AFCA Sides with Homeowners in Landmark Insurance Dispute Over Property Cracks
AFCA Sides with Homeowners in Landmark Insurance Dispute Over Property Cracks
3
The information on this website is general in nature and does not take into account your objectives, financial situation, or needs. Consider seeking personal advice from a licensed adviser before acting on any information.
Homeowners recently secured a favourable ruling against their insurer after a water leak led to significant structural damage.
After large cracks emerged on their property, Youi initially denied the insurance claim, attributing the damage to pre-existing issues like earth movement and tree root intrusion, both of which are exclusions in their policy.
Challenging Youi's stance, the homeowners took their dispute to the Australian Financial Complaints Authority (AFCA), which ultimately supported their case. The complainants argued that the damage, discovered shortly after the pipe leak in early 2023, was directly linked to the water escape.
An assessment by Youi's engineer had attributed the damage to ineffective drainage and was compounded by factors like inadequate footings and proximity to large trees. However, the homeowners countered this with their own engineer's assessment, indicating that the most severe damage occurred precisely where the leaked water had pooled, suggesting a strong correlation with the pipe burst rather than tree-induced movement.
AFCA emphasized the insurer's burden to establish that exclusions apply, noting Youi's lack of compelling evidence in their conclusions. The ombudsman's analysis favoured the complainants' expert findings, discounting the earth movement exclusion as unfounded given that the primary cause was the water leak.
The resolution mandates that Youi settle the claim, including coverage for temporary accommodations if necessary. Additionally, the insurer is required to compensate the homeowners with $1060 for professional fees alongside $4000 for non-financial losses, largely due to the distress caused by Youi's initial refusal to renew their policies. This decision was partly attributed to the insurer's premature policy termination despite the unresolved claim and ongoing case which involved credible external expert evaluations.
This development underscores the critical role of AFCA in ensuring that insurers adhere to fair practices and underscores the importance of homeowners closely documenting damage events to support their claims effectively.
The decision not only marks a significant outcome for consumer rights but also serves as a cautionary tale for insurers about the importance of comprehensive, evidence-based assessments before claim denial.
As of 1 July 2025, the Department of Health, Disability and Ageing has introduced a professional indemnity insurance (PII) product specifically designed for midwives providing intrapartum care. This development, under the Midwife Professional Indemnity Scheme (MPIS), ensures that private midwifery practitioners now have access to insurance coverage encompassing all facets of their practice, including intrapartum services. - read more
In recent developments within the Australian healthcare sector, a significant number of bariatric surgeons are contemplating the future of their medical practices due to a substantial increase in indemnity insurance premiums and a rising incidence of legal claims. This trend poses potential challenges to the accessibility of obesity-related procedures for patients across the country. - read more
Recent projections indicate that global health insurance costs are set to rise by 10.3% in 2026, marking a continuation of the upward trend observed in recent years. This follows a 10% increase in 2025 and a 9.5% rise in 2024, underscoring the sustained inflationary pressures faced by insurers and employer-sponsored health plans worldwide. - read more
Marsh, a leading insurance broker, offers tailored insurance solutions designed specifically for fitness professionals across Australia. Recognising the unique risks associated with the fitness industry, Marsh provides comprehensive coverage options to safeguard personal trainers, gym owners, and other fitness practitioners. - read more
AUSactive, Australia's peak body for the exercise and active health sector, has introduced the Professional Plus Membership, a comprehensive package designed to support fitness professionals in their careers. This membership combines the benefits of AUSactive's professional membership with an exclusive insurance policy tailored for those delivering fitness, exercise, and active health activities. - read more
As the landscape of finance and personal security evolves in Australia, the importance of being insured has never been more prominent. In a world of changing family dynamics, economic pressures, and higher living costs, life insurance stands as a bastion of support ensuring the well-being of loved ones in the event of unforeseen circumstances. - read more
Life insurance can seem complex at first, but understanding the basics can help demystify this important financial product. At its core, life insurance is a contract between you and an insurer, where the insurer promises to pay a designated beneficiary a sum of money upon your passing, in exchange for premium payments. - read more
The horizon of the insurance industry has undergone a transformative shift with the advent of digital technology. With a few clicks, consumers can navigate the once-complex world of insurance policies from the comfort of their home. The digital landscape for insurance services offers unprecedented access to information, comparisons, and instant communication, fostering a more empowered insurance client. - read more
Life insurance is a crucial part of any comprehensive financial plan, providing peace of mind that your loved ones will be financially secure in the event of your passing. - read more
Life insurance is an essential safety net for families, providing financial security when it's needed the most. As your family grows, the importance of having a well-structured life insurance policy becomes even more critical. In the busy lives we lead today, it’s easy to overlook this crucial aspect of financial planning. However, ensuring your coverage meets your family's evolving needs is vital. - read more
Start Here !
Apply now for your free Insurance assessment and price comparisons!
Knowledgebase
Rider: An optional provision added to an insurance policy that provides additional benefits or coverage.