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 government has approved a 4.41% increase in health insurance premiums, set to take effect in 2026. This adjustment reflects the rising costs associated with healthcare services and the need to maintain the sustainability of the health insurance sector. - read more
The Australian insurance sector is currently grappling with significant challenges, notably the affordability of premiums for consumers. A recent survey by Gallagher Bassett highlights that premium affordability, cybersecurity, and labour shortages are the top concerns for insurers in 2026. ([insurancenews.com.au](https://www.insurancenews.com.au/daily/industry-reshapes-priorities-amid-price-cost-pressures?utm_source=openai)) - read more
The Australian commercial insurance market is witnessing a notable decline in rates, driven by intensified competition and an increase in insurer capacity. According to reports from global brokers Marsh and Aon, the Pacific region experienced a 12% reduction in commercial insurance rates during the last quarter of 2025, marking the most significant drop since early 2024. ([insurancenews.com.au](https://www.insurancenews.com.au/local/commercial-pricing-tipped-to-stay-soft?utm_source=openai)) - read more
The Australian insurance industry has recently faced a substantial decline in profits, primarily due to a series of severe hailstorms that occurred in October and November 2025. Data from the Australian Prudential Regulation Authority (APRA) reveals that the general insurance sector reported a net profit of $132 million in the December quarter, bringing the annual total to approximately $5.8 billion. This marks a decrease from the $6.8 billion profit recorded in 2024. ([insurancenews.com.au](https://www.insurancenews.com.au/local/industry-profit-sinks-as-hail-hits-home?utm_source=openai)) - read more
Registered building practitioners in New South Wales are facing a critical deadline to secure professional indemnity (PI) insurance by July 1, 2026, in accordance with the Design and Building Practitioners Act 2021. This legislation, which originally set a 2025 enforcement date, has been extended by 12 months to allow the industry additional time for preparation. - read more
In the digital age, Australian small businesses find themselves navigating a world where online presence isn't just an advantage, it’s a necessity. With this increased online activity comes heightened vulnerability to cyber threats, making the protection of digital assets an urgent priority. - 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
Data breaches have become a significant concern for businesses in today's digital landscape. Simply put, a data breach occurs when sensitive, protected, or confidential information is accessed, disclosed, or used without authorization. The implications of such breaches can be far-reaching, affecting not just financial health but also the reputation of businesses and the security of individuals involved. - read more
In today's rapidly evolving digital landscape, Australian businesses face an ever-increasing array of cyber threats. From sophisticated phishing schemes to ransomware attacks, these dangers lurk in the virtual shadows, often going unnoticed until it's too late. Recognizing and understanding these cyber risks is not just important; it's crucial for the sustainability and success of any modern enterprise. - read more
In an age where digital presence intertwines with daily operations, the threat landscape in Australia has magnified, exposing businesses to an evolving array of cyber threats. From sophisticated phishing attempts to ransomware attacks, the risk of digital insecurity looms large. Australia, with its growing technological adoption, finds itself facing an upsurge in cyber threat incidents year over year. - read more
Knowledgebase
Coinsurance: A percentage of the cost of a covered healthcare service that you pay after you have paid your deductible.
