The AFCA Approach to general insurance claims handling

AFCA published a new Approach paper, The AFCA Approach to general insurance claims handling, on 10 August 2026, alongside updated and new papers on non-financial loss and uninsured motorist complaints. The paper brings together, in a single standalone document, AFCA's approach to common claims handling issues in general insurance complaints, which AFCA describes as the most complained about issue in that category.

The paper explains how AFCA assesses claims handling obligations and the remedies available where an insurer has not handled a claim fairly, covering topics including resolving claims fairly, claim delays, cash settlements in home claims, and claim denials based on expert evidence. It includes case studies illustrating scenarios such as an insurer failing to fairly decide to cash settle a vulnerable complainant, increased repair costs arising from claim delay, and reliance on inadequate information to decline a claim.

AFCA has stated that its Approach papers reflect established processes for assessing complaints and do not represent a change in how AFCA manages or resolves disputes, but are intended to help consumers, small businesses and financial firms better understand AFCA's reasoning. AFCA consulted on a draft of the paper before publication and has released a consultation feedback report summarising the issues raised, including commentary on standard timeframes, the interaction with the General Insurance Code of Practice, and insurers' discretion to offer cash settlements.

The Approach paper does not itself create new legal obligations and is described by AFCA as a guide only, since each complaint is assessed on its own facts and no determination is treated as a binding precedent.