Tuesday, 21 October 2014

WA Claims – The Realisation of Our Promise


Last night (October 21st 2014) Young Insurance Professionals (YIPs) held an educational event in Perth - WA Claims - The Realisation of Our Promise. 

Technical Assessing was one of the sponsors of the evening, where presenters (including our own David Outred and Mark Burke) shared their extensive experience in dealing with insurance claims and their roles in the claims process. The event was followed up by drinks and canapes at The Terrace Hotel in Perth.

Speakers Justine Siavelis from GC Legal, David Outred and Mark Burke from Technical Assessing and Ron Johnson from Allianz

Photos from the YIPS facebook page.

Women in Insurance Golf Day - Brisbane

The annual Queensland Women in Insurance Golf Day was held on Friday 12 September 2014 at the Bulimba Golf Club in Brisbane. Loss Adjuster Emma Doney together with Administration Manager Vicki De’Ath from the Brisbane office assisted in running the event which attracted an estimated 30 insurance professionals from all walks of the industry.

Finding typical Queensland sunshine and warmth, the participants enjoyed a relaxing and entertaining afternoon on the 9 hole layout and in the clubhouse afterwards. Vicki and Emma took out second place with their team mates from AON for the second year in a row, and the winners trophy landed in the hands of Zurich Insurance and their guests. Whilst commiserating over their ‘second second place’, the attention of the pair was quickly drawn to the arrival of Jon English to play a gig at the golf club that evening (Emma: “Who?”). Obviously the Bulimba Golf Club is at the forefront of modern entertainment, and the ‘place to be’.

The Queensland Women in Insurance Association is a not for profit organisation which provides a forum for insurance professionals to enhance the position of women in the insurance industry through professional and personal development. Membership is open to males and females, and a broad range of networking and educational events are held regularly throughout the year. For further information visit http://womenininsurance.com.au/.

Goods and Services Tax

By Andrew Buchanan

The treatment of GST on claims is often a source of confusion for Insureds and Claimants.  Whilst it is not the responsibility of claims practitioners to provide “tax advice”, it is often necessary to point out where GST has been incorrectly applied in claims presentation and to provide guidance on the approach to be adopted.  It is therefore important that any such instruction is in accordance with the GST rules in order to ensure not only that the Insured is property indemnified but also to potentially avoid exposing any parties to the future application of penalties and interest for incorrect treatment arising from misguidance.

Goods and Services Tax (GST) is “Value Added Tax”, meaning that it the tax is collected on the value that is added by GST-registered entities at each stage of the production/supply chain.   By way of simplified example: if a wholesaler purchases a good from distributer for $30, then sells it to a retailer for $50, the “added value” is $20, and the business’s GST liability  (at 10% of this added value) is therefore $2.

The mechanism by which the tax is collected involves a two-stage process.   Firstly, GST-registered businesses must include 10% GST on all taxable supplies of good and/or services they provide.   Secondly, GST-registered businesses are entitled to claim Input Tax Credits (ITCs) on the GST component of all those goods/supplies it has purchased for use in the business.

To return to the earlier example, the business is required to charge $5 GST when selling their product (10% of $50) but entitled to claim a $3 ITC (corresponding to the GST paid on the $30 purchase price).   The net result is that the business (which, in this simplified example, has no other costs on which they can claim ITCs) would be required to pay $2 GST; which, of course, corresponds to the GST liability on the “added value”.

GST is levied on each separate (GST-registered) business entity at every stage in the production/supply chain until the good or service is obtained by the final consumer.  GST is therefore technically a tax on each of the businesses supplying the goods/services and not the entity purchasing them (though it may not seem that way to the paying consumer at the end of the chain!)

When determining the liability of an Insured or Claimant (or Third Party) to pay GST as part of a settlement it is necessary to determine whether a taxable supply has been provided.    Section 9-5 of the A New Tax System (Goods and Services Tax) Act 1999 (GST Act) provides the requirements for a supply to be a taxable supply: a business makes a taxable supply if it makes a supply for consideration, the supply is made in the course or furtherance of the enterprise, the supply is connected with Australia, and the supplying business is (or is required to be) registered.

The Commissioner of Taxation has previously ruled that an award of damages by a court and its payment is not a taxable supply.  Goods and Services Tax Ruling GSTR 2001/4 (GSTR 2001/4) provides the Commissioner's view on GST consequences of court orders and out-of-court settlements. Significantly the Commissioner confirms that damage, loss, or injury, in itself does not constitute a supply under section 9-10 of the GST Act.
Accordingly, payment of damages does not represent a taxable supply. 

