Processes Relating to Applications for Insurance
12 Evidence concerning the processes involved in the Relevant Period for the application by customers for the defendant's home and contents insurance products was given in two affidavits by Ms Jenner, an underwriting manager for the defendant. Certain aspects of that evidence were clarified in correspondence between ASIC and the solicitors for the defendant on 20 and 23 February 2024, which was agreed to be admitted without limitation.
13 A customer could initiate the application process by obtaining a price quote for, and purchasing, home and contents insurance from the defendant in one of three ways: (i) via the website of Budget Direct or the website of one of the defendant's other brand partners; (ii) via the website of an insurance "aggregator", which is an intermediary providing price comparisons of insurance offerings from different insurers (such as the aggregator known as "Compare the Market"); or (iii) via telephone, by calling the Budget Direct call centre, the call centre of one of the defendant's other brand partners or the call centre of an aggregator, and speaking with a consultant to start an application. A customer could also complete an application using a combination of the above three methods, for example by starting an application online but then completing it over the phone, or vice versa. Whichever method was deployed, the customer was advised of their duty of disclosure and of the duty to take reasonable care not to make a misrepresentation, and the potential consequences of not complying with those obligations.
14 Under each method of application, potential customers were asked a series of questions about the customer and their home and contents. In relation to an online application through the website of Budget Direct or one of the defendant's other brand partners, the customer was required to answer questions concerning the following:
(a) the customer's address, being the address, including the postcode, of the property to be insured;
(b) the property type;
(c) whether the property was part of a body corporate or a strata title complex;
(d) the year in which the home was built;
(e) whether the home was heritage listed or subject to a National Trust classification. For online sales, if the customer indicated that the building was built before 1940, the customer was then asked whether the property was heritage listed or subject to a National Trust classification. That question was followed by the words: "Select 'yes' if the property is included on a local, state or national list that provides legal protection for items of heritage value or is subject to a heritage overlay". There were then two possible answers, "Yes" or "No", and the customer had to select one of those options. For call centre sales, if the customer selected an option indicating that the building was built before 1945 (noting that the relevant date range option was 1940-1945), the customer was then asked whether the home has a heritage, heritage overlay, or National Trust listing. I note that it would appear that the defendant was operating on the assumption that a building which was built in or after 1940 would not be heritage listed or subject to a National Trust classification, and there is no evidence before me which indicates that the assumption was wrong or unreasonable;
(f) the construction material of the home's exterior walls and roof. In this regard, the potential customer was first asked: "What is the main building material of the exterior walls?" That question was followed by the words:
If different building materials have been used on the home's exterior, please select the primary type of material that surrounds the main living area of the home. If any Asbestos exists in the walls, please select Asbestos. If your walls are rendered, please choose the material underneath the render.
They were then shown ten possible answers and the customer had to select one of those options. The ten possible answers included asbestos, and the customer was told to choose this if "any Asbestos exists in the walls e.g. Fibrolite, Hardiflex, Imitation brick cladding, Villaboard". The customer was then asked: "What is the main construction material for the roof?" followed by the words:
If different construction materials have been used on the home's roof, please select the primary type of material that covers the main living areas of the home. If any Asbestos is present in the roof, please select Asbestos.
They were then shown eight possible answers and the customer had to select one of them, which included "Asbestos e.g. Super Six, Fibrolite and corrugated cement sheeting". Customers who contacted the call centre were also given the specific instruction that if any Asbestos exists in the walls or roof, then the customer was told to select the asbestos option, but those who contacted aggregators were not given that precise instruction (noting that aggregators sought to standardise their questions across all insurers as a fundamental aspect of their service was to provide price comparisons of insurance offers from different insurers to customers);
(g) the nature of the occupancy, and in this regard the customer was asked "How is the property occupied?" and had to select one of seven options, namely (a) "Owner occupied", (b) "Owner - yet to occupy", (c) "Rented to tenants - landlord", (d) "Renting as a tenant", (e) "Owner - to be rental investment", (f) "Holiday home - not rented", and (g) "Holiday home - may be rented. Rented out for payment as holiday accommodation e.g. Airbnb, Stayz and holiday rentals etc". Similar questions were asked by aggregators and call centre personnel;
(h) the type of cover the customer wanted to purchase;
(i) the month and year in which the customer moved into the property;
(j) the name of any mortgagee or home lender for the property;
(k) the customer's estimate of the total cost to rebuild the home at today's prices;
(l) the security of the home, in which regard the potential customer was asked whether the home was fitted with a security alarm and, if so, was asked whether the alarm had an internal siren, external siren, external strobe light or active back to base monitoring;
(m) the customer's estimate of the total cost to replace the home's contents at today's prices;
(n) whether the property was used as business premises. In this regard, the potential customer was asked "Is any part of the property used as a business premises, or for buying, selling or storing business products or equipment?" The screen then displayed the words: "Business activity is defined as any registered business, or any activity that derives an income. This does not include working remotely from a home office." Customers who contacted aggregators were not given that definition of "business activity". If the potential customer said "yes", they were asked to select which type of business it was (eg surgery, childcare, bed and breakfast), and provide further information such as the number of rooms used in conjunction with the business, and the number of non-household members who worked in the business. Childcare centres attracted additional questions about the number of children and whether the business was registered;
(o) the customer's date of birth;
(p) the customer's claims and loss history; and
(q) whether any person living in the home was retired.
