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.
Australia's Compensation Scheme of Last Resort (CSLR) is facing significant pressure due to a surge in claims linked to failed financial products. This uptick has led the Insurance Council of Australia (ICA) to call for structural reforms to ensure the scheme's sustainability. - read more
Australia's financial services sector is currently experiencing a notable increase in professional indemnity (PI) claims, driven by intensified regulatory scrutiny and recent legal actions. This trend has significant implications for professionals and insurers operating within the industry. - read more
Effective 1 July 2026, all registered building practitioners in New South Wales (NSW) will be mandated to hold professional indemnity (PI) insurance, as stipulated by the Design and Building Practitioners Act 2020. This legislative change aims to enhance accountability and protect clients from potential financial losses due to professional negligence or defects in construction work. - read more
In a significant development for New South Wales' housing sector, Productivity Commissioner Peter Achterstraat has called for the prompt elimination of commissions received by strata managers. This recommendation aims to bolster transparency and affordability within the state's burgeoning strata housing market. - read more
In its recently released 2025 State of the Strata Market report, CHU, Australia's leading strata insurance underwriting agency, provides an insightful analysis of the current landscape of strata insurance. The report underscores a notable stability in strata insurance premiums, which have seen a modest increase of 2.8% over the past year, rising from $954 to $981 per lot annually. This increment is significantly lower than the 14% surge observed in house insurance premiums during the same period. - 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
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
Remote work has seen a significant rise in Australia, especially following the COVID-19 pandemic. More businesses are embracing flexibility, allowing employees to work from home or other remote locations. - read more
As the digital economy flourishes, Australian businesses are enjoying the fruits of their own cyber-infrastructure but are also becoming increasingly susceptible to cyber threats. The era of the internet has ushered in a wave of new opportunities, yet it also demands vigilance in the face of growing cyber risks. With cyberattacks becoming more sophisticated and frequent, the imperative for robust cyber security measures has never been more pronounced. - read more
Cybersecurity refers to the measures and practices put in place to protect digital information and systems from attacks, unauthorized access, damage, and disruption. - read more
Knowledgebase
Insurance Claim: Notification to an insurance company requesting payment of an amount due under the terms of the policy.
