If you have a complaint about your own insurer, there are a number of steps that you can take.
How to complain
If you have a complaint about your insurer, the first step is to complain to the insurer directly. Each insurer has an internal complaints process which you can contact to try to resolve your complaint.
If you and your insurer are unable to resolve the complaint, your insurer will send you a letter confirming that your complaint is "deadlocked". You can then take your complaint to the insurer's independent, external dispute resolution scheme.
The dispute resolution schemes have some limits on what complaints they can consider. Because the schemes are for the benefit of consumers, they can only take complaints from individuals or small organisations with 19 or less full time employees. They can also only consider complaints where less than $200,000 in financial loss is disputed: any more than this amount will need to be disputed in the High Court.
The disputes resolution schemes investigate complaints and try to resolve them by negotiation or mediation where possible.
Your rights when complaining
When you place a formal complaint, your insurance company must
- acknowledge your complaint within 5 business days
- respond to your complaint within 10 business days
- advise you of your right to take the complaint to their independent, external disputes resolution scheme if they are unable to resolve your complaint within 2 months.
Dispute resolution schemes
Dispute resolution schemes exist to resolve disputes between insurers and their customers. If you have a complaint about your insurer that your insurer cannot resolve, you can refer your complaint to your insurer's independent dispute resolution scheme, free of charge.
Any insurer who provides their services to retail clients (consumers) must belong to an approved dispute resolution scheme under the Financial Service Providers (Registration and Dispute Resolution) Act 2008.
The dispute resolution schemes are licensed by the Minister of Consumer Affairs under this Act, and must be
Insurers belong to one of 2 approved dispute resolution schemes:
What constitutes a 'significant breach'?