15 After obtaining a quotation, if a customer wished to continue to purchase the insurance online, further questions were asked of them which related to:
(a) whether the home was under an immediate threat of damage by severe storms, bushfires, grassfires or floods;
(b) whether the home was structurally sound. In this regard the potential customer was asked: "Is the home in good condition?" That was followed by the words:
This means your home, property and contents do not have any faults or defects that might cause:
a. loss or damage to your home/property and contents,
b. loss or damage to property of others or,
c. injury to people.
This includes but is not limited to:
- No leaks, holes, damage, rust or wood rot in the roof, gutters, windows, floors, fences or other parts of your home.
- A sound and solid structure with no damage to foundations, walls, steps, flooring, ceilings, gates and fences.
- No damage from or infestation of termites, ants, vermin, or other creatures,
- No broken or boarded-up windows.
The customer then had to select "Yes" or "No", and if the customer selected "No", the customer was given the following statement:
You have told us that the home, property or contents is not in good condition. We are unable to offer you insurance.
(c) whether the customer shared the home with anyone other than the customer's family and the number of those persons;
(d) the occupancy of the home. In this regard the potential customer was asked "Is the home currently unoccupied?" followed by the words: "You need to let us know if the home becomes unoccupied for more than 60 consecutive days during the term of the policy." The potential customer had to select "Yes" or "No", and they were then asked: "On what date will the home be unoccupied?" followed by a text box requiring the day, month and year to be input;
(e) the security of the home's exterior doors and windows;
(f) whether the home is under construction, undergoing renovation, alteration, extension or being demolished. If the customer selected "Yes", the customer was then asked: "What type of work is being conducted?" If the customer selected demolition, the screen stated: "You have told us that the home is being demolished. We are unable to offer you insurance." The customer was otherwise asked: "Are any of the external walls or areas of the roof being removed?"; "Is the home being raised, stumps removed or replaced or being built underneath?"; "When is the building work expected to be completed?"; and "What is the value of the work being completed?";
(g) whether the customer had held insurance for the home in the previous seven days;
(h) the customer's claims and loss history;
(i) whether the customer or a member of their household had other insurance cancelled or an insurance claim refused in the previous five years; and
(j) whether the customer or a member of their household had ever been convicted of a criminal offence.
16 The same process and questions set out above were asked of a customer who applied for home and contents insurance via an aggregator's website or via a call centre, subject to the exceptions and qualifications to which I have referred above.
17 As is apparent from the text of the Notification Clause which I have extracted above, that portion of the PDSs provided 11 examples of changes which the defendant said it wanted insureds to tell it about. Each of the 11 examples set out in the Notification Clause relates to questions seeking information concerning the relevant property to be insured which were asked of customers applying for insurance. Not all customers were asked exactly the same questions, nor were all the questions framed in exactly the same way, irrespective of the method used by the potential customer to make an application for insurance. I have indicated above the particular differences in relation to the questions concerning heritage listing and the presence of asbestos. However, those differences do not detract from the proposition that each of the 11 examples in the Notification Clause did relate to questions which were asked generally of customers applying for insurance, and to the information which either was or may have been provided in answer to those questions, depending on the circumstances of each customer.
18 Answers to the questions to which I have referred above provided the defendant with information about the customer and their home and contents which the defendant then used in its underwriting and pricing algorithms to make an underwriting decision whether to offer insurance to that potential customer and, if so, on what terms. Those questions were framed with reference to the defendant's Underwriting Policy and Underwriting Guidelines.
19 The Underwriting Policy sets out how the defendant manages the risks arising from its underwriting function across its main areas of business. The defendant says that its commercial objective is to offer customers competitive premiums and dependable insurance and the Underwriting Policy sets out how the defendant seeks to balance price competitiveness with product quality, service reputation and security by outlining the components of the underwriting framework. Those components included the underwriting processes used by the defendant which are largely automated and controlled by proprietary software (known as "DISC"), the scope of cover the defendant may offer customers, the unacceptable risks the defendant will not accept, the risk assessment criteria for underwriting decisions, and various operational matters (including indemnity limits, the authority limits for members of the underwriting team, and the process for reviewing the policy).
20 The Underwriting Guidelines also set out, for the defendant's home and contents insurance products, the acceptable and unacceptable risks to the business. Section 2 sets out the "underwriting rules" as to "unacceptable risks" and "risks to be referred to underwriting". Section 3 describes the rationale behind the guidelines and explains why the defendant does not accept certain types of risks and treats certain matters as posing a greater risk. As Ms Jenner explains, the pricing of the defendant's insurance is heavily dependent on the actuarial assessment of certain kinds of risks, and risks outside those which the defendant would normally accept have the potential to change materially the likelihood and size of the claims, and as such, the level of premium that would be charged to customers within the relevant pool.
21 In relation to the 11 examples set out in the Notification Clause, each of those examples corresponds to a matter described in the Underwriting Guidelines as posing either an unacceptable risk or a greater risk.
22 If a customer wished to renew an existing policy during the Relevant Period, they were advised before renewal (on their insurance renewal documents, on screen during the renewal process online, or over the phone by the consultant) that they needed to confirm if any changes or corrections needed to be made to insurance details already provided to the defendant before renewal in accordance with their duty of disclosure or their obligation to take reasonable care not to make a misrepresentation. A customer could update their details any time online or by calling the call centre of Budget Direct or the call centre of one of the defendant's other brand partners.