If your insurer denies your claim, underpays it, or delays unreasonably, you can lodge a free complaint with the Australian Financial Complaints Authority (AFCA). AFCA is an independent dispute resolution service that can review your case and make a binding decision your insurer must follow. You must first complain directly to your insurer and wait for their final decision (or 30 days, whichever comes first) before AFCA will accept your case.

What is AFCA?

The Australian Financial Complaints Authority is a free, independent ombudsman service that resolves disputes between consumers and financial firms, including all Australian insurers. According to the Australian Financial Complaints Authority, AFCA can handle complaints about car, home, contents, life, income protection, travel, health, and most other personal insurance products. AFCA’s decisions are binding on the insurer up to the compensation cap (A$1,115,000 for most insurance complaints as of October 2026; verify current limits on the AFCA website), but you are not bound and can reject the decision and pursue other options if you disagree.

When You Can Complain to AFCA

You can lodge a complaint with AFCA if your insurer has denied your claim, offered a settlement you believe is too low, delayed processing unreasonably, or disputed coverage under your policy. Before AFCA will accept your case, you must have already lodged a complaint directly with your insurer and either received their final decision (called an Internal Dispute Resolution or IDR response) or waited at least 30 days without a final answer. You must lodge your AFCA complaint within two years of receiving the insurer’s final decision, though AFCA may accept older complaints in exceptional circumstances.

AFCA cannot help with complaints about premium pricing, a decision not to offer you cover, or matters already resolved by a court or tribunal.

How to Lodge a Complaint

Visit the AFCA website and complete the online complaint form. You will need your policy details, the insurer’s final decision letter (if you have one), a summary of what went wrong, copies of your correspondence with the insurer, and any supporting evidence (photos of damage, repair quotes, medical reports, police reports, the Product Disclosure Statement). AFCA does not charge you any fee to lodge or manage a complaint.

Be clear and factual in your complaint: explain what happened, what the insurer decided, why you believe the decision is wrong, and what outcome you are seeking (for example, full payment of the claim, or reimbursement for specific losses). Attach all relevant documents when you submit the form.

Read also: How to Make a Successful Home Insurance Claim in Australia

What Happens Next

AFCA will acknowledge your complaint within a few business days and assign a case manager. The case manager will contact your insurer and ask for their response and file. AFCA may try to negotiate a settlement between you and the insurer first. If negotiation does not resolve the matter, AFCA will investigate and make a decision based on what is fair in all the circumstances, considering the policy terms, the law, relevant industry codes (such as the General Insurance Code of Practice), and good industry practice.

Most straightforward cases are resolved within 90 days, though complex disputes can take longer. According to ASIC MoneySmart, you should respond promptly to any requests from AFCA for additional information to avoid delays.

Your Next Step

If your claim has been denied or underpaid, first lodge a formal complaint with your insurer in writing (email is acceptable) and ask for a final decision in writing. Keep copies of all correspondence. Once you have the insurer’s final decision or 30 days have passed, visit afca.org.au/make-a-complaint and complete the online form. Gather your policy documents, the insurer’s letters, and all supporting evidence before you start.

The consumer rights framework underpinning AFCA’s role is discussed in general finance education materials such as Principles of Finance, which cover the regulatory protections available to consumers in financial transactions.

General Advice Warning

This article provides general information only and does not take into account your objectives, financial situation, or needs. Before acting on this information, consider whether it is appropriate for you and read the relevant Product Disclosure Statement (PDS). Each insurance dispute is unique; AFCA’s decision will depend on the specific facts of your case, the terms of your policy, and applicable law. For personal advice about your claim or complaint, contact a licensed insurance adviser or a solicitor with experience in insurance disputes. Check current AFCA complaint limits, processes, and eligibility on the AFCA website, as these may change.