Health Insurance Online :: News

Share this news item!

Hacked Company Loses Insurance Battle Over Customer Payment Scam

The information on this website is general in nature and does not take into account your objectives, financial situation, or needs. Consider seeking personal advice from a licensed adviser before acting on any information.

A company recently faced a significant setback after losing an insurance claim dispute related to funds stolen in a fraudulent email scheme.

Cybercriminals infiltrated the business's email system, sending out fake invoices that directed clients to pay into a bogus bank account.

Consequently, two customers inadvertently transferred a total of $66,148 to the fraudulent account.

Attempts to retrieve this money were unsuccessful, and the customers refused further payments to the company.

The company, holding a management liability insurance policy, sought to claim under its third-party crime coverage to recover the outstanding bills from the customers. However, AIG Australia denied the claim, stating that the policy only addressed "direct financial loss" from theft or fraud by a third party, and argued that since the stolen money belonged to customers, the business itself did not suffer a direct loss.

The Australian Financial Complaints Authority (AFCA) reviewed the case and acknowledged the company's loss. However, it determined that the loss did not align with the policy's specific terms. The ruling emphasized that only the company's customers faced direct financial loss, whereas the company experienced an indirect one due to subsequent non-payments.

The AFCA explained that the hack did not meet the company's policy definition of theft, as the stolen funds belonged to the customers, not the business. This discrepancy meant that the policy's electronic and computer crime coverage was not applicable. Additionally, the policy's criteria for "fraudulent act," which required acts of forgery or counterfeiting the insured had acted upon, were not met since the company was unaware of the false invoices.

This case highlights the critical distinction between direct and indirect financial losses in insurance claims, emphasizing the importance of understanding policy terms. For businesses, particularly those prone to cyber threats, it underscores the significance of having insurance coverage that appropriately addresses loss scenarios stemming from such events. It also serves as a cautionary tale of the complexities involved in recovering from cybercrime attacks without adequate protection.

Moving forward, businesses should ensure robust cybersecurity measures to prevent similar email hacks, coupled with clarifying insurance policies for adequate coverage against indirect financial losses as a result of customer fraud. This scenario may lead insurance providers to reevaluate their product offerings, potentially driving the development of more comprehensive cybercrime coverages. Additionally, the financial sector might witness increased discussions on how to formulate clearer policy definitions that align with the evolving nature of cyber threats.

Published:Tuesday, 11th Mar 2025
Source: Paige Estritori

Please Note: If this information affects you, seek advice from a licensed professional.

Share this news item:

Insurance News

Call for Enhanced Support for Indigenous Insurance Customers

09 Dec 2025: Paige Estritori

The Life Code Compliance Committee has identified significant gaps in support for Indigenous customers within the insurance sector, following an audit of three major insurers representing two-thirds of the market. The analysis reveals that these insurers lack adequate procedures for safe self-identification, a critical step towards ensuring cultural inclusivity and accessibility. - read more

Australian Insurtech Startups: Pioneering the Future of Insurance

09 Dec 2025: Paige Estritori

The Australian insurtech sector is experiencing significant growth, with startups introducing innovative solutions that enhance efficiency, security, and customer engagement within the insurance industry. A recent report titled 'Insurtech Down Under: Trends, Tech and Triumphs' highlights the pivotal role these companies play in reshaping the market. - read more

Australian Insurers Address Surge in Mental Health Claims

09 Dec 2025: Paige Estritori

The Australian insurance industry is facing unprecedented challenges due to a significant rise in mental health-related claims. The Council of Australian Life Insurers reports that mental health has become the leading cause of total and permanent disability claims, accounting for nearly one in three payouts. - read more

Calls for Overhaul in Australian Insurance Claims Handling Processes

09 Dec 2025: Paige Estritori

Australian consumer advocacy groups are intensifying their calls for substantial reforms in the insurance industry's claims handling processes. The Australian Consumers Insurance Lobby (ACIL) has criticised the current system, highlighting ongoing issues that compromise consumer outcomes. - read more

WFI Insurance Rewards Sustainable Farming with Premium Discounts

08 Dec 2025: Paige Estritori

In a significant move towards promoting sustainable agriculture, WFI Insurance has announced a new initiative offering premium discounts to farmers who obtain AgCarE certification. This program, developed by AgForce, aims to recognise and reward farmers implementing eco-friendly practices on their properties. - read more

Click for more Insurance News

Health Insurance Articles

The Digital Age of Health Insurance: Comparing Policies Online

The dawn of the digital age has significantly transformed the way we approach nearly every aspect of our lives, and the domain of health insurance is no exception. With the arrival of innovative digital tools, the health insurance landscape has undergone a striking evolution, allowing for unprecedented accessibility and convenience in managing healthcare coverage. - read more

The Ultimate Guide to Comparing Health Insurance Plans in Australia

Australia is renowned for its iconic landmarks, diverse ecosystems, and robust healthcare system. While the public healthcare system, Medicare, provides essential health services, it might not cover everything. The allure of private health coverage lies in its promise of broader options, reduced wait times, and coverage for services not included in Medicare, like dental and optical care. - read more

The Importance of Comparing Health Insurance Extras for Maximum Savings

Health insurance is more than just a precautionary measure; it's a vital component in managing both your health and financial well-being. In Australia, where healthcare costs can quickly escalate, health insurance extras serve as a buffer, ensuring that services like dental, optical, and physiotherapy remain within reach. These extras can significantly reduce the out-of-pocket expenses you might otherwise encounter for non-hospital treatments. - read more

Top 10 Tips to Find Affordable Health Insurance in Australia

Finding affordable health insurance can be a daunting task, particularly in a landscape as diverse as Australia’s. With a myriad of options available, it's crucial to understand the financial support mechanisms in place that can ease the burden of healthcare costs. One such mechanism is the health fund rebate, a key feature of the Australian health insurance system designed to make healthcare more accessible. - read more

What to Look for in Basic Health Insurance Cover

Welcome to our discussion on basic health insurance cover, a topic that is crucial yet often overlooked in the hustle and bustle of everyday life. Navigating the world of health insurance can be daunting, but understanding your options is vital for peace of mind and financial stability. - read more

Knowledgebase

Term Life Insurance:
A life insurance that provides a cover for a specific period of time - usually one to five years or until the insured reaches age 65 or 70.

This website is owned and operated by Clark Family Pty Ltd (ACN 010 281 008) as Trustee for the Clark Family Trust (ABN 35 957 893 714), 43 Larch Street Tallebudgera QLD 4228. Clark Family Pty Ltd is an Authorised Representative (AR 1298860) of Unique Group Broker Services Pty Ltd (AFSL 509434) for financial product referrals and an Authorised Credit Representative (ACR 401491) of Saccasan Pty Ltd (ACL 386297). Check our licensing details on the ASIC registers: Clark Family Pty Ltd ACR, Clark Family Pty Ltd AR, Saccasan Pty Ltd, Unique Group Broker Services.

IMPORTANT: We do not provide financial product advice or credit assistance. We act solely as an introducer and refer enquiries to licensed third-party intermediaries, insurers, and lenders - with whom you can then deal directly. We may receive a fee or commission from these third parties in consideration for the referral. Before any action is taken to obtain a product or service referred to by this website, advice should be obtained (from either the third party to whom we refer you or from another qualified intermediary) as to the appropriateness of obtaining those products having regard to your objectives, financial situation and needs. Whilst we have our own process for validating the legitimacy of our referral partners, you should always verify the credentials of your financial adviser before proceeding with recommendations that they may present. Visit the ASIC website for further information.