A denial is not the final word. Denied claims get overturned more often than people expect, and challenging one is free.
of complaints AFCA closed before a formal decision were resolved by agreement or in the consumer's favour.
AFCA, 2024-25. Across all products, not a win rate. Lodging costs you nothing.
The question almost no one answers. Here is a plain-English read on which denials tend to be worth fighting and which rarely are. A starting point, not legal advice.
Stronger grounds do not guarantee an outcome. Whichever column you land in, the free path below costs nothing to try.
Every step here is something you can do yourself, for free, from the first letter to a binding decision at the ombudsman.
Make the insurer state the exact reason and the policy clause they are relying on. That letter is the spine of your whole dispute.
Internal dispute resolution is the insurer's formal complaint channel. They generally must respond within 30 days.
The free, independent ombudsman. Their decision binds the insurer but not you, so there is nothing to lose by lodging.
Free and bindingEverything above is free to do yourself. When you are ready to act, pick the path that fits, and use the free public services first either way.
Get the free dispute kit: the IDR and AFCA letter templates, the evidence checklist and a deadline tracker. Emailed to you.
If your denial is complex or high value, we can check whether a vetted insurance-dispute lawyer can help, so you do not have to fight it alone.
Free to ask, no obligation, and only after the free path above. We connect you only with your consent. Free help first: AFCA and the Financial Rights Legal Centre, 1800 007 007.
Yes. In Australia you first lodge an internal complaint (IDR) with your insurer, then if needed escalate to AFCA, the free and independent ombudsman. Neither step charges you a fee.
For most general insurance complaints the insurer generally must give a final IDR response within 30 calendar days. If they miss that deadline, or you are not satisfied with the outcome, you can take the complaint to AFCA.
An AFCA determination is binding on the insurer if you accept it, but it is not binding on you. If you reject it you keep your other legal options, which is why lodging carries little downside.
No. IDR and AFCA are designed to be used by consumers directly, without a lawyer. Free financial counsellors and community legal centres can also help you prepare.