It is common for Claimants to present their claim by “invoicing” the Insured for the damages sought plus GST (or having their contractor address any repair invoices to the Insured; the thinking being that as the Insured is legally liable for the damage the repair service is provided to the Insured.  This approach is flawed: the Insured (as tortfeasor) is only liable to pay compensatory (financial) damages, not to repair the physical damage caused.   The Claimant is the recipient/beneficiary of any repair service provided and the party to whom any invoices should be addressed.

In such instances, the Insured’s liability to pay GST should generally be contested.   Exceptions include where the Insured does benefit and has actually contracted with the Claimant for provision of the supply (see example below), or where the Claimant is statutorily entitled to undertake repairs and charge the responsible party.

In a recent claim the Insured caused damage to a hired-in forklift.  Often in such cases the hire agreement will require the Insured to indemnify the hirer for the cost of repairs, the hire company then undertakes the repairs to their own equipment (no external taxable supply, so nil GST) and the Insured compensates them for the cost of doing so.  However, in this particular case the hire agreement instead made the Insured responsible for repairing damage to the hired forklift.  The Insured chose to contract the Claimant (the hire company) to undertake the necessary repairs on the Insured’s behalf; this repair service was a taxable supply to the Insured: the Claimant was therefore required to add 10% GST to their invoice and the Insured needed to pay such.

Of course, on the occasions where the Insured is liable for GST (on repair costs etc) they are normally able to claim an Input Tax Credit (ITC) on this cost and therefore suffer no loss in this regard.  Accordingly, even though the Insured will have to pay the GST element on the Claimant’s invoice, Insurer’s indemnity to the Insured will still be net of GST (it is, however, necessary for the full amount, inclusive of GST, to be recorded in any Deed of Release and for the Insured to pay the GST component to the Claimant).
Complications arise with the following situation: the Insured (a builder) causes damage to the property of a non-GST registered Claimant, the Insured then agrees to undertake the required repairs to the Claimant’s property in full satisfaction of the claim.  The Insured does not invoice the Claimant but seeks an indemnity for the repair cost under his Public Liability Insurance.

Whilst no money was exchanged between the Insured and Claimant, the Insured’s repair service was provided for a “consideration”: that being the extinguishment of the Claimant’s right to seek compensatory damages from the Insured.   The Insured’s repair works therefore meet all the requirements to be a taxable supply to the Claimant and the Insured must therefore charge 10%  GST.  Insurer’s settlement should therefore indemnify the Insured for the cost of undertaking the repairs, inclusive of GST.

As an aside, it is worth remarking that the above scenario also has implications for activation of the Operative Clause of typical Public Liability policy wordings.  It is not unknown for Insurers to seek to argue that, due to the Insured having undertaken works to avoid legal liability attaching, the Operative Clause (which requires legal liability on the part of the Insured) has not triggered.  In practice, however, the Insured has generally not “avoided” legal liability but, instead, settled the claim through provision of service.

Where the goods or services are provided by the Insured purely on a gratuitous basis (for example a business giving an injured customer flowers or vouchers in the hope that they will not pursue a claim) then there is no “consideration” provided by the Claimant (who has agreed to nothing!) and the supply does not attract GST.

In addition, replacement goods or repair services will not attract GST where they are provided by under a warranty or guarantee.   This is because the consideration was paid by the Claimant/customer at the time of purchasing the original goods/service (inclusive of guarantee/warranty service).   This, however, only applies to the element of the service(s) which are within the scope of the guarantee/warranty: if the Insured’s provided services post-incident go beyond this (to include, most obviously, repair of resultant damage) then such additional services will incur GST.

The earlier example of an Insured causing damage to the property of a (non-GST registered) Claimant is further complicated where the Insured (rather than undertaking repairs themselves) instead arranges for a third-party contractor to undertake repairs to the Claimant’s property; with the contractor then direct-billing the Insured.

The above situation gives rise to two possible scenarios: either a “payment arrangement” or a “tripartite transaction” exists.  This depends on whether the Third Party contractor’s contract is deemed to be with the Insured or with the Claimant.

