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.
The Australian Competition and Consumer Commission (ACCC) has expressed significant concerns regarding the proposed acquisition of the Royal Automobile Club of Western Australia's (RACWA) insurance operations by Insurance Australia Group (IAG). The watchdog warns that this transaction could substantially lessen competition in Western Australia's insurance market, potentially leading to higher premiums and reduced options for consumers. - read more
NEOS has recently announced significant enhancements to its income protection offerings, effective from 11 March 2026. Responding to adviser feedback, the insurer has increased the maximum coverage available without mandatory medical examinations, aiming to simplify the application process for Australians seeking income protection insurance. - read more
Acenda Life has recently implemented a series of updates to its Retail Life Insurance portfolio, effective from 11 April 2026. These changes are designed to provide greater flexibility and accessibility for Australians seeking income protection insurance, addressing common concerns about policy limitations and entry age restrictions. - read more
The Australian Financial Complaints Authority (AFCA) has recently ruled in favour of Nippon Life Insurance in a dispute concerning the application of an offset clause in an income protection (IP) claim. This decision underscores the critical importance of policyholders understanding the specific terms and conditions of their insurance policies. - read more
The Australian Superyacht, Marine Export and Commercial Marine Conference (ASMEX) is set to return to the Gold Coast on 19-20 May 2026, offering a pivotal platform for industry professionals to connect, share insights, and celebrate achievements. Hosted at The Langham Gold Coast, this year's conference introduces a refined format designed to cater to all sectors of the marine industry. - read more
Cyber Insurance is a type of insurance policy that protects businesses against internet-based risks and threats. This policy covers damages and losses caused by cyber attacks, such as theft of customer information, network downtime, and damage to reputation. - 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
In today's digital age, businesses are increasingly becoming more vulnerable to online threats. Cyber attacks are not just limited to large corporations. Small businesses are also at risk and can suffer severe financial losses due to cyber threats. It is essential for small businesses to invest in cyber insurance. Cyber insurance offers protection against online threats, providing financial assistance if a company experiences a data breach, cyber attack, or other forms of cybercrime. - read more
Cyber insurance is one of the most valuable business covers available today, but it is also one of the most confusing to apply for. Many business owners expect it to work like other insurance types, where you provide basic details such as turnover, industry, and location, then receive a quote. Cyber insurance is different. It behaves less like a simple application and more like a risk interview. - read more
Cyber risk management involves identifying, assessing, and mitigating risks related to digital and online threats. These threats can include unauthorized access to sensitive information, data breaches, and other malicious activities targeting an organization’s digital infrastructure. - read more
Knowledgebase
Disability Insurance: A type of insurance protection that pays a portion of a person's income lost due to a total or partial disablement arising from either an accident or a sickness.
