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Insurance

Insurance

Last updated: July 2020

The information set out on this page is intended as an introduction only and should not be relied on in place of legal advice. Your entitlements will depend on your circumstances and the terms of your insurance policy.

My home is insured

What should I do first?

If your home or property has been damaged or destroyed in a disaster, it is important to lodge your insurance claim as soon as you can. Before you lodge a claim, you need to understand what you are covered for under your insurance policy. Read the information on this page carefully and seek help if you need to. You need to understand any information your insurer sends you. Do not sign any documents until you understand what they mean.

The ‘Where to get help’ section at the end of this page contains contact information for support agencies that can provide you with information and, in some cases, legal advice to help you with your insurance claim. If you are unsure about any of the information on this page or need further assistance, you should contact these agencies.

First steps you can take after a disaster and to prepare to lodge your insurance claim (when it is safe to do so):

  1. Take photographs and videos of the damage.
  2. Secure your property from further damage where possible. For example, by putting a tarp over contents or moving them under shelter. Take photographs and videos to prove this.
  3. Try not to throw away any damaged goods, as this makes it difficult to provide your insurer with proof that items were damaged. If you need to throw away hazardous or dangerous items, make sure you document them with photographs or videos first. If you can, contact your insurer and speak with them first before discarding anything.

What does my insurance policy cover?

Your home insurance policy (also referred to as property insurance or home building insurance) can cover you for damage to your home including:

  • the main dwelling
  • your garage
  • any other outbuildings that can be locked up.

There are different types of home insurance policies. Most policies cover bushfires, storms and cyclones, but not all cover floods. Your contents insurance policy can cover you for loss of, or damage, to your possessions. You may have both home and contents insurance.

Home insurance

Most home insurance policies are for a ‘sum insured’ amount, which means you are insured up to a specific dollar amount. Usually, you will get no more than that amount when you claim. Sum insured policies will reimburse you for the value of your possessions in the condition they were in just before they were damaged or destroyed.

Check your policy carefully to see if any additional cover is provided, as some sum insured policies also cover items like emergency accommodation, cleaning up a site and professional fees for architects, accountants and planners. However, it may be that the total sum insured amount is to cover these extra costs as well as the replacement of the property. If you are unsure what your policy covers, you should contact one of the support agencies listed in the ‘Where to get help’ section at the end of this page.

Some home insurance policies are not for an agreed amount but are to replace any building/s. This is referred to as a ‘total replacement’ or ‘complete replacement’ policy. Total replacement cover pays out the full amount needed to replace damaged property with a new property, without taking into account the depreciated (reduced) value of the property over time. Usually, total replacement policies give the insurer the option to either:

  1. repair or rebuild the damage or loss to your property; or
  2. pay the cost of repairing or rebuilding to the same size and standard of your home before the disaster occurred.

Total replacement policies offer better protection against underinsurance (see below) than sum insured policies, but they are usually more expensive.

Contents insurance

Contents insurance will cover the cost to repair or replace household possessions and furnishings, such as furniture, appliances and electronics. This includes items belonging to you and to family members who live with you. It does not cover items that are permanently attached to the building. Some policies may cover items such as clothing, jewellery and sporting equipment. Or you may have to purchase additional cover for these kinds of items, or have a limit on how much is covered. For example, a policy may only cover jewellery and watches up to a limit of $2,500. Different policies cover different items and limits, so check your policy carefully. If you are unsure what you are covered for, contact one of the support agencies listed in the ‘Where to get help’ section at the end of this page.

Contents insurance can be purchased by both home owners and tenants. If you are a tenant, your possessions are not covered by your landlord’s building insurance policies.

If I rebuild, will my insurer cover extra costs to make the building compliant with regulations and laws?

This will depend on your policy. Some policies will pay for costs needed to make the building comply with current home building regulations and laws. These insurers may cover costs in addition to your regular cover. Check your policy carefully and, if you are not sure, contact one of the support agencies listed in the ‘Where to get help’ section at the end of this page.

How do I lodge a claim under my insurance policy?

When you make a claim, you are notifying your insurer about the loss or damage that you believe is covered by your policy. Your insurer will review your claim and, if it is accepted, work out the value of it and provide the benefit or payout.

