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 insurance industry is currently facing an unprecedented surge in consumer complaints, primarily due to delays in processing claims. This development underscores significant challenges within the sector, particularly affecting tradespeople and small business owners who depend on timely claim resolutions to maintain their operations. - read more
The Australian insurance industry has undergone significant consolidation in recent years, leading to concerns about reduced competition and its potential impact on consumers, particularly tradespeople and small business owners who rely on diverse and competitive insurance options. - read more
The Australian Senate has recently passed legislation that prohibits life insurers from using genetic test results in their underwriting processes. This landmark decision aims to protect consumers from potential discrimination based on their genetic information and to ensure fairness in the assessment of life insurance policies. - read more
In response to global supply chain disruptions affecting fertiliser availability, the Australian government has partnered with chemical companies CSBP and Incitec Pivot to ensure a steady supply for the nation's farmers. This initiative comes amid challenges posed by the closure of the Strait of Hormuz, a critical passage for global trade, which has led to increased prices and uncertainty in the fertiliser market. - read more
In a strategic move to bolster agricultural insurance offerings, IAG's Intermediated Insurance Australia business, encompassing the CGU and WFI Insurance brands, has announced an exclusive partnership with Ag Guard, a technology-driven agricultural insurance agency. This collaboration, set to commence in June 2026, aims to enhance risk selection processes and claims handling capabilities. - read more
In today's digital age, understanding the cyber threat landscape in Australia is not just important—it's essential. Cyber attacks are becoming more sophisticated and are affecting businesses and individuals at an alarming rate. Common types of cyber attacks include phishing, ransomware, and data breaches, each with the potential to cause significant harm. The impact of cybersecurity breaches on both the economy and the reputation of affected entities is profound, ranging from financial loss to long-lasting reputational damage. - read more
In today's digital age, cyber security has become a critical aspect for small businesses in Australia. As more operations move online, the potential for cyber threats increases. Small businesses are particularly vulnerable, making it essential to understand and address these risks proactively. - read more
In today's digital age, the rising importance of cybersecurity for small businesses in Australia cannot be overstated. As technology permeates every aspect of business operations, it offers tremendous advantages but also exposes small businesses to a growing array of cyber threats. These threats are increasingly targeting small companies, seeking to exploit vulnerabilities and potentially cause significant financial and reputational damage. - read more
As we dive deeper into the digital era, the topic of cyber security becomes increasingly critical. With businesses and individuals relying heavily on digital technologies, the threat of cyber attacks looms larger than ever. This introductory section aims to unpack the concept of cyber insurance as a tool to mitigate these risks. - read more
Cyber risk management involves identifying, assessing, and prioritizing potential risks to an organization's digital assets and implementing measures to mitigate these threats. - read more
Knowledgebase
Insurance Claim: Notification to an insurance company requesting payment of an amount due under the terms of the policy.
