Health Insurance Online :: News
SHARE

Share this news item!

Hacked Company Loses Insurance Battle Over Customer Payment Scam

Hacked Company Loses Insurance Battle Over Customer Payment Scam

Hacked Company Loses Insurance Battle Over Customer Payment Scam?w=400

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

AFCA Criticises TAL for Unfair Termination of Income Protection Benefits
AFCA Criticises TAL for Unfair Termination of Income Protection Benefits
16 Nov 2025: Paige Estritori
The Australian Financial Complaints Authority (AFCA) has recently ruled against TAL, a prominent life insurer, for terminating a policyholder's income protection benefits without prior notice. This decision underscores the critical importance of procedural fairness in the management of insurance claims. - read more
Actuaries Institute Highlights Financial Strain of Mental Illness on Insurance Systems
Actuaries Institute Highlights Financial Strain of Mental Illness on Insurance Systems
16 Nov 2025: Paige Estritori
The Actuaries Institute has issued a call for immediate action to address the escalating financial strain that mental illness is placing on Australia's insurance and compensation systems. This appeal underscores the pressing need to ensure the sustainability of the nation's financial safety net in the face of increasing mental health-related claims. - read more
Fitch Ratings Anticipates Continued Premium Increases in Australian Insurance Sector
Fitch Ratings Anticipates Continued Premium Increases in Australian Insurance Sector
16 Nov 2025: Paige Estritori
Fitch Ratings has projected that Australian insurers will continue to implement premium increases, with gross written premiums expected to grow by mid to high single digits. This forecast is driven by the need to offset rising claims and increased allowances for natural hazards. - read more
Surge in Cyber Insurance Adoption Among Australian Businesses
Surge in Cyber Insurance Adoption Among Australian Businesses
16 Nov 2025: Paige Estritori
In the past year, BizCover, a leading small business insurance provider, has reported an almost 50% rise in sales of cyber liability insurance. This significant uptick underscores the escalating awareness and concern among Australian businesses regarding cyber threats. - read more
IAG and Ag Guard Forge Partnership to Elevate Crop Insurance for Australian Farmers
IAG and Ag Guard Forge Partnership to Elevate Crop Insurance for Australian Farmers
14 Nov 2025: Paige Estritori
In a significant development for Australia's agricultural sector, Insurance Australia Group (IAG) has announced a strategic partnership with Ag Guard, a specialist rural underwriting agency. This collaboration will see Ag Guard managing the underwriting for IAG-owned CGU and WFI's crop insurance portfolios starting June next year. - read more


Health Insurance Articles

The Importance of Comparing Health Insurance Extras for Maximum Savings
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
Unlocking Affordable Health Insurance: Tips to Reduce Your Premiums
Unlocking Affordable Health Insurance: Tips to Reduce Your Premiums
The current health insurance landscape in Australia can be quite confusing for many people. With numerous options available, it’s not always clear which to choose to balance your budget with your needs. Premiums are on the rise, and Australians are becoming increasingly concerned about the costs of maintaining adequate coverage. - read more
5 Tips to Save on Health Cover as an Australian Senior
5 Tips to Save on Health Cover as an Australian Senior
Finding the right health insurance coverage is a critical concern for Australian seniors, who often face the dual challenge of managing chronic health conditions and maintaining financial stability in retirement. As the cost of healthcare continues to rise, the importance of securing an affordable health cover that still meets their needs cannot be overstated. - read more
Is Private Health Insurance Worth It? Exploring the Benefits
Is Private Health Insurance Worth It? Exploring the Benefits
In Australia, health insurance plays a significant role in ensuring individuals can access quality medical care without incurring prohibitive costs. - read more
What to Look for in Basic Health Insurance Cover
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


Your free Heatlth insurance quote comparison starts here!
First Name:
Postcode:

Insurance quotes are provided free and without obligation by a specialist from our national broker referral network. See our privacy statement for more details.


Knowledgebase
Depreciation:
The reduction in the value of an asset over time, used in insurance to calculate the actual cash value of property.