Onus of Proof: What is it and why it is so important?

Claims Explained: Onus of Proof

Onus of Proof sounds like a legal concept and it is.

Onus of Proof isn’t complicated though – it just refers to the responsibility of proving (or disproving) a fact.

When it comes to making an insurance claim, the claimant bears the Onus of Proof to demonstrate a valid claim against the policy. This means you must prove that you sustained a loss and that it is covered by the policy.

To discharge the Onus of Proof, you would normally be asked for evidence of the event and the loss you suffered. Let’s look at some travel insurance examples.

To claim for loss or theft of property, the insurance company will normally ask you to provide a police report (or similar document). This helps to verify that the theft / loss event happened while you were travelling and during the period of insurance. It will also outline the circumstances of the loss. The insurance company will ask you to provide evidence that you owned the items that were lost / stolen and what they were worth. Some insurers are very specific about the documentation they will accept as proof of ownership (eg purchase recepts and valuations). Other insurers may be more flexible and accept other forms of proof such as photographs, user manuals, repair dockets or statutory declarations. It’s best to check with your chosen provider regarding what is acceptable proof in the event of a claim.

To claim for medical expenses, the insurance company will ask you to obtain a report from the doctor to confirm the illness/injury and the diagnosis given. You will also be asked to obtain an invoice from the doctor to verify the services provided and the charges. If the injury / illness relates to your past medical history, the insurance company may ask for access to your past medical records.

If your claim is for travel delay, cancellation or curtailment, the insurance company will usually ask you to provide a letter from the airline confirming the reason for the disruption to your travel. You will also need to show evidence of the additional costs incurred due to the disruption and/or details of any pre-booked travel arrangements which were forfeited.

Providing this type of documentation helps you to discharge the Onus of Proof to show that you have a valid claim against the policy.

Once you have demonstrated that you have a valid claim against the policy, if the insurer agrees with you, the claim will be processed. However, if the insurer does not agree that you have a valid claim, the Onus of Proof shifts to it to demonstrate that an exclusion applies (or any other term within the policy which serves to limit or deny your claim).

If the insurer discharges the Onus of Proof to show that an exclusion applies to deny or limit your claim and you do not agree with its assessment, the Onus of Proof shifts back to you to show that the insurer’s decision is wrong.

Legally speaking, there’s a bit more to it than this simple explanation. Onus of Proof though essentially means you need to prove your claim and the insurer needs to disprove it (if they consider it isn’t covered).

Got questions about proving a travel insurance claim? Why not call us on 1300 819 888 or send an email to info@goinsurance.com.au