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 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
New modelling released on 7 July 2026 has added momentum to the debate over how New South Wales funds emergency services, with analysis suggesting that removing the Emergency Services Levy from insurance premiums could deliver meaningful savings for many households and businesses. The findings, commissioned by the Insurance Council of Australia and prepared by Lateral Economics, support a shift away from loading the cost onto insurance policies and towards a broader property-based funding model. - read more
Making a boat insurance claim can feel stressful after an accident, theft, storm or other loss. Understanding the usual claims steps, the information insurers may ask for and how your policy terms affect the outcome can help you approach the process more clearly. - read more
Life insurance stands as a pillar of financial stability in the lives of many Australians, providing peace of mind and security for families and individuals facing the uncertainty of the future. The importance of life insurance cannot be overstated; it offers a safety net that serves to protect your loved ones in the event of a tragedy, ensuring their financial well-being during difficult times. - read more
Financial planning plays a pivotal role in managing your economic resources effectively. By assessing your income, expenses, and goals, you can create a plan that helps achieve financial security. A comprehensive financial plan covers saving, investing, budgeting, and managing liabilities to secure your future. - read more
Public liability insurance can help Australian businesses respond to claims involving injury or property damage to third parties. This guide explains what it commonly covers, what it may exclude, who may consider it and how certificates of currency and claims usually work. - read more
As recreational boating continues to grow in popularity, boat insurance has become an important consideration for boat owners. Boat insurance provides protection for your vessel in case of accidents, theft, or damage. However, with so many different types of policies available, it can be difficult to determine which one is right for your needs. - read more
Knowledgebase
Loss of Use: Insurance coverage that pays for the additional living expenses if your home is uninhabitable due to a covered loss.
No comments yet. Be the first to share your thoughts.