Car insurance ombudsman

Have a dispute with your car insurance provider? Here’s what you can do about it.

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If your car insurance provider hasn’t held up its end of the bargain, then you may have valid grounds for a dispute. Financial service providers, including insurance companies, are required to live up to their obligations in good faith. Naturally, the exact obligations depend on which type of car insurance policy you have.

If you have a car insurance dispute, you can contact the Australian Financial Complaints Authority (AFCA) for a resolution. AFCA is responsible for settling issues between consumers and financial service providers. If you have exhausted all other options, then it might be time to give them a call.

Where to contact AFCA

Phone number: 1800 931 678
Website: www.afca.org.au

What can AFCA do?

The Australian Financial Complaints Authority (AFCA) is an impartial, non-profit organisation that offers dispute resolution to customers having difficulties with a financial service provider. Reputable insurers are AFCA members and they pay membership fees to ensure that AFCA services remain free for consumers.

When you go to the AFCA with a dispute, they will:

  1. Determine whether your car insurer, or financial services provider (FSP), acted fairly and promptly to resolve the claim. Familiarise yourself with what to do in the event of an accident to make sure you’ve taken the appropriate steps from the beginning.
  2. Look at which steps the FSP took to expedite repairs and help ease your burdens.
  3. If a cash settlement was offered, AFCA will determine whether it was a fair offer and enough to cover all the repairs.
  4. Decide whether you and the FSP tried to come to a reasonable solution first and whether any excuses given, such as difficulty finding spare parts for repairs, are legitimate.
  5. Determine whether either party is in the right and what kind of compensation is in order.

If they find that you’re in the right, AFCA can make the insurer take certain action including:

  • Paying your claim
  • Paying you a sum of money
  • Forgiving outstanding debt
  • Varying, reinstating or cancelling a contract
  • Repaying, waiving or varying a fee

What can’t AFCA do?

The Australian Financial Complaints Authority (AFCA) cannot:

  • Help with CTP insurance disputes. You will need to contact your state authority instead.
  • Decide on matters currently undergoing legal proceedings.
  • Offer assistance if the insurer is not an AFCA member. However, you can safely assume that all legitimate insurers are AFCA members.

What to do before contacting AFCA

Pay special attention to step 4 above and do not contact AFCA until you have first tried to come to an agreement with your insurer. It’s a good idea to use email when trying to resolve an issue as it automatically keeps written records, which may be important later if AFCA needs to make a decision.

  • If you have not tried to settle the issue with your insurer, then AFCA will not help.
  • After you have received a final answer from the insurer, you have two years to get in touch with AFCA if you want to pursue the issue.

What happens after I make a complaint to AFCA?

Generally, you should not make a complaint until you have been through the insurer’s internal dispute resolution process. Doing so streamlines the AFCA procedures, and shows that you have made an effort to reach an agreement.

In each stage, an agreement may be reached. If not, the dispute keeps progressing through the stages.

  • Registration: The AFCA will get in touch with you and the insurer, requesting that both of you respond. If you have tried internal dispute resolution, the insurer has 21 days to respond, if not, they have 45 days. During this period, the insurer may offer settlements, or they might otherwise look for ways to resolve the issue before the AFCA steps in.
  • Case management: The dispute will be allocated to a case manager. They will gather information on it and be in touch with both parties. The case manager will try to resolve the issue through negotiation, conciliation or by pointing out the relevant issues that might come into play if the dispute progresses to the decision stage.
  • Decision: Taking into account all relevant factors, situational, legal and otherwise, the caseworker will reach a decision. In complex cases this decision might end up in front of a panel rather than an individual.

You do not have to accept the decision. If you reject it, the insurer is freed from the terms of that decision and is not required to do anything in particular. Your remaining option is then to pursue legal action.

Your insurer does have to accept the decision. As AFCA members they are required to accept it. If you need a car insurance ombudsman to settle a dispute, there is a clear option available.

Is it time to dump your insurer? Find your new one here

Name Product Roadside Assistance Accidental Damage Storm Choice of Repairer Agreed or Market Value
Budget Direct Comprehensive
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⭐ Current offer: Get 15% discount on first year's premium when you take out a policy online. T&Cs apply.

Who it might be good for: People who want a comprehensive policy without breaking the bank.
Australia Post Comprehensive
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Agreed or Market
Finder's summary: Australia Post car insurance offers comprehensive cover for things like theft, fire, new for old replacement and emergency accommodation and transport. Cover also extends to anyone who uses your car, not just you.

