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.
Small business insurance premiums in Australia have surged by up to 60% since 2019, rendering coverage increasingly unaffordable for many enterprises. The Insurance Council of Australia attributes this escalation to outdated liability laws, escalating legal costs, and governmental red tape. - read more
In the fourth quarter of 2025, Australian commercial insurance rates experienced a notable decline, with prices dropping by 12%. This marks the most significant decrease among the eight regions monitored by Marsh's Global Insurance Market Index. The primary driver behind this trend is heightened competition within the market, as international insurers have expanded their presence, providing additional capacity that has contributed to the rate reductions. - read more
Insurance affordability has emerged as one of the most pressing challenges facing small businesses across Queensland and increasingly across Australia. A recent submission by Business Chamber Queensland to the Parliamentary Joint Committee on Corporations and Financial Services outlines why insurance products are not keeping pace with the realities small businesses face, and what can change. - read more
In a significant development for Australia's agricultural sector, Harland Green, a newly established Lloyd's coverholder, has introduced an all-risk farm insurance package tailored for large commercial farming operations. This initiative seeks to address the complex and often underserved insurance needs of substantial agribusinesses. - read more
WFI Insurance has reported a notable decrease in farm liability claims across various categories, signaling a positive shift in safety practices within the Australian agricultural sector. This trend underscores the industry's commitment to enhancing on-farm safety and reducing incidents. - read more
Cyber insurance, also known as cyber liability insurance, is a type of coverage designed to protect businesses from the financial repercussions of cyber attacks and data breaches. As cyber threats become more sophisticated, the need for a safety net to mitigate the impact of such incidents has grown significantly. - read more
In this digital age, online liabilities have become a crucial concern for individuals and businesses alike. At its core, an online liability refers to the potential risks and responsibilities associated with using the internet. These risks can range from data breaches to financial theft, and they have significant implications in our increasingly connected world. - read more
Cyber threats refer to malicious acts that seek to damage data, steal information, or disrupt digital operations. These threats can come in various forms, such as malware, phishing attacks, ransomware, and more. - read more
Cybersecurity incidents are a growing concern for small businesses. These incidents can have disastrous consequences on the affected businesses and their customers. Cyber insurance policies provide a form of financial protection for small businesses in the event of a cyber-attack. This article will provide an overview of cyber insurance claims and its importance for small business owners. - read more
In today's rapidly evolving cyber landscape, Australian businesses must prioritize data security more than ever before. As companies continue to digitize operations and store sensitive data electronically, the need for robust cybersecurity measures has become paramount. This introduction lays the foundation for understanding the criticality of protecting your company's most valuable asset—its data. - read more
Knowledgebase
Insurance: In law and economics, insurance is a form of risk management primarily used to hedge against the risk of potential financial loss.
