Insurance Law Case Study: Chen's Claim for Medical Expenses, Omission to Disclose Tooth Ache, and Stolen Money

Running Head: INSURANCE LAW
CASE STUDY
Name of the Student
Name of the University
Author’s Note

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Issue:
The first issue in the case (a) is whether Chen is likely to succeed when making a claim
for medical expenses.
The second issue in the case (b) is whether omission to tell the insurance company about
his ‘intermittent tooth ache’ potentially affects his claim.
The third issue in the case (c) is whether there is any impediment to Chen successfully
making a claim in relation to the stolen money.
The fourth issue in the case (d) is if Chen is unhappy with the outcome of a claim explain
how complaints are resolved.
Rules:
Australia is governed by many laws, most importantly the Insurance Act 1973, the
Insurance Contracts Act 1984, and the Corporations Act 2001. According to section 30(G) of the
Insurance Contracts Regulation 2017, it has been stated that the person shall be indemnified
against financial loss in any form of transport or accommodation used, or loss of specific
personal belongings, or sickness or diseases contracted or an injury sustained by the insured
person in the specified course of journey. However, the exceptions are laid down in section 31,
as the prescribed acts wherein, it has been stated that the self-inflicted injury which is in
contradiction with other safety laws shall not be protected by claim under the insurance. It has
further been explained that if the injury has been inflicted by the insured person’s travelling
party, the same shall not be entitled for the claim. Furthermore, the exceptions also extend to the

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sickness, disease or disability, which was prevailing since 6months before the parties entering
into the travel insurance contract and the same shall continue to prevail, shall not be entitled for
the indemnification. However, in case of person’s injury or sickness or disability occurred during
the course of journey, the insurer shall be liable to indemnify such person for the reasonable cost
of ambulance and the medical treatment including the nursing and surgical home charges as
incurred by the insured person. It has further been stated that malicious acting of the insured
person or self-inflicted injuring during the course of travel shall not be indemnified by the
insurer. In Parks Shire Council vs. South West Helicopters Pty Limited1, famously called the
South West Judgment, it was held by the High Court of Australia that in case of a non-passenger
claiming matters related to death or injury to another passenger, then the matters are in sole
control and discretion of Civil Aviation Carrier’s Liability Act 1959 including the damages, strict
liability scheme and the provision for extinguishment.
In another case, DIFIII-Global Co-Investment Fund LP vs. Babcock & Brown
International Pty Limited2 the Court held that the facts which may cause the indemnification to
have the benefit of doubt should be known to the insured before the making of the policy. Hence,
the section 54 of the Insurance Contract Act cannot cure what is not in the knowledge of the
party.
In Globe Search Incorporated vs. Allianz Australia Insurance Limited3, it was held by the
Court that when a contract of indemnity to hold harmless has been entered into by the parties,
then if the property is damaged, the contract is breached and the cause of action arises. In other
1 [2019] HCA 14
2 [2016] VSC 623
3 [2019] NSWCA 27