This page provides information about the process the Australian Financial Complaints Authority (AFCA) follows when we resolve a complaint. We have a range of methods to resolve complaints. We select the method, or combination of methods, that we think is most likely to resolve the complaint fairly and efficiently.
We try to resolve complaints in the most fair, effective and efficient way possible. We will generally try to first resolve a complaint by informal methods, and reach a settlement between you and the financial firm through negotiation or conciliation.
If this doesn’t work, we may then use more formal methods, where we may provide a preliminary assessment about the merits of your complaint, or we may make a decision (called a determination). If we make a determination that is in your favour and you accept it, the financial firm is required to comply with the determination and any remedy that we award. For superannuation complaints, any determination that we make is binding on both parties.
Sometimes, it may be appropriate for us to make a decision straight away, rather than try and reach a settlement through negotiation or conciliation.
When considering the appropriate methods to resolve a complaint, we will take into account:
- the nature of the issues raised in the complaint
- the parties to the complaint, their circumstances and the nature of their relationship
- how we can resolve the complaint in a fair, cooperative, efficient and timely manner.
We will tell you and the financial firm about our proposed approach to resolving a complaint, to ensure you understand what is involved.
Examples of complaints AFCA may refer directly to determination include:
- complaints that need to be finalised urgently. For example, because the complainant is experiencing financial hardship
- where the complainant has suffered a natural disaster such as flood or bushfire
- a low-value claim where the complainant suffers from a serious medical condition or is a victim of family violence
- a high-value claim, where a prolonged period may see the claim amount exceed our monetary limits.
Find out about our approach to complaints that involve financial difficulty
Time limits to make a complaint to AFCA
For most complaints, we will generally only be able to consider it if you make your complaint:
- within six years after you first became aware, or ‘should reasonably have become aware’, that you suffered the loss you want to complain about; or
- if you have already complained directly to your financial firm through its internal dispute resolution (IDR) process, then you need to complain to us within two years of getting an IDR response from your financial firm.
We may extend the time limits to make certain types of complaints if we think there are special circumstances.
See section B.4 of our Operational Guidelines for the specific time limits relating to Superannuation and National Credit Code contract variation complaints.
Informal methods to resolve complaints
Often we will work to resolve a complaint with the parties by helping them negotiate a settlement. This may involve us exchanging settlement offers and discussing them with each party. To assist negotiations, we may provide guidance about the type of outcome that might occur through AFCA if a settlement is not negotiated and the complaint proceeds to determination.
Sometimes we will hold a telephone conciliation conference with both parties. This is conducted informally. It provides the parties with a chance to hear the other’s perspective in a conversation facilitated by us. During a conciliation we will normally provide the parties with guidance on the issues raised in the complaint and what outcome might be provided if the complaint proceeded to Determination.
If negotiations or a conciliation conference do not achieve an agreed settlement, we will decide the complaint.
Formal methods to resolve complaints
If informal methods to resolve a complaint don’t work, or there is a reason to progress the matter without conducting any negotiations or conciliation with the parties, we will make a decision on the merits of the complaint (also referred to as a determination).
Often we will provide the parties with a preliminary assessment before making a binding decision. Sometimes, however, we proceed very quickly to make a binding decision.
We may provide a preliminary assessment verbally or in writing.
A preliminary assessment includes:
- an overview of the facts of the complaint
- the issues raised in the complaint and our preliminary assessment of those issues
- how we think the complaint should be resolved and why
- when the parties must tell us whether they are willing to settle the complaint in line with our preliminary assessment.
Typically, we will give the parties seven days (for fast track complaints) or 30 days (for other complaints) to tell us whether they are willing to settle a complaint based on the preliminary assessment we have provided or, alternatively, whether they want the complaint to proceed to a determination.
Determination (a binding decision)
A determination is the final stage in our complaint resolution process. For complaints not relating to superannuation and a regulated superannuation fund, you may choose to accept the decision we make, or not. Other than by reference to the courts, it is not possible to appeal a determination.
When determining a complaint, the AFCA decision maker must do what is fair in all the circumstances, and take into account:
- legal principles
- applicable industry codes or guidance
- good industry practice
- previous relevant determinations of AFCA or predecessor schemes.
There are different decision-making requirements for superannuation complaints. Please refer to our Operational Guidelines for more information about this. In summary though, when determining a superannuation complaint, the AFCA decision maker must consider whether the original decision made by a trustee, insurer, RSE provider or other person was fair and reasonable in all the circumstances. If we are satisfied that the trustee’s decision was fair and reasonable in relation to the complainant (and, in the case of a decision about payment of a death benefit, all joined parties) in the circumstances, we must affirm the original decision.
A determination will be made in writing, and will outline the reasons for the decision. Any remedy that we award, whether it be monetary compensation or some other remedy will also be included. The financial firm is required to comply with our decision, if you choose to accept it.
The determination will set out:
- the relevant factual information available at the time of making the determination
- the relevant issues arising in the complaint and our analysis of those issues
- our decision as to how the complaint should be resolved and why, including a particular remedy (if any) to be provided to the complainant.
If you accept our determination, the financial firm must provide any remedy in the determination within the timeframe we have stated. Determinations for superannuation complaints, however, normally come into effect immediately once they are made, and do not require you to accept the determination.
If a financial firm does not comply with a determination, we are required to report this to ASIC.
For non-superannuation complaints, if you choose not to accept our determination, you have a right to pursue your claim against the financial firm through the courts. If you accept the determination the complaint will normally resolve on the basis set out in the determination, but if for some reason you become dissatisfied with this outcome and wish to take your matter to another forum, you should seek legal advice.
Closing or withdrawing a complaint
We may decide that it is not appropriate to continue considering your complaint. This could be because you haven’t suffered a loss, or you have already been appropriately compensated or the financial firm hasn’t committed an error.
We will not exercise our discretion to exclude a complaint lightly. It will only be used in cases where there are compelling reasons for deciding that we should not consider or further consider a complaint.
If we decide to close your complaint, we will inform you and the financial firm in writing with reasons. You are able to object if we advise that we have exercised our discretion to not further consider your complaint. If you object, we will formally review and consider your objection.
You may, at any stage, tell us that you do not want to continue with your complaint.
We may also conclude that you want to withdraw your complaint if you fail to respond to us when we ask you to contact us and provide information.
In either case, we are unlikely to re-open a complaint unless special circumstances warrant further consideration of the complaint.
Note: This text is reproduced, based or adapted from AFCA's Operational Guidelines.