Consumers & Small Business
The General Insurance Code of Practice sets out standards that insurers must meet when dealing with consumers, including small business consumers. Insurers who subscribe have committed to being open, fair and honest at all times. The Code also gives you specific rights in a range of situations, such as when you are buying insurance or making a claim.
An independent Code Governance Committee monitors insurers to ensure that they are following the Code. If you believe that an insurer has breached the Code, you can report it to us. If we find that an insurer has breached the Code, we make sure that it addresses the cause of the problem so that other consumers aren’t affected in the future.
Your rights under the Code
The Code gives you rights in many areas of your relationship with an insurer, from buying insurance to making a claim or complaint. Some of the most important rights include:
When you buy insurance
- Insurers must act in an efficient, fair, honest and transparent way when selling you insurance. (Subsection 4.4)
- Your policy may give you the right to cancel and receive a refund. If you are entitled to a refund, you should receive it within 15 days. (Subsection 4.9)
When you make a claim
- When you make a claim, your insurer must handle it in an honest, fair, transparent and timely manner (Subsection 7.2)
- Insurers must update you on the progress of your claim at least every 20 business days. (Subsection 7.13)
- When an insurer denies your claim, it must explain why in writing, offer you copies of the information it used to make the decision, and tell you how you can make a complaint. (Subsection 7.19)
After a catastrophe
- If you make a property claim that is finalised quickly after a catastrophe (within a month), you may realise later that your losses were higher than originally assessed. If this happens, you have an extended time – up to a year – to ask your insurer to review the claim, even if you have already signed a release. (Subsection 9.3)
When you owe money to an insurer
- If you tell an insurer that you’re having financial difficulty, it must tell you how to apply for assistance and refer you to the national financial counselling hotline. (Subsection 8.4)
- When you apply for financial hardship assistance, the insurer must respond as soon as reasonably practicable. If they decide not to assist, they must explain why and tell you how you can make a complaint. (Subsection 8.6)
- If an insurer decides to offer you financial hardship assistance, it must work with you to decide how to help and confirm the arrangement in writing. (Subsection 8.8)
When you have a complaint
- When you make a complaint, your insurer must handle it in a fair, transparent and timely manner (Subsection 10.4)
- Insurers must respond to complaints in writing, explaining their decision, the reasons for the decision, and how you can escalate the complaint if you’re not satisfied. (Subsection 10.13)
- Insurers must give you a final response to your complaint within 45 days. Otherwise, they must explain the delay and tell you how you can take your complaint to the Australian Financial Complaints Authority. (Subsection 10.10)
If an insurer breaches the Code
If you think an insurer has not lived up to the standards in the Code, you can report your concern to the Committee. If we find that an insurer has breached the Code, we will work with it to find and address the cause of the breach.
Making a complaint
We investigate potential Code breaches to improve insurers’ practices for the future – not to get a specific outcome in your individual case. If you want your individual problem to be addressed – for example, if you want compensation, an apology, or for the problem to be fixed – you should instead contact your insurer to make a complaint.
If you’re not happy with your insurer’s response to your complaint, you can take the complaint to the Australian Financial Complaints Authority (AFCA). AFCA is a free, fair, independent service that helps resolve disputes between consumers and insurers.
Reporting a Code breach to the Committee
If you would like to help the Committee drive higher standards in the insurance industry, you can report your concern that an insurer has or may have breached the Code to the Committee.
What happens next
Once you report your concern to the Committee, you will receive an email confirming we have received your message. We will:
- Assess the issue — We will check whether your issue is something we have the power to investigate.
- Consider the evidence — If we decide to investigate, we will ask the insurer for its response and consider the evidence.
- Make a decision — We will make a decision about whether the insurer has breached the Code. You and the insurer will be informed about the outcome.
- Make improvements — If a breach has occurred, we will work with the insurer to agree to changes they will make to prevent the same issue occurring again in future.
Other help for consumers
A range of other organisations provide free information and services to help consumers with insurance issues.
Help to resolve a complaint
- Australian Financial Complaints Authority (AFCA) — If you have a complaint that you haven’t been able to resolve with your insurer directly, AFCA may be able to assist. AFCA provides free, accessible and independent help to resolve disputes between consumers and financial firms.
Help if you’re in financial difficulty
- Insurance Law Service — The Financial Rights Legal Centre Insurance Law Service provides free advice and advocacy for consumers in financial stress. Call its Insurance Hotline on 1300 663 464.
- National Debt Helpline — Call the National Debt Helpline for over-the-phone financial counseling – free help to manage your debts and get your finances back under control. Freecall 1800 007 007 from 9:30 am to 4.00 pm, Monday to Friday.
- Financial Counselling Australia — For free, face-to-face financial counselling, use FCA’s service locator to find a service close to you.
- MoneySmart — The MoneySmart website has free, independent information and tools to help you make decisions about insurance.
- Understand Insurance — The Insurance Council of Australia’s Understand Insurance website has straightforward explanations of insurance matters plus a range of apps, calculators and checklists.