⭐ Current offer: Get $75 off your first year’s premium when you buy online. T&Cs apply.

Who it might be good for: If multiple people use the one car and you don’t want to worry about listing all drivers.
Bingle Comprehensive
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Finder's summary:Bingle consistently comes up as one of the cheaper insurers out there. It only covers the basics. You don't get to choose your own repairer, you're not covered for personal items in the car and unless you add it as an option, you won't get a hire car if your car is stolen. But this keeps its premiums low.

Who it might be good for: Someone who wants a low-cost option that covers them for the basics.
Coles Comprehensive
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Finder's summary: With Coles comprehensive car insurance, you could earn double flybuys points at Coles supermarkets and you can get $10 off your Coles grocery bill every time you redeem 2,000 Flybuys points. If your car is damaged, you could benefit from a one-week turnaround on repairs.

⭐ Current offer: Get 10% off your first year's premium when you take out a policy online. T&Cs apply.

Who it might be good for: Coles customers and Flybuys collectors.
Virgin Comprehensive
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Agreed or Market
Finder's summary: Finalists for the 2021 Finder Awards for Best Car Insurance - Value in VIC, QLD, SA, WA and TAS, Virgin Comprehensive provides a good level of cover for a decent price.

⭐ Current offer: Get 15% off on your first year’s premium when you purchase a new eligible comprehensive car insurance online. T&Cs apply.

Who it might be good for: People who'd like to manage their policy online 24/7.
Huddle Black Comprehensive
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Finder's summary: Huddle's black comprehensive is its cover with highest limits and exclusive benefits. It includes roadside assistance. You can also get up to $2,000 for emergency travel and accommodation and up to $30 million legal liability cover.

Who it might be good for: Someone who wants a 24/7 claims processing.
Youi Comprehensive
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Finder's summary: Youi Comprehensive Car Insurance is one of the few providers to include roadside assistance in its policy. You'll also get access to YouiRewards which gives you discounts on furniture, parking and more. Youi also has a live chat feature on its site to talk through any questions.

Who it might be good for: People over 25 who want comprehensive cover with a focus on customer service.
Qantas Comprehensive
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Agreed or Market
Finder's summary: You'll be able to choose how comprehensive you want your cover to be with optional extras like choice of repairer and the option of agreed or market value.

⭐ Current offer: Earn Qantas Points for joining and paying your premium. Sign up today and earn up to 20,000 Qantas Points (points awarded will be based on your premium). T&Cs and eligibility apply.

Who it might be good for: People who'd like to earn Qantas Points.
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22 Responses

    Avatarfinder Customer Care
    MayJuly 23, 2018Staff

    Hi Ron,

    Thank you for your inquiry.

    Sorry to hear that you’re having trouble with your claim. I would recommend getting in touch with the Financial Ombudsman Service if you want to dispute the way your claim is being handled. I know it would involve much of your time and effort but if this will resolve the issues on your claim, it would be worth speaking with FOS.

    Hope this will be sorted out soon.

    Best,
    May

    Default Gravatar
    HelenMay 18, 2018

    Hi, I purchased a brand new Mercedes in November 2017, came home to see a small damage on right side quarter panel and boot lid.
    Advised by Mercedes insurance at the time of claim back early April 2018 ( 14/4 )to take vehicle to there recommended repairer !!
    I was told my car would be finished (4/5) for pick up. During this period I was staying in contact with my repairer as to the process they were at with my vehicle. Come Friday (4/5) I received a phone call early morning from repairer saying the car won’t be ready till (8/5) when I asked why what’s the hold up I was told he wasn’t sure and would call me back ASAP. After 3 hours no call I personally went to my repairer to find my car back in pieces due to the manager himself not happy with the result of there repairs, when I asked why didn’t someone just say something this morning during our phone call the manager replied with we are really busy. Walking out and making phone calls to my insurance I was left with someone would contact me later that day.
    3 days later once again I’m calling my insurance back to see who’s looking after my claim I then managed to speak with the manager. I explained what was happening with my car as my repairer decided not to hand back my car due to unsatisfied results, then I was assured my insurance would step in and take it from here.
    Second time round my insurance told me it would be fixed to factory standards and be ready in a week. Finally new pick up date was (17/5) I come at midday to find the paint work way off my exterior side skirts aren’t clipped in properly they’ve basically sprayed the whole car to blend in there previous mistakes which now my vehicle has 3 shades. I was never informed of the repairs made around the whole car whilst the damage was so minor and only on right quarter panel and boot.
    My insurance states new for old on policy and repairs are factory standards, this is not the brand new vehicle I purchased less than 6 months ago. My car is still at repairer as I refused to take it home what’s my rights as I’m awaiting a phone call from the insurance as we speak can I push for a new car ????
    I’ve got photos throughout this process and lots of emails to my insurance stating how disappointed I am I’ve been given the run around for nearly 6 weeks and just want my car.
    My insurance is sending a senior to look at it today what are my rights as I don’t want a third attempt to get it right this time ???
    PLEASE HELP

