Homeowner Successfully Challenges Insurer in Disclosure Dispute

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.

According to Auto & General Services, it denied the claim for flood damage because the homeowner failed to disclose that he had been running an air conditioner and refrigerator retail business from the shed. The insurer pointed out that during the most recent policy renewal, the homeowner confirmed that no part of the property was used for business activities or for buying, selling, or storing business products or equipment.

The homeowner admitted to operating a business out of the shed but argued that he was not required to disclose the details because the policy specifically excluded coverage for business and farming structures, including sheds. He emphasized that the policy referred to the insured dwelling as a "freestanding house" and that any losses to the shed were covered by a separate business insurance policy.

The Australian Financial Complaints Authority (AFCA) sided with the homeowner, stating that the home and contents policy did not cover the shed and it was fair for him not to disclose the business. AFCA ruled that when the homeowner answered the insurer's question about whether any part of the "property" was being used as a business premises, he understood the question to refer only to the freestanding residential dwelling where he lived. AFCA also noted that the certificate of insurance specifically mentioned the freestanding home and did not include any reference to outbuildings or sheds.

As a result of the ruling, Auto & General is now required to accept the claim and appoint a qualified expert to prepare a scope of works for repairs to the insured property. The insurer must arrange and complete the repairs or provide a cash settlement with a 15% contingency. AFCA has also instructed Auto & General to assess the homeowner's entitlement to temporary accommodation benefits and reinstate his policy.

Published:Saturday, 9th Dec 2023
Source: Paige Estritori

Please Note: If this information affects you, seek advice from a licensed professional.

Share this news item:

Insurance News

Clear

Understanding the 4.41% Increase in Private Health Insurance Premiums for 2026

22 Feb 2026: Paige Estritori

Australian private health insurance premiums are set to rise by an average of 4.41% from 1 April 2026, marking the most significant increase since 2017. Health Minister Mark Butler stated that this adjustment reflects the escalating costs of medical and hospital services, which have risen by 5% over the past financial year. This increase is expected to impact over 15 million Australians who hold private health insurance policies. - read more

Health Insurers Respond to Rising Costs with Increased Payments to Private Hospitals

22 Feb 2026: Paige Estritori

In response to escalating operational costs faced by private hospitals, health insurers have increased their payments to these facilities. Recent data indicates that payments to private hospitals have risen by 7.7% in the year leading up to March 2025. This adjustment aims to support private hospitals during a period of financial strain and to ensure the continued delivery of quality health care services. - read more

Health Insurers to Include Natural Therapies in Coverage from 2026

22 Feb 2026: Paige Estritori

In a significant policy shift, Australian health insurers will begin offering rebates for a range of natural therapies, including Yoga, Pilates, Tai Chi, Shiatsu, Naturopathy, Western herbal medicine, and the Alexander Technique, starting early 2026. This change follows legislative amendments allowing these therapies to be covered under private health insurance for the treatment of health conditions or as part of health management programs. - read more

Australian Insurers Highlight Key Challenges for 2026

22 Feb 2026: Paige Estritori

As 2026 approaches, Australian insurers are facing a trio of pressing challenges: rising premium costs and shrinking insurability, escalating cyber and data risks, and increasing difficulty in hiring and retaining skilled workers. These concerns have been highlighted in industry feedback cited in Gallagher Bassett’s upcoming report, 'The Carrier Perspective: 2026 Claims Insights.' - read more

Australian Insurers Under Fire for Steep Premium Increases

22 Feb 2026: Paige Estritori

In recent times, Australian consumers have been grappling with substantial increases in insurance premiums, prompting widespread concern and calls for greater transparency within the industry. Reports indicate that some policyholders have experienced premium hikes of up to 600%, leaving many questioning the justification behind such steep increases. - read more

Click for more Insurance News