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Complete 8-step guide. Covers documentation, IICRC assessment, insurer obligations, and your free escalation path through AFCA.
To make an insurance claim in Australia, notify your insurer in writing within 24–48 hours, document all damage with photos and video, obtain an independent IICRC-certified damage assessment, complete your insurer's claim form with supporting evidence, and track all communication in writing. If your claim is disputed or denied, escalate to the Australian Financial Complaints Authority (AFCA) at no cost. Under the ICA General Insurance Code of Practice, your insurer must acknowledge within 10 business days and decide within 4 months.
Before documenting damage, ensure your property is safe to enter. If structural damage is severe, flooding is ongoing, or there is electrical hazard, do not enter the property. Contact emergency services (000) if anyone is at immediate risk. Wait for official all-clear from local authorities before proceeding.
Take photos and video of all damage — exterior wide shots and close-ups, all affected interior rooms, contents damage, and evidence of the cause (fallen trees, water lines, burn patterns). Create a written inventory of all damaged items with estimated replacement costs, receipts, and model numbers. Keep damaged items and preserve all evidence.
Most policies require written notification within 24–48 hours. Email or send certified mail — never rely on phone calls alone. Include your policy number, date and time of incident, type of damage, and brief description. Request written acknowledgment of your notification and keep copies of everything.
Do not rely solely on your insurer's assessment. Search the IICRC directory at iicrc.org for certified restorers in your area. The assessment should include detailed damage scope, water categories or smoke classification, recommended repair methodology per IICRC standards (S500, S520, or S700), estimated replacement cost, and any secondary damage risks.
Submit your claim form with all supporting documents: organised photos and video, IICRC damage assessment, written inventory, receipts and credit card statements, Bureau of Meteorology weather data (for weather events), proof of notification, and any repair quotes. Use your insurer's online portal if available. Do not start repairs before claim approval.
From this point forward, communicate with your insurer only in writing. After any phone call, send an email summarising what was discussed. Document all claims officer names, reference numbers, timelines promised, and any changes to your claim status. Keep all documents organised in a dated folder and back up to cloud storage.
Under the ICA General Insurance Code of Practice: your insurer must acknowledge within 10 business days, and must decide most claims within 4 months. They must notify you in writing if the claim requires extended assessment. You can request a copy of any assessment or report your insurer commissions. Request to be present at any insurer-arranged inspection.
The Australian Financial Complaints Authority (AFCA) provides free, binding dispute resolution. Lodge online at afca.org.au or call 1800 931 678. Provide your policy number, claim number, explanation of dispute, and all supporting documentation. AFCA can order full payment, revised assessment, or compensation for non-financial loss (distress, breach of Code).
Defines water categories (clean, grey, black), drying procedures, and what qualifies as secondary damage. If your insurer denies mold caused by water damage, S500 establishes that proper drying was required.
Distinguishes mold caused by water damage (covered) from mold caused by poor ventilation (may be excluded). Defines scope of containment, remediation, and verification required.
Defines smoke damage categories and odour assessment. Specifies cleaning and restoration procedures. Prevents insurers claiming smoke odour is "cosmetic" or will "naturally dissipate."
Request your Product Disclosure Statement. If the exclusion is clear, the dispute won't succeed. If policy wording is ambiguous, argue the ambiguity should be interpreted in your favour (consumer-friendly interpretation). Consider whether a different policy class might cover the loss.
Provide before-and-after photos, an IICRC assessment distinguishing pre-existing from new damage, BOM weather data, and neighbour testimony. In AFCA, your insurer bears the burden of proving pre-existence — not you.
Provide maintenance records, an IICRC assessment documenting sudden accidental damage, and expert testimony from a building inspector. In AFCA, argue that sudden, accidental damage is covered — not gradual deterioration — and your insurer must prove poor maintenance directly caused this specific damage.
Provide evidence of your notification date and time. If outside the timeframe, argue the delay did not prejudice your insurer: they could still inspect, received full documentation, and the loss did not deteriorate further. In AFCA, argue waiver if your insurer accepted the claim without immediately raising late notification.
Obtain an independent valuation from a licensed valuer showing current replacement cost. Submit this to dispute the insurer's estimate. If the insurer actively misled you about the appropriate sum insured, consider an ACL claim for misleading conduct.
Your insurer must:
Insurers cannot make false or deceptive statements about coverage (s.29(1)(g)), engage in unconscionable conduct (s.21), or include unfair contract terms (s.23). Breaches can be taken to AFCA or the ACCC.
If your claim is denied, underpaid, or delayed, lodge a complaint at afca.org.au or call 1800 931 678. AFCA is free for consumers and binding on insurers. AFCA can order full payment, revised assessment, or compensation for non-financial loss.
Most claims are decided within 4 months under the ICA General Insurance Code of Practice. Simple claims may be resolved within 2–4 weeks. Your insurer must acknowledge within 10 business days and must notify you if the claim requires extended assessment.
Yes, you have the legal right to select your own repairer, even if your insurer has preferred contractors. Check your policy for any clauses requiring an insurer-nominated repairer.
You can dispute underpayment in AFCA. Provide an independent IICRC-certified assessment showing the actual cost of repairs. AFCA will order revised payment if your assessment is more reasonable.
Yes, AFCA is completely free. It is funded by the financial services industry, not by consumers. You pay no fee to lodge a complaint or have AFCA investigate.
The Insurance Council of Australia General Insurance Code of Practice is a voluntary industry code that sets minimum standards for claims handling: responding within 10 days, deciding within 4 months, treating consumers fairly, and providing written reasons for decisions.
IICRC stands for the Institute of Inspection, Cleaning and Restoration Certification. IICRC-certified professionals are trained in industry standard methodologies for restoring property damage (water, fire, mold, smoke). IICRC certification is recognized by insurers and courts as objective and credible.
Yes, if the mold is caused by the flood. Under IICRC standards, proper drying is required to prevent mold. If your insurer failed to ensure proper drying and mold developed as a result, they are liable for remediation.
You are not obligated to stay in an uninhabitable home. Most policies cover temporary accommodation (hotel, rental) while repairs are done. Claim these costs as part of your insurance claim with supporting invoices.
NRPG advocates for policyholders from first contact through AFCA resolution. Independent IICRC assessment arranged within 48 hours. No upfront fees — paid only if you recover.
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