Another Big Thanks for Sunshine

A big shoutout to Sunshine for his help with an insurance issue I had recently.

 
I made a claim for a tear in my artificial lawn with my insurer and they said the full cost ($4,100) would be covered under my accidental damage extra cover so I went ahead and got more quotes than required and filled out the paperwork. A month went by and I get a call to say a Manager has gone through my policy and artificial lawn is capped at $1,000 so they will only pay out $500 ($1000 minus $500 excess).
 
At this point I flicked Sunshine a message to see if I had a leg to stand on and he went well above and beyond this and provided some key info and terminology to dispute the adjusted claim and even proof read my email suggesting a few edits. The Manager is question obviously took my follow-up email personally and rang me to inform me he had gone through the policy again and determined that artificial lawn is only covered under ‘building’ and not ‘contents’ so my accidental damage cover does not apply and he was completely withdrawing the claim.
 
Again with Sunshine’s guidance and terminology I initiated a dispute with their disputes resolution team. The basis of the dispute being that via verbal confirmation and on numerous occasions, they have committed to entering into a contract for the entire replacement cost of $4,100 based upon their repeated representation that the loss was fully covered and that if they breach this contract entered to into good faith then I have a very strong case for having the Ombudsman deem a breach of this contract as manifest misrepresentation.
 
After a month long review, I received word last week that my insurer have overturned the Manager’s decision and will now be paying me out the $4,100. 
 
I keep trying to get info out of Sunshine as to which local fishing shop I can get him a voucher for as a token of my appreciation and he’s stonewalling me on that saying he was just happy to help so if anyone can help me out there please let me know which store I can organise a behind the counter voucher with for him. Sorry Gordon but you are definitely going to have to accept something even if it's a BCF voucher than I email to you 
 
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Officially off the Pies bandwagon


Livewire's picture

Posts: 270

Date Joined: 25/11/16

 Sunshine you legend... my

Mon, 2023-02-20 12:14

 Sunshine you legend... my the fishing gods be kind, good karma! As for the companies we put our hard earned into, just for them to find a technicality to worm there way out of rotten bastards . it's far to common and encouraged. Everyone needs good solid advice too hold them to account. Well done.

Posts: 480

Date Joined: 09/11/06

Good to see

Mon, 2023-02-20 12:18

Good to see there are some nice people in the world . Sunshine has helped lots of people on

Fishwrecked . I wish him good carma for all his helpful acts .  

Adam Gallash's picture

Posts: 15610

Date Joined: 29/11/05

Legend

Mon, 2023-02-20 12:28

 True legend

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Site Admin - Just ask if you need assistance

Posts: 218

Date Joined: 08/03/09

Gordon deserves a medal,

Mon, 2023-02-20 12:47

He has been a big help to me and many others.  Thanks again.

davewillo's picture

Posts: 2254

Date Joined: 08/09/16

 The stroies of Gordon

Mon, 2023-02-20 14:03

 The stroies of Gordon helping people just keep on coming. What an absolute legend of a bloke!

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 PGFC member and lure tragic

sea-kem's picture

Posts: 14851

Date Joined: 30/11/09

 I relate all these stories

Mon, 2023-02-20 14:13

 I relate all these stories to my brother in Melbourne who's an insurance investigator, he reckons Gordon's a bloody legend for keeping his employers honest. It truly does work both ways.

Take the voucher Gordon!!!

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Love the West!

Brock O's picture

Posts: 3163

Date Joined: 11/01/08

Recon you could squeeze him

Mon, 2023-02-20 14:34

Recon you could squeeze him for a Stella Gordon...Good Stuff!

Da pirate's picture

Posts: 1518

Date Joined: 03/05/15

Look after .

Mon, 2023-02-20 14:39

We gotta look after each

other .. no one else will .

cheers pirate. 

Posts: 439

Date Joined: 06/02/14

Sunshine = Good

Mon, 2023-02-20 16:30

 Sunshine sounds like a top bloke, well done.!

 

Does he have a legal background or similar?

little johnny's picture

Posts: 5328

Date Joined: 04/12/11

Top guy

Mon, 2023-02-20 21:09

Helped me out big time

paul d's picture

Posts: 252

Date Joined: 16/03/13

 Well done Sunshine , I'm

Tue, 2023-02-21 17:59

 Well done Sunshine , I'm sure we'd all kindly help you out if your ever in need of something , just ask here mate.

Faulkner Family's picture

Posts: 17861

Date Joined: 11/03/08

Another great outcome where

Wed, 2023-02-22 13:02

Another great outcome where Gordon has helped. True gentleman and not expecting anything in return is awesome.

Maybe if he won't take anything maybe make a donation on his behalf to Cockburn Sea rescue where he donates his time

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RUSS and SANDY. A family that fishes together stays together

sunshine's picture

Posts: 2554

Date Joined: 03/03/09

Thank you for the great comments

Wed, 2023-02-22 14:23

 As I have said several times before having had a 44 year career in the insurance industry world wide as a technical claims manager it absolutely pisses me off that some companies go out of their way to deny claims even though they are completely legitimate and should be met without question. 

I have trained literally hundreds of claims personnel and the over-riding focus was on paying claims .....that is what insurers contract to do f f s .........and it the claim falls into a grey area then pay.   

Their conduct of recent times has been unconscionable and that is why I don't hesitate to help where I can.

In this case the first contact JF made was with a claims officer who actually knew what they were doing and correctly interpreted what was a very poorly worded policy only to have her manager overrule and take personal affront at being corrected when JF asked them to reconsider. He simply refused to listen to any argument.

JF did all the hard work himself, I just pointed him in the direction that would likely achieve a satisfactory result.......DONT take  denial as gospel and fight for your rights.  

Happy Hooker's picture

Posts: 307

Date Joined: 12/11/08

I am one of of those trainees many moons ago .

Wed, 2023-02-22 14:40

Great outcome for you Jackfrost. He is a very smart man. 

His Words of Wisdom that stay with me -  " If in doubt , pay out " .

Most claims people and insurers are just doing their jobs ...  Like anywhere you just need one idiot within a company to be a peanut , not focus on customer and damage the company reputation .   

 

 

beau's picture

Posts: 4104

Date Joined: 24/01/10

Onya Sunshine

Sat, 2023-02-25 06:02

His fishing reports mostly mention ffb/garden island, my poorly educated guess would be Compleat Angler Rockingham

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