When something goes wrong that is covered by your insurance policy, you can decide whether to make a claim.
It won’t always be worthwhile to make a claim, even for something that is covered by your insurance – there are a few things to weigh up.
Check you’re covered for the thing that happened
When something goes wrong, check your Product Disclosure Statement (PDS) and insurance policy terms and conditions to see if you have cover to claim. Some things that might make it hard to get your claim approved can include:
- what you’re claiming for is not covered by your policy – for example with car insurance, your policy may only cover drivers named on your policy, but not if someone else was driving when the car was in an accident
- the problem that has happened involves breaking the law – for example, if you’re claiming on car insurance, the driver was under the influence of drugs or excessive alcohol, or the car is not registered or roadworthy
- you haven’t looked after the item you have insured – for example, for cars, have you been having it serviced regularly; for homes, have you been making sure any leaks or other damage have been fixed
- any older damage to the item was not reported to your insurer
- you stopped paying your premiums – so you no longer have insurance cover
- the damage was done on purpose – if you are experiencing family or domestic violence, some insurers have procedures to assist you (and other support is available)
- you take a long time to make a claim
There is no shame in getting help with your insurance claim. If you think your insurer has made a wrong decision, if you're not sure if your claim meets the rules, or you're worried about the questions you might be asked – it’s a good idea to get legal advice.
You can talk to the Insurance Law Service on 1300 663 464.
You can always contact your insurer when something goes wrong to understand more about the types of things your policy covers and decide whether to make a claim. If your insurer tells you that you can’t claim or your claim is rejected, and you think the decision is unfair, you could get legal advice to learn more about your options.
Decide whether to make a claim
The thing that goes wrong might be covered under your policy, but you might decide that it’s not worthwhile to make a claim.
You might not claim if:
- the damage is only minor and it will be cheaper for you to pay for repairs yourself, instead of paying your insurer your excess amount
- the damage is because the item wasn’t looked after properly, or is because of normal wear and tear
- you know for sure the damage isn’t covered by your insurance
You might want to claim if:
- you know the repairs will cost more than your excess amount
- the insurance company can arrange immediate support to stop more damage while they assess your claim, such as putting a tarp on a damaged roof
- your insurance will cover costs to help when it happens, such as your car being towed to a repairer
- you don’t know who to contact to organise repairs, or you aren’t confident to manage the repair process
Making a claim can affect your insurance
Making a claim can increase how much you pay for insurance in the future. Your insurer might increase the cost of your premium when it’s time to renew. If you get a quote from another insurer, they will ask you if you’ve made any recent claims.
For some cover, you can’t claim on the same thing again in the near future. For example, some insurance policies won’t cover you for a stolen car if you have had a claim paid out for a stolen car in the last year.
Marg scratches her car
Marg scratches her car pulling out of the driveway. She has comprehensive insurance, so she calls her insurer to talk about the damage and whether or not to make a claim. After sending photos, the insurer says repairs will probably cost $400. Marg’s excess for making a claim is $650 – which is more than the repairs. She decides to organise repairs herself and pay out of her own pocket, rather than making a claim, because that’s cheaper and she feels confident she can organise them herself.
How to claim on your home or car insurance
To make a claim for insurance, you’ll need to contact your insurance company.
For car insurance, follow the steps on claiming on your car insurance.
For home insurance claims see how to make a home insurance claim.
Get help if you need it
Insurance can be tricky and there are things that can go wrong. There is no shame in getting help if you’re having trouble.
Common problems with insurance claims can include:
- you have made a claim but haven’t heard from the insurance company
- your insurance claim is rejected, either partially or fully
- you and your insurer disagree about what caused the damage, or how much it will cost to repair the damage
- you can’t afford to pay your excess (talk to your insurer about ‘hardship’ options)
- the repairs organised by your insurer (or replaced item) aren’t very good
If your insurer wants to ‘cash settle’ the claim, this means they want to give you money so you can arrange the repairs. You might not want to do this if you think repairs will cost more than the amount offered to you, or if you don’t think you can manage arranging and overseeing the repairs yourself.
Making a claim can be a stressful time and you can get help at any time. If you need help, try to reach out as soon as you can. You can get help from any of these organisations.
Financial Rights Legal Centre’s Insurance Law Service
For free and independent legal advice about your insurance coverage or for support with a claim, call the Insurance Law Service on 1300 663 464.
Mob Strong Debt Help
A free, confidential and independent financial counselling and legal service for Aboriginal and Torres Strait Islander peoples, they can help you talk to your insurer and work through your options. You can call the free Mob Strong Debt Help line on 1800 808 488.
National Debt Helpline
The National Debt Helpline can give you free help from financial counsellors if you need more guidance on your options, or support with talking to your insurer. Call the free National Debt Helpline on 1800 007 007.