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.
Fresh industry attention on insurance affordability in northern Australia has reinforced a message many strata communities already understand: premium relief is not delivered by a single reform, even where government-backed risk sharing is in place. For apartment buildings, townhouse complexes and mixed-use strata schemes exposed to cyclone, storm surge, flood or severe rainfall, insurers are still looking closely at the physical characteristics of each building before deciding price, excesses and available cover. - read more
The agenda for the 2026 AFR Insurance Summit points to an insurance sector that is increasingly focused on affordability, technology, trust and operational resilience. While much of the summit is framed around the broader insurance market, the themes are highly relevant for employers, CFOs and directors reviewing corporate life insurance, group salary continuance, key person cover and executive protection arrangements. - read more
Fresh complaint trends across the Australian insurance market are another reminder that the real test of any policy often comes after something has gone wrong. While many disputes involve household cover, the same pressure points can affect tradies who rely on tools, vehicles, plant, public liability cover and income protection to keep work moving. - read more
The review of Australia’s Life Insurance Code of Practice has moved from a broad governance discussion into a more practical question for households: what should good insurer behaviour look like when people apply for cover, update a policy or make a claim? - read more
Australia’s financial advice reform agenda has moved from broad policy debate into the more practical question of how advice will be delivered, documented and accessed. For business owners, this matters because life insurance decisions are rarely isolated personal choices. They often intersect with debt facilities, director guarantees, shareholder agreements, succession plans and family wealth protection. - read more
Hiring plant or equipment can help Australian contractors stay flexible, but insurance responsibilities are not always straightforward. This guide explains how dry hire, wet hire, hired-in plant cover, damage waivers and hire agreement terms can affect who is responsible for loss, damage, theft, liability and downtime. - read more
Plant and equipment insurance is a specialized form of coverage designed to protect the tools and machinery that businesses rely on for their operations. This type of insurance typically covers various assets, including construction machinery, agricultural equipment, and industrial tools. By safeguarding these critical assets, you can ensure that your business continues to run smoothly even in the event of loss or damage. - read more
Plant and equipment insurance claims generally involve securing the site, gathering evidence, notifying the insurer, assessing the loss and agreeing on repair, replacement or settlement options. The exact process depends on the policy wording, the insured event and the insurer's claims criteria. - read more
Mobile plant can face different insurance and regulatory issues when it is transported between worksites or operated on or near public roads. Businesses should understand how plant insurance, transit cover, registration, CTP and liability policies may interact. - read more
In the bustling world of business, safeguarding your assets is crucial. This is especially true for industries reliant on machinery and equipment. One essential type of coverage for such businesses is plant and equipment insurance. It provides financial protection against risks associated with the loss or damage of your essential tools. - read more
Knowledgebase
Aggregate Limit: The maximum amount an insurer will pay for all covered losses during a policy period.
No comments yet. Be the first to share your thoughts.