How to make a complaint
The Insurance Code of Practice requires our members to be open, fair and honest in dealings with customers and commits insurers to high standards of service when selling insurance, dealing with claims, responding to disasters and handling complaints.
Before you complain
- Have a clear understanding of what the issue is, why you believe your insurer is at fault and the outcome you would like to achieve.
- Read your policy schedule/certificate and Product Disclosure Statement (PDS), and consider how your concerns match up with the terms your insurer agreed to in the conditions of your policy.
Making a complaint
If you are unhappy with a decision made by your insurer, you can ask for your claim to be reviewed.
1. Lodge a complaint with your insurer – Internal Dispute Resolution
- Contact your claims manager or your insurer’s customer relations team and let them know you would like to lodge a complaint. Contact details can be found in your PDS and on the insurer's website.
- Your complaint will be reviewed by an employee with the appropriate experience, knowledge and authority to review the complaint.
- They may require additional information from you.
- Your insurer will inform you of the outcome of your complaint in writing.
2. Lodge a dispute with AFCA – External Dispute Resolution
If you are unsatisfied with the outcome of your complaint, you can lodge a dispute with the Australian Financial Complaints Authority (AFCA).
Your insurer will provide you with AFCA’s contact details when they respond to your complaint.
AFCA will review the dispute and has the authority to make a binding decision.
TIP: If you try to lodge a dispute with AFCA before you have gone through the internal dispute resolution process, AFCA will likely refer you back to your insurer before they will hear your dispute.