Where the contract is deemed to exist between the contractor and the Claimant, then this is a “payment arrangement”.   All the Insured is doing is short-cutting the funding chain by paying the contractor directly on the Claimant’s behalf (rather than the Claimant paying the contractor, then the Insured reimbursing the Claimant).  The taxable supply is provided by the contractor to the Claimant (as sole recipient) and the Claimant (if not-GST registered) cannot claim an ITC on the transaction, nor can the Insured.

Conversely, where the Insured directly contracts directly with the contractor, for the contractor to provide a supply to the Claimant, then this is a “tripartite transaction”.  In this instance the contractual supply is made by the contractor to the Insured, but the actual/physical supply is provided to the Claimant. 

In genuine tripartite transactions, the (GST-registered) Insured will be entitled to claim an ITC on the supply received.   The rules surrounding tripartite arrangements are complex but may, for example, include the situation where the Insured engages a third party to provide a warranty repair service to a customer on the Insured’s behalf.

However, if the Insured’s entering into the arrangement with the contractor was done on the basis of receiving “consideration” from the Claimant (i.e. the Claimant’s agreement to extinguish/reduce their claim in exchange for the Insured arranging repairs) then this is not a genuine tripartite agreement and the Insured will not be entitled to claim an ITC.


Whilst all the forgoing may seem overly complicated, this reflects the nature of the GST rules (and the rulings determining the correct interpretation thereof).  Unfortunately there is no one simple “rule of thumb” that covers all possible situations and it is important that the fundamental nature of any supplies between an Insured and Claimant are investigated and understood in order that GST is correctly addressed in any agreed settlement.

Monday, 25 August 2014

Real or Not? - You Be the Judge

We were recently appointed by a national insurer to check on a premises in the western suburbs of Sydney, where the Claimant alleged that the activities of New Years Eve, in particular fire works, caused irreparable damage to the building air conditioning system located on their roof. A total new air conditioning system was being claimed at a total cost, labour and materials of around $50K plus GST.

By way of background we were provided with various photographs showing extensive used fireworks on the roof, however no photographs were provided showing any damages to the air conditioning equipment. The Insured and broker were very forceful in their allegations and required immediate settlement of the claim.

The allegation by the Insured was that the perpetrators placed fireworks on top of air conditioning units located on the roof with the result that the heat and smoke from the fireworks, after they had been let off caused extensive damage to the air conditioning equipment.

When we arrived on site on our first visit we were not able to gain access to the air conditioning equipment located on the roof. We were advised that no access was possible and no ladders on site were available, this being contrary to advices initially provided to us when the matter was discussed with the Insured.

We were required to re-attend the site, this time bringing a ladder to gain access to the roof, which is located around four metres above ground. We also brought on site a specialist air conditioning technician, who proceeded to check the air conditioning equipment for electrical integrity. When on the roof we could not see any damage whatsoever to the air conditioning equipment that is consistent with fire, heat, burning, flames or smoke.

The air conditioning technician on site conducted various checks of the air conditioning equipment and determined that only one out of the four air conditioning units was working correctly and that the other three had various breakdowns in place including fusion of sealed compressor motors, fusion of condenser fan  motors, problems with control systems and the like.

In summary the damages in place to the air conditioning equipment were due to general breakdowns and wear and tear and had nothing to do with the activities of New Years Eve.

The moral to the story is when a claim is received it is always important to conduct a site inspection and also view the equipment that is being claimed. When any doubt exists as to the cause of damages it is always advisable to have a specialist attend the site to do various checks of the equipment.

By the way, the Insured always maintained that the air conditioning was working fine prior to New Years Eve and that after New Years Eve the air conditioning equipment was not working. What do you think?

I hasten to add that this was an unusual circumstance as the writer’s experience is that information provided with the majority of claims is quite legitimate, though often knowledgeable interpretation is required.

PS: This claim was denied by the Insurer and no further representations were received from the Insured!

Defects Liability

By Steve Nance


There are usually two types of cover available under the material damage section of the Contract Works policy. The first covers any material damage during the construction period. However, once the construction period ceases, many construction contracts enter into the “Defects Liability” phase. This is a period of time after practical completion of the works where the contractor is responsible for the making good associated with any defects in the works. This forms the second portion of the material damage section of the contract works policy. 

Many policies describe this as being the “Maintenance Period”. It is unclear as to how this term came about, but it is quite clear that the responsibility of the contractor is not one of maintenance, but rather of rectification of defects.  It is for this reason why the majority of contracts refer to this section of the contract as being the “Defects Liability” period.

