Insurer Penalized for Mishandling Storm Damage Claim

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
Author: Paige Estritori
Sources

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

Share this news item:

Insurance News

Clear

CGU and WFI Collaborate with Ag Guard to Boost Farm Insurance Services

14 Mar 2026: Paige Estritori

In a significant development for Australia's agricultural sector, CGU and WFI Insurance have announced an exclusive partnership with Ag Guard, a technology-driven agricultural insurance agency. This collaboration, set to commence in June 2026, aims to bolster the agricultural insurance capabilities of both insurers and enhance digital services for brokers, partners, and customers. - read more

Insurance Council Declares Significant Events for Northern Territory and Queensland Floods

14 Mar 2026: Paige Estritori

The Insurance Council of Australia (ICA) has declared two Significant Events in response to the severe rainfall and flooding that have recently impacted the Northern Territory and Queensland. This declaration pertains to the flooding in Katherine and surrounding regions in the Northern Territory, as well as the Bundaberg region and Burnett River catchment in Queensland. - read more

Insurance Council Advocates for Climate Resilience Investment on Cyclone Alfred Anniversary

14 Mar 2026: Paige Estritori

Marking one year since Tropical Cyclone Alfred caused $1.5 billion in insured damages and an estimated $2.7 billion in total economic losses, the Insurance Council of Australia (ICA) has renewed its call for urgent investment in climate resilience. The ICA emphasises the need for proactive measures to mitigate the impact of extreme weather events, which are becoming more frequent and severe due to climate change. - read more

Summer Surge in Rural Crime: Protecting Australian Farms

06 Mar 2026: Paige Estritori

WFI Insurance has reported a significant increase in rural crime during the summer months, with January experiencing approximately 14% more crime-related insurance claims than any other month. This trend underscores the need for heightened vigilance and enhanced security measures on Australian farms during this period. - read more

Achmea Australia's Comprehensive Flood Cover: A Game-Changer for Farmers

06 Mar 2026: Paige Estritori

In a significant development for Australian farmers, Achmea Australia has announced that flood cover is built into its farm insurance policies. This offering addresses a critical gap in the market, as many leading underwriters have traditionally excluded flood coverage from their farm policies. - read more

NRMA's Departure from Farm Insurance: Implications and Alternatives for Australian Farmers

26 Feb 2026: Paige Estritori

In a significant shift within the Australian insurance landscape, NRMA Insurance ceased offering farm insurance policies, including Hobby Farm and Rural Farm Insurance, as of July 1, 2025. This decision has left many farmers seeking reliable alternatives to safeguard their livelihoods. - read more

Click for more Insurance News