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.
A federal parliamentary inquiry into small business insurance has pushed back its reporting date from 27 October 2026 to 26 February 2027, extending the wait for recommendations on issues that directly affect many Australian trade businesses. The inquiry is examining the provision, regulation and pricing of modern insurance products for small businesses and not-for-profits, including public liability, professional indemnity, cyber cover and business interruption. - read more
A federal parliamentary inquiry into small business insurance has reportedly pushed back its final report from 27 October 2026 to 26 February 2027, extending the wait for recommendations on insurance affordability, availability and regulation. For Australian tradies and small trade businesses, the delay matters because the inquiry is examining the types of cover many operators rely on daily, including public liability, professional indemnity, cyber risk and business interruption insurance. - read more
A new Insurance Brokers Code of Practice has been launched by the National Insurance Brokers Association, putting clearer disclosure, renewal contact and client support standards on the agenda for Australian businesses that use brokers to arrange cover. The 2027 Code takes effect on 1 January 2027 and is designed to set out, in plainer language, what clients should be able to expect from subscribing insurance brokers. - read more
The Australian Financial Complaints Authoritys latest annual review has put income protection insurance back in focus, with the product again attracting the highest number of life insurance complaints in 2025-26. The figures are a useful reminder that the real value of cover is tested not at purchase, but when illness or injury interrupts a persons capacity to earn. - read more
A recent Australian Financial Complaints Authority determination involving a flooded farmhouse has put claims handling back under the microscope for rural policyholders, after the insurer was ordered to pay almost $432,000 across building repairs, additional temporary accommodation, professional costs and compensation for non-financial loss. The decision, dated 27 August 2026 and reported by Insurance News on 15 October 2026, is a useful reminder that the practical aftermath of a farm flood can extend well beyond the first clean-up. - 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
Australian businesses that experience a data breach may need to assess whether the Notifiable Data Breaches scheme applies, notify the OAIC and affected individuals, report cybercrime through ReportCyber, and carefully document their response. This guide explains the key notification and reporting steps in general terms, and how cyber insurance may support breach response planning. - 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
Cyber insurance is a type of insurance designed to protect businesses from internet-based risks and, more generally, from risks relating to information technology infrastructure and activities. It covers losses related to data breaches, cyber extortion, and other kinds of cyber attacks. - read more
Knowledgebase
Insurable Interest: A financial or other kind of interest in the insured item or person, necessary for a valid insurance contract.
No comments yet. Be the first to share your thoughts.