      Default Gravatar
      NikkiMay 18, 2018

      Hi Helen,

      Thanks for your message and for visiting finder – the leading comparison website & general information service built to give you advice in your buying decision needs. How are you doing today?

      We’re sorry to hear the trouble you’ve been through, we know this is difficult & a big hassle to you.

      Please note that we’re a product comparison website and we do not represent any company we feature on our site. We provide general information on products to assist you in your buying decision process hence we cannot recommend product / service that is rightfully fit for you.

      Here’s what you can do:

      1. Review your policy with a legal adviser.
      2. Should your lawyer find any discrepancies to your policy, contact the complaints department of insurance company to lodge a complaint.

      Hope you find a resolve to this soon. Don’t hesitate to message us back if you have more questions.

      Cheers,
      Nikki

    Default Gravatar
    ThomasApril 3, 2018

    Hi!

    I have full comprehensive insurance. My vehicle was stolen 2 weeks ago. Insurance have told me the total loss. They also stated as a person cannot be charged to the theft, I have to pay the excess. Is this right even though it isn’t my fault?

    Thanks,
    Thomas

      Default Gravatar
      ArnoldApril 3, 2018

      Hi Thomas,

      Thanks for your inquiry

      Please note that the T&C of policies may vary extensively.

      Usually, Assuming the car is not recovered, you would usually pay the excess. If the car is recovered but damaged, then you’d pay the excess as part of the repair costs. You may need to pay the excess initially, but if it can be proven that the accident was the fault of anyone else involved in the claim (a ‘third party’) and they accept blame, then you (essentially, your insurance company) claims it back from the insurers of the driver who was at fault. Likewise, if there’s a dispute about who is at fault, you may have to pay excess initially until a decision is made. This may involve taking them to court if they refuse to give you the money. If you have motoring legal cover protection as part of your regular car insurance, this may cover the excess in some cases.

      It may be best to refer to the terms and conditions of your policy for more clarification about this.

      Hope this information helps

      Cheers,
      Arnold

    Avatarfinder Customer Care
    JonathanFebruary 22, 2018Staff

    Hi Tina, thanks for your comment. We are sorry to hear about your accident and hope you are okay.

    In regards to your policy and claim, it would be best to contact the Financial Services Ombudsman directly. Things you may like to have prepared beforehand would include:

    -Dates you contacted your insurer.
    -Staff/ conversation details when they told you three times that your policy was active during the period of accident.
    -Your insurance account details.

    I have emailed you the Financial Ombudsman Service for car insurance page.

    I hope this helps.

    Jonathan

    Default Gravatar
    RobertFebruary 12, 2018

    im with real insurance. my car was stopped at a traffic light when it was rear ended by a road train. it was accessed as a writeoff. i have finally got my payment now. but my question is when i asked them to transfer my insurance policy over to my new car they said no it was now null and void even though it was insured until Dec 2018. i asked for a refund they said no. then they said if i was paying monthly i would still have to pay each month up until dec???? thats on top of my new policy. is this right. i also have home and contents with this company. thanks for any information Robert

      Default Gravatar
      JoelFebruary 23, 2018

      Hi Robert,

      Thanks for leaving a question on finder.

      Since you have been through your insurance’ internal dispute resolution process, it’s a good idea to use email when trying to resolve an issue as it automatically keeps written records, which may be important later if the FOS needs to make a decision. If you are convinced that you have a valid case, you can contact the Financial Ombudsman Service (FOS) for a resolution.

      Hope it helps.

      Cheers,
      Joel

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