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Insurance disputes dominate Seroja complaints: AFCA

The Australian Financial Complaints Authority (AFCA) says insurance tops the list of 25 disputes it has received so far from Cyclone Seroja and more than $500,000 have been awarded to date, a year after the storm struck the WA mid-west region.

With the exception of one complaint against a bank, the rest of the disputes are all related to insurers and the main issues are claim amount, delay in claim handling and denial of claim because of an exclusion or condition.

Eight of the insurance disputes were about claim amount and there were six each for claim handling and denial of claim.

Most of the insurance complaints relate to home building – 19 in all – with two about home and contents cover and two in relation to commercial property. There was one complaint each about livestock and personal transaction accounts.

AFCA says 16 of the 25 cases have been closed and nine are still in progress.

The ombudsman says 75% of the complaints were resolved by agreement between the firm and complainant or in favour of the complainant, resulting in full compensation in 43% of cases and partial compensation in 57% of cases.

“We encourage people to work with their insurers, but we’re here to help if we’re needed,” Lead Ombudsman for Insurance Emma Curtis said.

She urged those who are thinking of lodging a complaint to take some time to prepare their case.

“First, think about what type of loss you’ve experienced and what sort of outcome you want to achieve,” Ms Curtis said.

“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.”

Last month the Insurance Council of Australia (ICA) and its insurer members visited WA communities affected by the cyclone, meeting with policyholders who needed assistance with their claims.

ICA data shows the insurance industry has paid out about $351 million from some 9300 claims that have been lodged.