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.
Renewed rural industry attention on insurance affordability is a timely warning for Australian farm businesses preparing for renewal season. Premium pressure is not only a household issue in regional areas; it can affect the commercial reality of running a farm, from insuring sheds and machinery to protecting stored produce, livestock infrastructure and liability exposures. - read more
The continuing review of Australia's Life Insurance Code of Practice has become more than an industry governance exercise. For policyholders, it is a timely reminder that the real value of life insurance depends on what happens at underwriting, at renewal, and especially when a claim is made. - read more
The latest industry attention on Australia's cyclone reinsurance arrangements is a timely reminder that premium relief for strata schemes is rarely driven by one policy lever alone. The cyclone pool was designed to reduce insurer exposure to cyclone-related losses in higher-risk regions, particularly across northern Australia. However, for owners corporations and body corporates, the practical impact can still vary sharply from building to building. - read more
Renewed attention on apartment building defects is a timely reminder that strata insurance is not assessed in isolation from the physical condition of a scheme. For owners corporations and body corporates, the issue is not only whether cover is in place, but whether the building can be clearly presented to insurers as a well-managed and understood risk. - read more
Fresh complaints data from the Australian Financial Complaints Authority has again put pressure on the general insurance sector, with policy disputes, delays and communication breakdowns remaining a major source of frustration for customers. For Australian tradies, the headline is not just that complaints are being lodged; it is that many disputes appear to begin with mismatched expectations between what a policyholder thought was covered and how the insurer interpreted the wording when a claim arrived. - read more
Life insurance is designed to provide financial support to your loved ones if you pass away. For Australian families, it can help cover debts, everyday living costs, funeral expenses and future needs such as children's education. This guide explains how life insurance works, what affects premiums, how to estimate cover, and what to check before choosing or maintaining a policy. - read more
A life insurance claim usually involves notifying the insurer, confirming the policy and beneficiaries, providing evidence such as a death certificate or medical information, and waiting for the insurer or super fund trustee to assess the claim. - read more
The importance of life insurance in financial planning: Life insurance isn’t just a policy; it’s a cornerstone of comprehensive financial planning. By protecting your family’s financial future, life insurance offers peace of mind, knowing that your loved ones will be taken care of in the event of your untimely passing. It’s not solely about leaving behind a legacy, but also ensuring that your family can maintain their standard of living, pay off debts, and cover end-of-life expenses without financial burden. - read more
Life insurance in Australia commonly pays a lump sum if the insured person dies or is diagnosed with a terminal illness, but policy terms, exclusions and related cover options can vary significantly. - read more
Single parenting brings with it a mosaic of responsibilities and challenges, not least of which is securing a stable financial future for your child. The rollercoaster of raising a child alone often means that planning for the future can take a back seat to the day-to-day demands of parenting. Unexpected illnesses and injuries can compound these challenges, causing stress to multiply and plans to go awry. - read more
Knowledgebase
Income Insurance: Insures your income in the event of you being unable to work due to sickness or accident.
No comments yet. Be the first to share your thoughts.