Have you had your home insurance claim rejected?

Last updated on December 17th, 2024

No homeowner wants to receive a letter or email with the subject line ‘home insurance claim rejected’.

But it is a very common experience, judging by the number of complaints to the Australian Financial Complaints Authority (AFCA). Chief Ombudsman David Locke said complaints about general insurance, including home and car insurance, were at a record high for the second year running in 2023-2024.

“We are disappointed the sector has not yet been able to achieve sustained improvement,” he said.

There are stories of homeowners, for example, who were hit by devastating floods in 2022 who are still waiting to have their homes repaired. Of the 244,000 claims made, more than 7000 remained unresolved two years after the costliest weather event in Australia’s history.

 

 

Whether your home has been affected by flood, fire, storms or another event, or you have been burgled, this is a very stressful time, so it is essential you get the right help with your home insurance claim.

What can I do if my claim is rejected?

If you have had your home insurance claim rejected, the first thing you should do is ask for the reasons in writing. If they have already been provided, ask for all supporting evidence – such as the assessor’s report and any external reports that may have been conducted to reach that decision.

Once you see all the details, you may remember some crucial information you forgot to add to your claim because you were upset or injured. It is not too late to provide those extra details. Ask the insurer to review their decision.

Do all of this in writing so that you have accurate records. If you do make any phone calls to try to get answers, take detailed notes so that you have them to refer to if you need to escalate your complaint.

What if the insurer refuses to reverse its decision?

If you are still not getting the right result, you can take your complaint to the Australian Financial Complaints Authority (AFCA). The independent body offers a free and impartial service to help resolve financial disputes, including insurance.

 

 

As they will ask if you have already complained to the insurer, make sure you have exhausted that option first. The authority suggests you also take the following steps before getting in touch:

• • Decide if you want someone else to handle the complaint for you. This may be the case if you are too distressed or have been injured, in which case you need to authorise the person of your choice to act on your behalf.
  • Determine the outcome you are seeking – a reversal of the decision, a partial payment, compensation – and gather any documents that could help support your claim.
  • If you’re experiencing financial difficulty, complete a Statement of Financial Position to help strengthen your case for assistance.

How do I complain to AFCA?

AFCA has an online portal that enables you to create an account in a few minutes. It is through this portal that you submit your complaint, track the status of your case and manage any requests for information. The portal uses multi-factor authentication for extra security.

If you are unable to lodge a complaint online or would prefer to speak to someone, you can email [email protected] or call 180 931 678.

 

 

What if AFCA can’t help?

If AFCA is unable to handle your complaint for any reason, they can suggest several bodies that can provide further assistance, including if you choose to take legal action. This is something you need to consider carefully, given the potential added costs at a time you are already experiencing significant financial loss.

We know this all sounds like a lot of hassle to get what you believe is rightfully yours, so why not let us handle your home insurance complaint? At Handle My Complaint, we are dedicated to looking after consumers just like you, so please tell us what has gone wrong so we can advocate on your behalf.