's in the industry to illustrate that I am not on some fanciful tangent with the argument that bicycles can indeed be defined differently to sporting equipment, as well as my experience with the wrong advice initially given by CGU phone staff and underwriter that later resulted in an apology and retraction. I will post the final result, for better or for worse! THANKS again for your valued words, Ray.

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Permalink Reply by Ray Morris on February 27, 2012 at 14:45

Sorry about the long delay, but I have been corresponding regularly with the internal dispute resolution (IDR) folks at CUNA, actually very helpful. Having lodged my 'case', the IDR officer actually went back to the first level of complaints underwriters who didn't budge. So they had their IDR committee meeting on Friday and have advised that they will allow my claim on the grounds that I was using the bike for commuting at the time of the accident, so considered it not a sporting usage. They stuck to their PDS definitions of 'sporting good in use' as applying to bikes, so did not concede to me that it was wrong or ambiguous. I must confess that I was not expecting that outcome. Anyway, I am happy that I got what I believe to be a fair and reasonable result and have thanked the IDR officer who managed it.

I also learned recently that there has been other cases where the insurer has only committed to repair cracked carbon, rather than replace it. This has implications for manufacturer's warranty (ie., void!). I have heard of a court case on this point that was settled in favour of the insured, ie., the the insurer should replace and not just repair cracked carbon frames.

The morals of the story, again: read your PDS carefully, seek clarification if you think it is ambiguous, get that in writing not just what you may be told on the phone (or at least ask for the call to be noted and recorded on your policy), and be prepared to push beyond what the folks at the call centre and even underwriters might say on a particular matter. THANKS all for this discussion, Ray.

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Permalink Reply by Mike Andy on February 27, 2012 at 18:00

Great to hear the good news.

On the flip side, it would have been very interesting to see how FOS would have determined had it gone all the way.

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Permalink Reply by heather on February 27, 2012 at 16:15

Ray, thanks for keeping us updated. The process should have been simpler. How many would have given up and not received payment when cyclist was paying for insurance? Consider if cyclist seriously injured or on-going physio appointments.

I have added a link to your post on the AC group Look For Cyclists under topic Insurance at http://www.adelaidecyclists.com/group/lookforcyclists/forum/topics/...

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