It is the cover under this period that will be discussed in this item. Specifically, the types of cover which are available.

The wording of the Defects Liability Period/cover varies significantly from policy to policy. Generally speaking the policy provides cover for physical loss or damage to the contract works which occurs or “manifests itself” during the Defects Liability Period of the contract, but which originates from the contract works. It also provides cover for any physical loss or damage to the contract works which may occur when any of the insured parties attend the site to rectify any defects, or indeed any other works which the contractor is responsible for carrying out as a result of the contract.

For example, let’s take a building which has reached Practical Completion two months prior to a significant rainstorm. There is a 12 months Defects Liability Period under the construction contract. As a result of the rainfall, leaking occurs as a result of a defective membrane, causing damage to ceiling tiles, the electrical installations, and carpet (all of which formed part of the contract works) and other contents items which were owned by the tenant.

In this instance the loss occurred as a result of defective work which occurred during the construction period and as such would usually fall within the defects liability provisions of the contract. It is also arisen out of the contract works during the construction period. As a result, the policy will respond to the loss, but subject to the terms and conditions of the policy.  Depending on the wording, this would usually exclude the cost of making good the membrane, however would provide cover for physical loss or damage to other sections of the contract works. Given that the policy only provides cover for the contract works, it would not provide cover for the contents owned by the tenant, such as the desks, chairs, PABX installation, computer installation and the like. This would be more appropriate for a liability cover.

To continue the example further, the contractor re-attends the site to undertake the rectification of the membrane, as well as rectification of the other damage to the building, as well as some other defects. In doing this, he causes a fire which causes yet further damage to the building. As a second proximate cause, this is a separate event, however would also be covered as it is works being carried out by the contractor in complying with the requirements of the defects liability clauses of the construction contract.

The above is fairly straightforward, and is addressed in most of the construction policies, which the writer has seen.

There are, however, some circumstances which are not as straightforward.

Let’s take for example the situation where the Defects Liability Period under the construction contract either does not exist or is of a short period (say three months) under the construction contract. The policy, however, provides a 12 months “maintenance period” cover. Given that the contractor under various states legislation is responsible for repairing the defect, and as such also responsible for the resultant damage, would the policy respond? This of course depends on the wording of the policy.

Some policies specifically provide the necessary period of cover up to a maximum of the Defects Liability Period which is required under the contract. If therefore a contract has only a three months Defects Liability Period, then the policy would respond to losses up to three months after Practical Completion, but then would not provide cover for the events manifesting themselves during the nine months after this, being the maximum amount provided by the policy. Other more generous policies specifically state that they provide cover up to the end of the maintenance period allowed for in the policy. This suggests that even though the three months Defects Liability Period under the contract may have expired, cover would be provided up to 12 months, where this is the maximum allowable under the policy. This effectively provides cover where it may not be required.

Another issue is where some construction contracts actually allow for an extension of the Defects Liability Period. Typically this would be where a defect has originally been determined, and then repaired. Some contracts then require a new Defects Liability Period to commence at the completion of that rectification. Indeed, the writer has been involved in claims 27 months after Practical Completion where a Defects Liability Period of 12 months only had been provided. Whether cover is provided for this or not will again depend on the detailed words of the policy. Where a policy simply mentions that the cover provided will follow that of the construction contract, then where the construction contract does allow for this accumulated defects liability provisions, cover would probably be provided.

A further issue associated with the maintenance period under the contract can relate to the (usual) requirement that the cause has to arise out of the contract works which is carried out by the Insured and occur during the construction period. If we take the example of a defective generator which has been installed in our building and becomes badly damaged during the Defects Liability Period. What cover would be provided to the generator if the cause was a manufacturing defect within the generator itself, and the generator was manufactured some time prior to the contract commencing? The extent to which cover would be provided for both the generator and any resultant damage which may occur will again depend on the policy wording.


Further, most policies require the defect to occur at the construction site. Given the same generator, which was constructed off site, possibly overseas, even if the manufacture was during the construction period, cover may not be afforded to this. Again, this will depend on the policy wording, which is often tailored to suit the needs of the Insured.

Tuesday, 12 August 2014

Golfing in the UK!

A few blokes from the Australian insurance industry, a couple of doctors, an accountant, a bed manufacturer and a few ring-ins got together in the UK to play some of the best golf courses in the world. Birkdale, Turnberry, St Andrews, and Carnoustie amongst them. And didn’t they have a great time!