What to Do When Your Insurer Delays Your Claim

In 2025, the Australian Financial Complaints Authority (AFCA) received 111,373 complaints — the highest number in its history, up 14% on the prior year. The single largest complaint category was delay in claim handling: 9,274 complaints. AFCA secured $643 million in compensation for consumers — a 120% increase year on year.

These figures reflect a pattern that has been building since the 2022 Australian floods, which generated over 300,000 insurance claims and stretched insurer assessment capacity to breaking point. The Insurance Council of Australia (ICA) and the Australian Securities and Investments Commission (ASIC) have both expressed concern about the pace at which major catastrophe claims are being resolved.

If your property damage claim is not progressing, you are not alone — and you have rights under Australian law and the General Insurance Code of Practice that most policyholders are unaware of.

The General Insurance Code of Practice (the Code) sets mandatory timeframes that all subscribing insurers must meet. It is enforced by the Insurance Council of Australia and can be applied by AFCA in dispute determinations.

Source: General Insurance Code of Practice (2020, amended 2024). These timeframes apply to subscribing insurers. Confirm whether your insurer subscribes at codeofpractice.com.au.

If your insurer has missed any of these timeframes without giving you a written explanation and a revised date, the Code has been breached. This is the basis for your formal complaint.

Before contacting your insurer or escalating, create a clear written record of what has happened and what has not. This timeline is the foundation of any IDR complaint or AFCA submission.

• Date the damage occurred and the date you first notified your insurer.
• Every contact you have made — dates, times, who you spoke to, what was said. If communications have been by phone, follow up each call with an email confirming the conversation.
• Every commitment your insurer made — "we will send an assessor within five days," "a decision will be made by the end of the month" — and whether they were met.
• What the delay has cost you — alternative accommodation, ongoing property damage, contents deteriorating, secondary damage developing. Keep receipts for every cost.
• Photographs with timestamps — damage progression photos demonstrate that delay is compounding the loss. Mould, timber swelling, and structural deterioration all worsen over time and generate costs the insurer will later need to cover.

Save copies of all written communications. Do not rely on verbal commitments alone — request everything in writing.

Internal Dispute Resolution (IDR) is the formal complaints process your insurer is required to operate under ASIC Regulatory Guide 271 and the General Insurance Code of Practice. It is not the same as ringing your claims manager — it is a separate complaints channel that triggers specific legal obligations.

To lodge an IDR complaint, write to your insurer and:

• State clearly that you are making a formal complaint about the delay in handling your claim.
• Include your claim number, policy number, and the date the claim was lodged.
• Attach a summary of the delay timeline you prepared in Step 1.
• State the specific Code timeframe that has been missed (e.g., "The claim was lodged on [date]. Under the General Insurance Code of Practice, a decision was required within four months. That date has passed without a decision or written explanation.").
• State what outcome you are seeking: a decision on the claim within [specific date], written reasons for any further delay, and compensation for costs incurred due to the delay.

Send the complaint to your insurer's complaints team — not your claims handler. The complaints team email or postal address will be on your policy documents or the insurer's website under "Complaints" or "Dispute Resolution."

Your insurer must respond to your IDR complaint within 30 calendar days. If they do not, you can go directly to AFCA without waiting for the IDR response.

If your insurer's IDR response does not resolve the delay — or they do not respond within 30 days — you can lodge a complaint with the Australian Financial Complaints Authority (AFCA).

• AFCA is free for complainants. There is no cost to lodge, regardless of the claim amount or outcome.
• Lodge at afca.org.au — online is the fastest method. You can attach your delay timeline, IDR complaint, and all correspondence at lodgement.
• You have two years from the date of the IDR response to lodge with AFCA.
• What AFCA can order for delay: that the claim be decided within a specific timeframe; interest on amounts owed for the delay period; compensation for non-financial loss (distress and inconvenience) up to $5,500.

AFCA's 2025 data shows that delay complaints are increasingly being resolved in the complainant's favour — particularly where the insurer cannot demonstrate that its handling met the Code's timeframe requirements. The combination of your written timeline and a clear IDR record is your strongest evidence.

For more detail on the full AFCA complaint process, see the AFCA Complaint Guide.

Many policyholders believe they must wait for insurer authorisation before starting any work. This is not correct under Australian law.

Section 56 of the Insurance Contracts Act 1984 imposes a duty to mitigate on the insured. This means you are legally required to take reasonable steps to prevent further damage — and you are entitled to do so. Reasonable mitigation costs are claimable, even if incurred before the insurer authorises repairs.

In practice, this means:

• Make-safe work — tarping a damaged roof, extracting standing water, removing hazards — can and should proceed immediately.
• Drying and dehumidification — deployed within 24–48 hours of water damage significantly limits mould growth and structural damage.
• Contents at risk — items that will deteriorate further (soft furnishings, documents, electronics) can be removed and stored or assessed without waiting for authorisation.

Critical: document everything before, during, and after any mitigation work. Photographs, moisture readings, equipment logs, and contractor invoices are all required to claim these costs. A qualified IICRC-certified restoration contractor will provide this documentation as standard.

Full rebuilding and structural repairs are generally more complex — insurers typically require scope approval before permanent repairs. However, the mitigation steps above should not wait.

If the delay involves a dispute about scope — what damage the insurer is prepared to cover — an independent assessment from a qualified restoration contractor provides AFCA and your IDR with technically credible evidence.

An independent scope of works:

• Documents what work is required and why, with reference to Australian restoration standards (IICRC S500, S520, S770 as applicable).
• Quantifies the cost of repairs with line-item transparency, giving AFCA a factual basis for comparison against the insurer's position.
• Demonstrates that any scope gap is due to the insurer's delay — secondary damage that has developed since the initial loss event is documented separately.

AFCA can and does prefer independent contractor evidence over insurer-engaged assessors where the independent evidence is thorough and credible.

The Disaster Recovery platform connects property owners with IICRC-certified restoration contractors across Australia. An independent assessment can typically be arranged within 24–48 hours of contact.

This guide provides general information only and does not constitute legal or financial advice. For complex disputes involving large amounts, consider consulting a lawyer or public loss assessor who specialises in property insurance claims.