Insurer Penalized for Mishandling Storm Damage Claim
Insurer Penalized for Mishandling Storm Damage Claim
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.
In a recent development, Auto & General has been instructed to both apologize and compensate a Brisbane property owner with a $2000 payment after an inadequate review of his storm damage claim led to an initial denial of coverage and subsequent policy cancellation.
The homeowner reported his damages following severe storms that hit in February 2022. The insurance company consulted a builder, referred to as PB, to evaluate the property damages.
PB's assessment claimed that the home had pre-existing damage and lacked waterproof integrity. Specific issues highlighted included clogged gutters, cracked and missing roof tiles, and an unconventional roofing method that permitted water intrusion.
According to PB, the storm did not directly damage the roof but worsened existing issues. This led Auto & General to deny the claim and revoke the policy in October 2022, accusing the homeowner of misrepresenting the property's condition as "good" when the policy began and during its renewal.
The homeowner contested the insurer’s stance, arguing that it was unjust. He presented a separate builder’s report, along with written statements and photographs, which demonstrated a lack of prior wall or ceiling damage.
The policyholder attributed the defects cited by PB to partial make-safe work, asserting that the gutters had been regularly maintained prior to the storm. He also mentioned the emergence of storm-induced mold in sections of his home.
While Auto & General did ultimately reverse its initial claim denial and arrange for a cash settlement the preceding October, the Australian Financial Complaints Authority (AFCA) has decreed that the company must retract its claims of disclosure breach and issue a formal apology.
The AFCA identified “multiple erroneous assertions by PB alleging the complainant had neglected to maintain the property appropriately before the storm,” for which the homeowner provided contradicting proof.
The authority’s ombudsman commented, "I am satisfied the complainant reasonably believed that his home was in good condition and waterproof at the time of policy renewal in July 2021. Moreover, I think a reasonable person would agree with the complainant’s evaluation of his home's condition."
They further stated, "I conclude that the complainant did not misrepresent the property's state. Thus, the insurer made a mistake in deciding to cancel the policy."
The insurer has been directed to pay $2000 to cover non-financial losses due to its oversight in investigating the homeowner’s challenges to PB’s report, failure to acknowledge present mould, and incomplete make-safe actions.
The AFCA concluded that Auto & General should have sought a second, independent evaluation of PB’s findings. The resultant protracted claim process subjected the policyholder and his family to undue stress and anxiety.
The original source of this matter was reported by the Insurance News.
Please Note: We do not endorse any specific products or companies. Some content is sourced from third parties, including press releases, and may not be independently verified for accuracy or completeness.
The commencement of New South Wales’ professional indemnity requirements for registered building practitioners marks a significant compliance shift for the state’s construction sector. From 1 July 2026, relevant practitioners must be indemnified under an insurance policy for work carried out in that capacity, bringing insurance evidence closer to the centre of day-to-day building compliance. - read more
The National Insurance Brokers Association’s revised Insurance Brokers Code of Practice is moving the sector further towards clearer communication, stronger client care and more consistent professional standards. For Australians who rely on insurance brokers to navigate complex cover, the development is more than an industry housekeeping exercise. It goes directly to how clients understand advice, remuneration, service commitments and complaint pathways. - read more
Fresh heavy vehicle crash research from transport insurer NTI has again put a spotlight on the practical causes of serious truck incidents, with speed for the conditions, fatigue, distraction, equipment issues and vehicle fires all remaining central risk themes for Australian operators. For truck owners, fleet managers and owner-drivers, the findings are more than a safety update. They are a reminder that risk management and insurance outcomes are closely connected. - read more
A fresh round of transport safety coverage has put truck fires back on the risk agenda for Australian operators. While major crashes often attract the most attention, a vehicle fire can be just as disruptive for a business: the truck may be written off, the load may be damaged, a route may be blocked and the operator may lose income while replacement equipment is sourced. - read more
Fresh industry attention on Australian Financial Complaints Authority complaint trends is a timely reminder that insurance value is not only tested when a policy is bought. For trade businesses, the real test often comes when a damaged tool trailer, public liability allegation, stolen equipment claim or storm-affected worksite needs to be resolved quickly so the next job can proceed. - read more
Shareholder agreements lay the cornerstone for stable business relationships and continuity in Australia. Acting as a contract among business owners, these agreements set forth the expectations, rights, and obligations of all parties involved. They are particularly vital in delineating clear paths for dispute resolution, succession planning, and the transfer of ownership shares under varied circumstances, including the untimely death or departure of a shareholder. - read more
Navigating the complex world of insurance can often feel daunting, but understanding the importance of life stage consideration when choosing life insurance is essential. As we journey through the various chapters of our lives, our financial responsibilities, dependents, and personal circumstances evolve. These changes invariably have significant implications for our insurance needs. - read more
Life insurance might not be at the forefront of your mind, especially when you're young and healthy. However, understanding the essence of life insurance early on can significantly impact your financial future and provide much-needed peace of mind. - read more
Life insurance serves as a crucial safety net, guarding your loved ones against the unforeseen. Just as you would take care of your health through regular check-ups, it is equally important to ensure that your life insurance policy remains in sound condition to provide the necessary protection. - read more
Life insurance is an essential financial protection that provides peace of mind to policyholders and their loved ones. The premiums you pay are determined by various factors, including age, health, lifestyle, and occupation. - read more
Knowledgebase
Insurance Underwriter: An insurance company, a financial institution that sells insurance.
No comments yet. Be the first to share your thoughts.