Different insurers have slightly different processes, but the following steps will help guide you in lodging your claim:

  1. Contact your insurer as soon as possible after the event happens. Even if you don’t know the full extent of the damage to your property, you should still contact your insurer as soon as you can. Don’t worry if your policy documents have been lost or destroyed as your insurer will have your details.
  1. Your insurer may be able to process your claim over the phone. Otherwise, they will provide you with a form to fill in.
  1. Insurers may request certain documents and evidence to support your claim and prove what has been lost or damaged. Your insurer may request things like proof of ownership, receipts, valuation reports, photographs and videos. It is a good idea to write out your version of the event while it is fresh in your mind, and take photographs and videos of the damage as soon as possible. Where you have suffered a total loss, such as your house burning down, your claim should be treated with sensitivity. If you are unable to provide proof of ownership because it was lost in the event, your insurer may not require such proof and also may not require a list of property that was lost or damaged.
  1. If your claim is large, the insurer will usually ask an assessor to examine the circumstances of the loss or damage to your property, and work out the value of that loss or damage.
  1. You may need to work with your insurer to get repair quotes and agree on a plan for the work.. The insurer may send qualified tradespeople to your property to quote for repair work, or you may be asked to find your own quotes for the insurer to consider.
  1. Insurers should respond to your claim within 10 business days. If the insurer does not require any further information, assessment or investigation, they may tell you whether your claim is accepted or denied. If the insurer does require further information or assessment, they will contact you within 10 business days to request this information and explain to you what happens next. The insurer will make their final decision within four months of receiving your claim, unless exceptional circumstances apply. Exceptional circumstances include where there has been a catastrophe or disaster declared by the Insurance Council of Australia and can include fires, floods and earthquakes. In exceptional circumstances, the insurer has 12 months to make their final decision.

Can I request a review of my claim?

If your claim was finalised and you think the assessment of your loss was wrong you have options:

  • If you received your settlement within one month after the disaster, you have 12 months to request a review. Your insurer should inform you about this entitlement when they finalise your claim.
  • If you received your settlement more than one month after the disaster, the process will be different. You will need to lodge an internal dispute resolution complaint (see below). If you need help lodging your complaint, contact one of the support agencies listed in the ‘Where to get help’ section at the end of this page.

I do not agree with my insurance assessment or I am unhappy with how my claim is being handled. What can I do?

You may not agree with your insurer’s decision. Maybe the insurer rejected your claim altogether, or perhaps you think your settlement is too low. Maybe you are unhappy with how your insurer is handling your claim and feel there have been unnecessary delays. In these situations, you may wish to make a complaint.

If you do not agree with your insurer’s decision, there are two complaints processes:

  1. Internal dispute resolution

This involves making a complaint to your insurer directly. Your insurer must provide you with information on its internal dispute resolution process, including details of how to lodge a complaint and how they will deal with your complaint. This information should be included in your insurer’s Product Disclosure Statement (PDS), and may also be set out on your insurer’s website. Your insurer will have someone review your complaint and write to you to let you know the outcome or to request additional information. Your insurer has 45 calendar days to make a decision about your complaint. If you are still unhappy with the outcome, your insurer will provide you with information about other complaint options available to you, including external dispute resolution.

  1. External dispute resolution

Your insurer is required to be part of a free and independent external dispute resolution scheme managed by the Australian Financial Complaints Authority (AFCA). AFCA can mediate between you and your insurer. Where mediation is unsuccessful, AFCA can make decisions (called determinations) that the insurer must comply with. You should contact AFCA as soon as possible if you are not satisfied with your insurer’s internal dispute resolution decision.

You must request an internal review first. If you are still unhappy with your insurer’s decision, you should take your claim to AFCA. See contact details in the ‘Where to get help’ section below.

I am in urgent need of money. Is there anything I can do to get my payout quicker?

Yes, if you can prove to your insurer that you urgently need the money you are entitled to under your insurance policy (as a result of the disaster). Your insurer must do either or both of the following:

  1. Fast-track the assessment and decision process for your claim.
  2. Make an advance payment to you within 5 business days. Any advance payment will be taken off the total value of your claim.

Am I responsible if someone hurts themselves on my property?

Public liability insurance is usually included in your home and/or contents insurance policy. Usually, it will cover an owner’s liability for injury or death to a person that occurs on your property, because of negligence (being careless). It may also cover your reasonable legal costs. You can buy public liability insurance if you are not already covered.

My home is not insured, or it is underinsured

I forgot to/did not pay my insurance premium, or my policy lapsed. What can I do?

If you do not pay a premium instalment by the due date, your insurer has the right to cancel your policy. They must first provide you with a written notice about your non-payment at least 14 calendar days before any cancellation. When you get this notice, you can make the late payment to avoid cancellation. If you do not pay, your insurer will send you another notice informing you that your policy is being cancelled. If your insurer has validly cancelled your policy due to non-payment, unfortunately it is possible that the insurer may deny your claim after a disaster.

