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.
Australia's latest severe-weather claims updates are a timely reminder that insurance resilience is tested long before a claim is lodged. As insurers continue working through damage from recent storms, floods and cyclones, the bigger message for households and business owners is clear: cover needs to be practical, current and matched to real replacement costs. - read more
Australia’s prudential regulator has sharpened its focus on the insurance sector, with its latest priorities pointing to a market under pressure from affordability concerns, severe weather exposure, cyber threats and operational disruption. For households and business owners, the message is clear: insurance is no longer just a renewal task to be handled once a year. It is becoming a core part of financial resilience. - read more
Australia’s latest financial dispute data has put insurance claims handling back in the spotlight, with consumers and small businesses continuing to seek outside help when problems with insurers cannot be resolved directly. The trend is a timely reminder that an insurance policy should be assessed not only on premium, but also on how clearly it explains cover, how exclusions work, and how effectively claims are managed when pressure is highest. - read more
Australia’s insurance sector is facing a larger contribution to the cost of financial regulation, with ASIC’s 2025-26 industry funding estimates putting insurance levies at $23.838 million. That is a sizeable rise from the $17.608 million levied in 2024-25 and reflects a broader increase in the regulator’s expected cost recovery across the financial system. - read more
A proposed takeover of Steadfast Group has become one of the most closely watched insurance market stories in Australia, after global investment firm KKR joined the consortium seeking to acquire the ASX-listed broker network. The bid, led by Amwins Group and Dragoneer Investment Group, values Steadfast at about A$7.7 billion and remains pitched at A$6 per share. - read more
Comparing insurance providers in Australia means looking beyond premiums to cover, exclusions, excesses, claims support and the pathway you use to get quotes. This guide explains how to compare insurers and the practical differences between using a broker, a comparison website or going directly to an insurer. - read more
Home insurance is a critical element for any Australian homeowner, providing financial protection against an array of unexpected events. Essentially, it's a policy that covers losses and damages to an individual's residence, along with furnishings and other assets in the home. This type of insurance also offers liability coverage against accidents in the home or on the property. - read more
Embarking on the journey of entrepreneurship entails foreseeing and mitigating risks before they turn into setbacks for your business. In Australia, safeguarding your enterprise with adequate business insurance is not just a regulatory requirement, but also a strategic move to protect your company's future. In this article, we delve into the importance of being fully covered and guide you through the myriad of insurance options suitable for your business venture. - read more
In the landscape of personal financial planning, income protection insurance emerges as a critical safeguard against the unpredictable nature of life's many uncertainties. As we navigate through economic turbulence and job market volatility, the importance of income protection becomes ever more apparent. This type of insurance serves as a financial backstop, designed to provide a stable flow of income when you're unable to work due to sickness or injury. - read more
Life insurance is a contract between an individual and an insurance company. The insurer promises to pay a designated beneficiary a sum of money upon the death of the insured person. - read more
Knowledgebase
Peril: A specific risk or cause of loss covered by an insurance policy, such as fire, theft, or flood.
No comments yet. Be the first to share your thoughts.