A year since Cyclone Seroja hit regions in Western Australia, complaints to the Australian Financial Complaints Authority (AFCA) have resulted in payments to consumers of just over $500,000.
Tropical Cyclone Seroja was declared a catastrophe on 14 April 2021 by the Insurance Council of Australia (ICA). As at 14 April 2022, AFCA had received 25 complaints about Cyclone Seroja, with 16 closed and 9 in progress. AFCA data shows the top 3 issues are:
- the claim amount (8 complaints)
- delay in claim handling (6 complaints)
- denial of claim because of an exclusion or condition (6 complaints).
Most complaints related to home building (19), with 2 complaints about home and contents insurance and 2 in relation to commercial property. There was one complaint each about livestock and personal transaction accounts. All complaints related to insurers with the exception of one complaint in relation to a bank.
Some 75 per cent of complaints were resolved by agreement between the firm and complainant or in favour of the complainant. That resulted in full compensation in 43 per cent of cases and partial compensation in 57 per cent of cases. Nearly 60 per cent of cases were resolved with AFCA’s help in under two months.
AFCA's Lead Ombudsman for Insurance, Emma Curtis, said people who may be considering lodging a complaint with AFCA should take some time to prepare. "First, think about what type of loss you’ve experienced and what sort of outcome you want to achieve. Then gather key documents, so you have them ready to support your complaint - for example, any photos, reports and other information that you have supporting your case.”
"We encourage people to work with their insurers, but we’re here to help if we’re needed," Ms Curtis said.
She noted that people affected by Cyclone Seroja, or any other natural disaster, do not have to pay someone to represent them at AFCA. "AFCA’s process is free and it’s designed to be accessible by the ordinary person. That said, if you would prefer to have someone help – whether that’s a family member, a financial counsellor or someone else – that’s fine too."
Registering a complaint with AFCA
- AFCA offers free and accessible dispute resolution for individuals and small businesses.
- Policyholders who disagree with the outcome of an insurance claim, for example, should first seek resolution through their insurer’s internal dispute resolution process, making a formal complaint to their insurer in writing (including by email), over the phone or in person.
- Insurers have 30 days to try to resolve a formal complaint once it’s lodged.
- If the policyholder doesn’t agree with the outcome of that internal complaint process they can then register a complaint with AFCA, using our online form at afca.org.au or by calling 1800 931 678.
- AFCA will help the parties try to reach agreement, but if no agreement is reached it can issue decisions that are binding on financial firms if accepted by the complainant.
- Consumers should tell AFCA they have been affected by a natural disaster such as Tropical Cyclone Seroja when making a complaint.
- The General Insurance Code of Practice provides a ‘cooling off’ period for claims arising from a catastrophe or natural disaster.
- If your insurer has signed up to the General Insurance Code of Practice and it finalises your claim within one month of a natural catastrophe or disaster, you have a 12-month cooling off period to check whether your claim included everything that was lost or damaged. This review period is available to you even if you signed a release when your claim was finalised.
- If you think the assessment of your loss was not complete or accurate, contact your insurer and ask it to review your claim.
- Some insurers also have guidelines which allow a review of your claim arising from a natural disaster at any time after finalisation.
- AFCA has a dedicated page on our website with information for people who have been affected by Cyclone Seroja.
- The Insurance Council of Australia also has this page on its website.
Published: 20 April 2022
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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.