Insurance Claim Help
Claim Help pages are designed for people who are no longer choosing a policy and are now dealing with a live problem. That may be a delay, denial, underpayment, communication breakdown or dispute about evidence, causation, scope of repair or policy interpretation.
Overview
Claim Help pages are designed for people who are no longer choosing a policy and are now dealing with a live problem. That may be a delay, denial, underpayment, communication breakdown or dispute about evidence, causation, scope of repair or policy interpretation.
Claims, complaints and dispute handling
A strong insurance file is chronological, specific and evidence backed. That means recording the date of the event, the date you notified the insurer, every request for information, every document provided and every reason the insurer gave for its position. In Australia, insurance complaints generally start with the insurer's internal dispute resolution process. If the matter is not resolved, AFCA may be available for eligible complaints. If the insurer has rejected all or part of a home insurance claim, For denied home insurance claims, Moneysmart says the insurer must explain in writing what part of the claim was not accepted, why, your right to ask for copies of reports relied on, and how to complain. If you ask for those reports, the insurer must send them within 10 business days. Even outside home insurance, asking for the reasoning, the relied on policy wording and any expert reports often clarifies whether the issue is genuinely about cover, evidence, valuation or process.
How to use this page effectively
Use this page to narrow the issue before you act. Identify whether your problem is selection, renewal, claim lodgement, claim delay, denial, underpayment, complaint handling or comparison. Once you know that, gather the relevant policy wording and supporting documents, keep your timeline straight and move to the more specific sub pages linked below. That usually produces a faster and cleaner result than trying to solve every insurance question at once.
Common questions
What should I do first if a claim is delayed or denied?
Start by asking the insurer for its reasons in writing, confirm exactly what information is outstanding, gather the supporting documents and then use the insurer's internal dispute resolution process if the issue remains unresolved.
Can AFCA deal with insurance complaints?
AFCA can consider many eligible insurance complaints after the insurer's internal process has been used. Eligibility depends on the product, issue and complaint type.
What documents usually matter most?
The most useful documents are the policy schedule, PDS, claim correspondence, photos, invoices, quotes, expert reports, incident records and any reasons letter from the insurer.