Home insurance (building insurance) covers the cost of rebuilding or repairing your home when something goes wrong.
Homeowners often bundle their home insurance into a combined 'home and contents' policy to cover both home and belongings.
Your insurer must handle your claim efficiently and fairly. Follow these steps to lodge a claim.
Step 1. Contact your insurer
Contact your insurer as soon as practical after the event happens, even if you don’t know the full extent of the damage yet.
Some types of policies may have time limits to lodge a claim, so check your policy.
Temporary accommodation
Ask your insurer about temporary housing or accommodation if your home has been destroyed, or damage has made it unliveable.
Your insurer may give you a list of options. Or you may be able to find your own housing up to a set limit.
If your insurer asks you to pay for the housing upfront, keep receipts so you have a record of your costs.
If you can't afford to pay upfront, let your insurer know you need financial hardship assistance.
Speak to your insurer before doing emergency repairs
Talk to your insurer before you spend money on temporary repairs after an incident.
Many insurers have preferred repairers and suppliers and can arrange emergency repairs for you. This can include things like removing loose debris or installing a roof tarp.
Step 2. Start the claim
Your insurer can help you even if you don't have your policy information. Ask them to give you details about the key features of your insurance, including inclusions and exclusions, excesses, and sums insured.
If you delay reporting your claim, your insurer may not pay for any loss or damage caused by your delay.
Some types of policies may also have time limits to lodge a claim, so check your policy.
Response to your claim
Your insurer will review your claim to see if your policy covers the event or circumstances you are claiming for.
The insurer must respond to your claim in 10 business days. If they need more information before deciding, they will let you know what they need within that time.
Once your insurer has all the relevant detail, they have another 10 business days to tell you if they accept or deny your claim .
The General Insurance Code of Practice sets out what insurers should do when handling your claim. This includes timeframes for making a decision and keeping you updated.
Financial hardship
If you are experiencing financial hardship, speak to your insurer. They could give you an advance payment of your claim or defer any excess you may need to pay.
You can complain to your insurer if you are not satisfied with how your claim is progressing. See how to complain for the steps you can take.
Step 3. Get assessment and decision
The nature of your claim will determine how long it takes for your insurer to make a claim decision. For example, if your claim is more complex and needs specialist reports, the decision may take longer.
If your home has been damaged or destroyed, the insurance company will appoint a Loss Assessor or Loss Adjuster to assess your claim. They will tell you within five business days of appointing that person and let you know what their role is.
Reports from specialists like a Hydrologist or Engineer may be needed to assess your claim. If your insurer engages an external expert, they will ask for the report to be provided in 12 weeks. If that timeframe is not met, the insurer will let you know and keep you updated.
If your claim is denied
If your claim is denied, the insurer must provide in writing:
- what part of your claim they did not accept
- the reasons for their decision
- your right to ask for copies of any reports they relied on to make their decision
- how you can complain about their decision
If you ask for copies of reports used to assess your claim, your insurer must send them to you within 10 business days.
How to complain about a claim decision
If you are unhappy with the decision, or disagree with the assessor's report, you can make a complaint with your insurer.
Your insurer has a dispute resolution process to resolve your concerns. Ask them for information about how to complain.
If you are not satisfied with the outcome of the internal review, you can make a complaint with the Australian Financial Complaints Authority (AFCA).
Step 4. Review the scope of works
If your claim is approved, and involves rebuilding or repairs, you will get a written report you will need to review and sign. This is known as a 'scope of works' or 'statement of works'.
This sets out the repair or rebuild work that will be done, and the products that will be used.
Make sure you check:
- what will be repaired or replaced
- what won't be repaired or replaced
- the materials being used
- any dependencies on the work being done. For example, you may need to pay for repairs not covered by your policy before work covered by your insurance starts.
Contact your insurer if you need more detail or aren't happy with what's in the statement of works.
If you can't come to an agreement, you can ask for your claim to go to the insurer's internal complaints team.
Step 5. Repair or rebuild
To settle your claim, your insurer may offer to:
- handle the repairs or rebuild of your home
- offer you a cash settlement, or
- a combination of both.
Insurer managed
If your insurer is managing the repair or rebuild, they will project manage the work for you, including:
- notifying you of the construction schedule
- arranging trades such as builders, electricians, or plumbers
- managing local council approvals, if required.
Your insurer will manage communication between all parties and oversee the work. Your insurer is responsible for the quality of work and materials used by anyone directly authorised by them.
You can complain to your insurer about builders or other contractors if their conduct or work completed doesn’t meet your needs.
Cash settlement
By opting for a cash settlement, you are responsible for managing the repair or rebuild process yourself. This includes sourcing and managing contractors or building approvals.
You may be left out of pocket if the repairs and costs are more than the cash settlement.
If you decide to manage the works yourself, make sure you comply with council regulations and building codes. Always use a licensed builder. If you don't, your home may not be insurable.
Claims after a natural disaster
If your claim is because of a natural disaster, and was finalised within one month of the event, you have the right to ask for a review. You have 12 months from the date of finalisation of your claim to request this if you think the assessment of your loss was not complete or accurate.
You can do this even you have agreed to the settlement.