Insurer Penalized for Mishandling Storm Damage Claim

1

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.

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.

Published:Thursday, 23rd Jan 2025
Source: Paige Estritori

Please Note: If this information affects you, seek advice from a licensed professional.

Share this news item:

Insurance News

Clear

NSW Introduces Strata Law Reforms to Strengthen Community Governance

19 Nov 2025: Paige Estritori

On 27 October 2025, the New South Wales (NSW) Government implemented significant reforms to strata laws, aiming to enhance transparency, accountability, and financial management within strata schemes. These changes are designed to better meet the evolving needs of strata communities across the state. - read more

Strata Insurance Affordability Holds Steady Despite Rising House Insurance Costs

19 Nov 2025: Paige Estritori

In its 2025 State of the Strata Market report, CHU has revealed that strata insurance premiums have experienced a modest increase of 2.8%, rising to an average of $981 per lot in the year leading up to June 2025. This increment is notably lower than the 14% surge observed in house insurance premiums during the same period. - read more

Consumer Advocates Push for Ban on Strata Insurance Commissions in NSW

19 Nov 2025: Paige Estritori

Consumer advocacy groups, including the Australian Consumers Insurance Lobby (ACIL) and the Owners Corporation Network (OCN), are urging the New South Wales (NSW) Government to implement a ban on commissions related to strata insurance. They argue that such commissions create conflicts of interest and compromise transparency within the strata management sector. - read more

Sure Insurance Boosts Strata Coverage to $20 Million

11 Nov 2025: Paige Estritori

In a significant move to address the longstanding issue of insurance affordability in Northern and Regional Queensland, Sure Insurance has announced an increase in its residential strata insurance coverage from $5 million to $20 million. This strategic enhancement aims to provide body corporates and lot owners with more competitive premium options and improved access to essential insurance services. - read more

CHU's 2025 Report Shows Stability in Strata Insurance Premiums Amid Climate and Regulatory Shifts

11 Nov 2025: Paige Estritori

CHU has released its 2025 State of the Strata Market report, providing a comprehensive analysis of the current state of the industry. The report offers valuable insights into premium movements, the impact of weather events, regulatory developments, and emerging risks affecting strata insurance. - read more

Click for more Insurance News