Unfair Cash Settling

PAYMENT BREACH UNFAIR CASH SETTLING - IDR FORM

AMBRA has compiled this Internal Dispute Resolution (IDR) business tool as a guide to help our members lodge and resolve disputes between our members and Insurers under the Motor Vehicle Insurance and Repair Industry Code of Conduct (the "Code"). This tool should not be used or relied upon as a substitute for legal, financial or other professional advice. Your use of this tool is at your own risk. The use of this tool does not guarantee compliance with all aspects of existing legislation, regulations or codes. The business remains solely responsible for its compliance obligations. The results produced by this tool are hypothetical and may not accurately affect your business. The data and formulae used within this tool may change at any time, without notice. Whilst this tool has been prepared with all due care, AMBRA does not accept any liability to any person, business, firm or company, for any loss suffered in connection with the use of, or reliance on, this tool, the information it produces, its contents, data, or part(s) thereof. Further, AMBRA does not accept any liability for any variations, deletions or additions to this tool, the information it produces, its data or part(s) thereof. AMBRA excludes, to the maximum extent permitted by law, any liability for any act or omission to any person, business, firm, company or third party that may arise as a result of the use of, or reliance on, this tool, its contents, data or parts(s) thereof.

Know Your Code
Download to read and/or apply the Motor Vehicle Insurance and Repair Industry Code of Conduct by taking this link.

Download the Deed of assignment to be used in conjunction with this IDR by taking this link

The Problem You Have
Cash Settling – I have read and understood the Motor Vehicle Insurance and Repair Industry Code of Conduct commencing 1 May 2017, and note my obligations and those of insurers detailed under the Code.

First and foremost I say the insurer has breached the Code at Clause 1 - Standards of fair-trading, process and transparency in the relationship between Insurers and Repairers because they failed to be open (transparent) in their dealing with me because they are cash settling the insured unfairly. This practice is not only detrimntal to me, more importantly it is deterimental to the insured. More specifically, breaches 1.1 a, b, and/or c also bring into question possible breaches for the consumer as it relates to the General Insurance Code (GIC) at Clause 1.1 (c) in which the repairer knowing this and if not corrected by the insurer, the repairer is duty bound to inform the consumer of their rights according to this insurance repair claim and their entitlement to lodge an IDR under the GIC.

I also say that the insurer has breached its obligations under Clauses 4.2(a)(iv) in relation to current industry practice, and Clause 8.1 concerning the ordinary course of business.

In summary, the following has occurred:

	Most Relevant
1.The customer has exercised choice of repairer rights under the policy;
2.All documents in relation to the cost of repairs have been submitted by me to the insurer;
3.The insurer has had the opportunity to inspect and assess the vehicle;
4.The insurer has not followed process or been transparent in that they have not provided me with an assessors assessment report and have skipped procedure arbitrarily deciding to unfairly cash settle the policyholder.

Notes (please include any relevant information):
I therefore say that the insurer has breached both the letter and spirit of the Code, and I request that this matter be reviewed in a timely fashion and within the Guidelines stipulated within the Code.
Type of relationship with Insurer based on this repair claim*
if 'other' please explain the arrangement you have with the accident driver.
REPAIRER'S DETAILS

Repairer's Details
Date of Entry

DayMonthYearHourMinutesAM/PM Option
State or Territory*
State Based MTA Membership Number
Full Name of Person Authorised to Make this Submission*

First NameLast Name
Repairer's Business Name
E-mail Address (Repairer)*
Repairer's Telephone
Repairer's Business Address*

Street Address

Street Address Line 2

CityState / Territory

Postal CodeCountry

Insurer's Details
Insurance Company Details*
Claim Number*
Contact/Assessor

First NameLast Name
Contact/Assessor

Area CodePhone Number
Contact/Assessor Email
Vehicle Details

Vehicle Details
Make*
Model*
Year*
Registration Number
VIN

Remedy Requested
Procedural fairness is concerned with the procedures used by a decision-maker (e.g., insurer or repairer), rather than the actual outcome reached. It requires a fair and proper procedure be used when deciding, for example when a policyholder exercises a choice of repairer right within the PDS and their policy holders’ choice or repairer produces, or seeks to produce, a Code compliant estimate, the insurer (decision-maker) must follow a fair procedure and will reach a fair and correct decision to award the repair work or to fairly cash settle the insured. I therefore seek the Insurer recommits to fair trading, process and transparency in their delaings with me and the insured.

IDR 'In-Progress' Records
Follow up messages from the Insurer and the Repairer
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Failure to Respond
Repair Dispute Breach

Failed to respond to Clause 10 breach in 2 days
IDR Breach

Failed to acknolwedge IDR submission in 3 days (Clause 11.2)Failed to conclude the IDR process in 9 days (Clause 11.2)

IDR Lodgement Advice
Please note: by hitting the submit button below, you are submitting a draft version of your IDR to AMBRA only. You will receive an email with your draft IDR.

You can repeat the process as many times as you like until you are satisfied your final version is ready for submitting.

If you would like someone to review your draft please call your state division manager for further assistance.

Once you are satisfied that your submission is complete, notify Vanessa Gibson at the VACC (idrambra@vacc.com.au) by reply email and she will lodge your IDR submission to the Insurer via the Code Advisory Committee (CAC) website

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