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If you have an issue with any aspect in how your insurance claim has been handled, you should lodge a complaint via their internal Dispute Resolution Process. If you are still dissatisfied with the outcome, you can seek the assistance of The Australia Financial Complaints Authority (AFCA).

AFCA is a free, fair and independent dispute resolution scheme. They consider complaints about financial products and services. AFCA’s service is offered as an alternative to tribunals and courts to resolve complaints consumers and small businesses have with their financial firm. They are impartial and independent. They do not act for either party to advocate their position. If a complaint does not resolve between the parties, they will decide on an appropriate outcome.

Click on this link for the dispute process and more information www.afca.org.au

Issues and problems you can complain about:
  • Insurance premiums that were incorrectly applied or calculated.
  • Information that wasn't disclosed about a product or was misleading or incorrect.
  • Decisions your financial firm has made, such as denial of an insurance claim, the value of an assessed loss, or delays in making a decision.
  • If you have instructions and they weren't followed.
  • Privacy and confidentiality breaches.
  • Where you dispute liability for a car accident or insurance excess.
Types of complaints AFCA can consider about insurance policies

You may wish to complain about several issues arising from your insurance policy, including:

  • Advice that was not provided to you, or that you received about the insurance policy that may have been inappropriate or misleading.
  • Premiums that were incorrectly charged. We can also consider complaints about the incorrect application of a no claim bonus by an insurer or a broker - for example, if the insurer reduced or removed a no claim bonus discount due to an at fault claim, or the broker did not obtain a no claim bonus for you when you were entitled to one.
  • Disclosures that the financial firm didn’t make such as incorrect, insufficient or misleading information about costs of fees, or about the product they provided to you.
  • Denial of you claim based on non-disclosure of a pre-existing condition or exclusion; driving under the influence; where loss or damage occurred as a result of a breach of the insurance policy or an excluded event (such as flood where flood is excluded); where the claim is alleged to be false or fraudulent; where the policy is claimed to be lapsed or cancelled; where you have been unable to prove that the loss has occurred or that the goods damaged or lost were yours.
  • Instructions you gave the financial firm that it did not follow or delayed in following, or if the sum insured was not increased, or change of vehicle wasn’t noted on the contract.
  • Privacy and confidentiality including disputes about privacy breaches and disclosure of personal information by an insurance company.
  • Transactions such as overpayment or underpayment of an insurance benefit, or an insurance claim paid to someone other that the insured and/or a refund provided to another party.
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