Most insurance policies run for 12 months. Your insurer must tell you in writing that your policy is going to end. This will usually be 14 days before, but information about your policy will be on your Product Disclosure Statement (PDS). If your insurer did not give you notice as required by your PDS, your policy may not be able to lapse and you will still be covered. Check your PDS carefully and contact one of the support agencies listed in the ‘Where to get help’ section at the end of this page if you need assistance.

I am underinsured. Is there anything I can do?

Being underinsured means the value of your home and contents in your insurance policy is not enough to pay to replace or repair your home. This can mean that you end up paying the difference.

If your property is underinsured and you cannot afford to rebuild, and your sum insured amount was decided on or recommended by your insurer, mortgage provider or other financial institution, you may be able to lodge a complaint. That person or institution may have given you inappropriate advice. Contact one of the support agencies listed in the ‘Where to get help’ section at the end of this page.

If you cannot afford to rebuild and you are left with a shortfall (gap) between the value of your property and the amount on your mortgage, you should contact a financial counsellor.

If your policy lapsed or was cancelled recently, you may not be able to make a claim. If you were a long-term customer of your insurer, it is worth contacting them to check if there is anything they can do to help you. You could also contact one of the support agencies listed in the ‘Where to get help’ section at the end of this page about your situation.

I want to make sure my property is properly insured from now on. Which cover should I choose?

Local governments have set extra requirements on rebuilding in areas affected by bushfires. If you choose to replace your policy, this will cover the additional cost to rebuild. You will not be underinsured if you were to lose your house in future fires. But replacement policies are hard to find.

If you choose a ‘sum insured’ policy for a specific amount of money, it is important that you know the true cost of rebuilding your property to make sure you are covered. Otherwise, your policy may not cover rebuilding if you were to lose your house again.

Some tips to work out the true cost of rebuilding or replacing your property:

  • Use online home and contents calculators. Many insurers now have calculators on their websites.
  • Go through each room of your house and write a list of fixed items and contents. This may be useful later if you need to make a claim.
  • Speak to a builder or professional valuer about the cost of rebuilding your property and any external structures.

Claims management companies

Insurance claims management companies can help you calculate your insurance claim for a fee. If you are thinking about using a claims management company, first contact one of the support agencies listed in the ‘Where to get help’ section at the end of this page for more information.

Other insurance cover

Superannuation

Most people are covered for some life insurance cover in their superannuation policy. If you have lost a family member in a disaster, contact their superannuation fund to make a claim to release their superannuation and life insurance.

While it is rare to get superannuation early, you may be able to get it on compassionate grounds or if you are on eligible income support from Centrelink and have financial hardship. The superannuation fund may also include cover for total and permanent disability, where you cannot continue working because of an injury or illness. Contact your superannuation fund or Centrelink for more information.

Consumer credit insurance

You may have consumer credit insurance on a personal loan, mortgage or credit card. This covers you if something happens that means you cannot make payments on your loan. This includes if:

  • you lose your job
  • get sick or have an accident
  • there has been a death in the family.

If you borrowed money with another person and they die in a disaster, you may have loss-of-life cover. Contact your loan provider and get help from one of the support agencies listed in the ‘Where to get help’ section at the end of this page.

Where to get help

Legal support

Consumer Action Law Centre

Legal advice and financial counselling for vulnerable people in Australia.

Tel: 1800 466 477 or (03) 9629 6300, Monday to Friday, 10 am to 1 pm
www.consumeraction.org.au

Victoria Legal Aid

Legal advice and services for people in Victoria.

Tel: 1300 792 387, Monday to Friday, 8 am to 5 pm
www.legalaid.vic.gov.au

Insurance Law Service

Legal advice for people under financial stress.

Tel: 1300 663 464, Monday to Friday, 9.30 am to 4.30 pm
www.insurancelaw.org.au

Other support

Australian Financial Complaints Authority

To make a complaint against an insurance agency

Tel: 1800 931 678, Monday to Friday, 9 am to 5 pm
www.afca.org.au

Insurance Council of Australia

Information to help people understand their insurance needs

Tel: 1300 728 228 or 02 9253 5100, Monday to Friday, 8.30 am to 5 pm
www.insurancecouncil.com.au

National Debt Helpline

Free financial counselling and help with dealing with debt

Tel: 1800 007 00, Monday to Friday, 9.30 am to 4.30 pm
www.ndh.org.au