Tuesday, March 5, 2024

AFCA concerned by escalation in flood claim delay complaints

The Australian Financial Complaints Authority (AFCA) received more than 2,000 complaints from flood-affected consumers in the year since the devastating South-East Queensland/northern NSW storms, with delays in claim handling the most significant issue. 

Disputes with insurers in the wake of the floods are the second largest “significant event” since AFCA’s inception in November 2018, behind the COVID pandemic, the Authority said in a statement released today.

The number of complaints escalated to AFCA is more than four times that received in relation to the next most significant weather-related event – the South-East Coast storms of February 2020, which generated 493 complaints. 

“We are concerned by the volume of complaints that have been reaching us about delays by insurers,” AFCA’s Chief Ombudsman and Chief Executive, David Locke, said.

“We understand that the scale of this event has put pressure on insurers but these sorts of complaints can often be avoided through good, regular communication with customers. 

“We would also prefer to see insurers resolving many more complaints within their own dispute resolution process, rather than consumers having to take the extra step of coming to AFCA – prolonging the time they spend in limbo, unable to get on with their lives,” he said. 

AFCA was also concerned about a rise in complaints about general insurance overall, beyond the floods, Mr Locke said. 

The ombudsman service has experienced a 65% increase in general insurance complaints in the 2022-23 financial year so far. As at February 23, it had registered 17,163 general insurance complaints, compared with 10,417 at the same point in the 2021-22 year. 

In relation to the SEQ-NSW floods, delays in claim handling account for nearly 40% (37%) of complaints to AFCA. Denial of claims because of policy exclusions or conditions accounted for one in three complaints (33%) and disputes over claim amount represented one in four complaints (26%).  

Some 40% of SEQ/NSW flood complaints were resolved at the earliest stage of AFCA’s process, at “registration and referral”, when a complaint is referred back to the firm to resolve. This is below the 51% early resolution rate for all complaints to AFCA in 2021-22. 

In the past year, flood-affected policyholders have secured nearly $13 million in compensation and refunds from insurers through the AFCA process. 

AFCA’s Lead Ombudsmen for Insurance, Emma Curtis said AFCA continues to encourage insurers to address complaints as quickly as possible in-house or as early as possible in the AFCA process. 

“We acknowledge that the heavy flow of unresolved insurance complaints to AFCA means we have not been able to address complaints as quickly as usual,” Ms Curtis said.

“But we have increased our resources and capacity to handle insurance complaints significantly   over the past year, and this is having a positive effect. By working closely with insurers to help them resolve simpler complaints early, and take a consumer-centric approach, we are confident complaint volumes will reduce over time.”

AFCA has also instituted new ways to regularly update consumers on the progress of their complaints.

“We expect insurers to do all they can to assess claims promptly, to regularly inform customers about expected timeframes, and to clearly communicate about claims options,” she said. 

As at 24 February 

  • 2,021 complaints had been registered in connection with the SEQ/NSW floods of 2022; 
  • Two-thirds of complaints (1,328) had been closed;
  • About three-quarters of complaints (74%) were closed by agreement or in favour of complainants;
  • $12.9 million in compensation and refunds was secured;
  • About three-quarters of complaints (74%) were in relation to home building insurance, followed by home contents (9%) and landlord insurance (5%). 

 State data: 

 Queensland  

  • 957 complaints;
  • $6.1 million in compensation and refunds ordered.

NSW 

  • 999 complaints;
  • $6.6 million in compensation and refunds ordered. 

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