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Insurance cases to the fore in ‘busy’ start for AFCA

Disputes with general insurers accounted for 22% of the 23,681 cases the Australian Financial Complaints Authority (AFCA) received in the four months from its launch last November.

General insurance was the second-biggest complaints category behind credit, which topped the list at 44%.

The external dispute resolution body plans to expand its staff in anticipation of more complaints following the Hayne royal commission.

“It’s been a really busy first four months here at AFCA,” CEO and Chief Ombudsman David Locke said. “Since opening our doors… we have received many more calls and complaints than the three predecessor schemes combined over the same period the previous year.

“We’re expecting to be even busier… and we are recruiting for more staff to investigate and fairly resolve complaints as quickly and efficiently as possible.”

Claims handling delay was the main source of disputes, with 910 complaints received in the four months, followed by claim amounts on 832, denial of claim linked to exclusion or condition on 815, denial of claim at 695 and service quality on 258.

AFCA says disputes over “incorrect premium application” fall within its jurisdiction after ruling in favour of a consumer who fought a 39% spike in home and contents rates.

Insurers have the right to assess and set premiums under AFCA’s rules, but they must also demonstrate the process has been conducted “fairly and consistently”.

“As this complaint concerned the method by which the insurer set the premium and not the process of renewal, we accepted it as being within [our] jurisdiction,” AFCA says.

The insurer was ordered to cut its flood premium increase at renewal by 50%.