If you're a consumer or small business and have insurance issues, you can lodge a complaint with us if you are not satisfied with the progress or outcome of the insurance claim. Our service is free for all consumers and small businesses.  

Issues may relate to the decline of your claim, the amount your insurer is agreeing to pay, disagreements as to the works required, delays and service issues.

Things AFCA may ask:

1. Did you receive a Certificate of insurance and Product Disclosure Statement?
2. What does the policy specifically cover?
   1. Does the policy cover flood, storm, accidental damage?
3. Does the policy cover water escaping a pipe or blocked drain?
4. How did the damage occur?
   1. What time did the inundation first occur?
   2. what time was the most intense rainfall?
   3. Was there storm water runoff before the flood?
   4. Was there damage from water entering through the roof or due to storm water runoff?
5. Do you have access to hydrology reports?
   1. do the hydrology reports address stormwater runoff before the flood inundation?
   2. was anyone on site at the time of the loss – are there any witness statements, photos or videos?
   3. what is the height of the floor level of the building? Is the floor level above the surrounding ground?
   4. are there inconsistencies in the report or between different reports?
   5. do the reports include the insured’s version of when the property was inundated?
   6. are there any obvious errors in the reports? i.e. does the location of the insured property match up with the report’s findings.
6. How was the policy arranged?
   1. Was it through a broker?
   2. Was it through an agent?
   3. Was it arranged directly with the insurer?
   4. Was it arranged in person, online or over the phone?    
   5. Did you discuss flood cover when arranging the policy?
   6. Did you ask for flood cover or ask for flood cover?
   7. Did you read the product disclosure statement and certificate of insurance (the documents sent out after arranging the policy or when it is renewed)?
7. What is the loss/damage your small business has suffered?
   1. building damage?
   2. contents?
   3. business stock?
   4. business interruption

Published: 5 February 2019

Media enquiries media@afca.org.au

About AFCA

The Australian Financial Complaints Authority (AFCA) is a non-government ombudsman service providing free, fair and independent help with financial disputes. It is a one-stop-shop for consumers and small businesses who have a dispute with their financial firm, over things such as banking, credit, insurance, advice, investments or superannuation. Where an agreement cannot be reached between parties, AFCA can issue decisions that are binding on financial firms.