Useful information and links
You pay a regular amount (called a premium) to the insurer who, in return, provides financial protection against losses (like damage, theft, disaster or illness). When an incident occurs, you can make a claim for compensation.
This page includes information on:
Who to talk to
The insurance industry in Australia provides cover for many things in your day-to-day life like your health, home, car and valuables.
Some insurance is required by law (like compulsory third-party motor vehicle insurance), others (like private health insurance) are encouraged, and other insurance policies are entirely voluntary.
Different organisations look after the different insurance questions and complaints. Find out which one is looking after your concern below.
Your insurer
In the first instance, contact your insurer.
All insurers are required to have an internal dispute resolution service, and this is usually the fastest way to resolve an issue. If you are still unable to resolve the issue with them, try the appropriate authority below.
Australian Financial Complaints Authority
The Australian Financial Complaints Authority (AFCA) is a not-for-profit external disputes resolution scheme that deals with complaints from consumers and small businesses about financial products and services, including insurance.
AFCA can help you with complaints regarding general insurance products for domestic and personal items including:
- consumer credit insurance
- home building
- home contents
- motor vehicle
- personal and domestic property
- trust bond
- residential strata title
- sickness and accident
- ticket insurance
- travel insurance.
AFCA does not have jurisdiction over workers compensation, compulsory third-party or home owners warranty matters.
Contact AFCA on 1800 931 678 or visit the website for more information.
Australian Prudential Regulatory Authority
The Australian Prudential Regulatory Authority (APRA) can help you with issues regarding life insurance and superannuation.
As an independent statutory authority, APRA supervises Australia’s banks and financial institutions, insurance companies, friendly societies and superannuation funds (excluding self-managed funds).
Contact APRA on 1300 558 849 or visit the APRA website for more information.
State Insurance Regulatory Authority
The State Insurance Regulatory Authority (SIRA) can help resolve disputes with workers compensation, home building compensation and motor accident CTP insurers.
SIRA regulates workers compensation, home building compensation insurance and motor accidents CTP (green slip) insurance in NSW. SIRA also investigates system fraud.
Visit the website for more information or contact SIRA on:
- 13 10 50 for workers compensation and home building issues
- 1300 656 919 for CTP queries
- 1800 600 444 to report CTP fraud
- 1800 347 788 to lodge a dispute against a CTP insurer.
Medicare
Medicare is the universal health care system in Australia. Providing rebates for scheduled fees, it helps pay for some or all the costs of health care services including:
- seeing a GP or specialist
- tests and scans, like x-rays
- most surgery and procedures performed by doctors
- eye tests by optometrists
- medicines under the Pharmaceutical Benefits Scheme (PBS).
If you have an issue regarding a Medicare claim, benefits or would like more information about Medicare, call (02) 6124 6333 or see the website.
Private Health Insurance Ombudsman
The Private Health Insurance Ombudsman (Commonwealth Ombudsman) is an independent body that deals with issues and complaints relating to private health insurance. Complaints must be about a health insurance arrangement, the Ombudsman does not take complaints about the quality of service or treatment by a provider.
Contact the Private Health Insurance Ombudsman on 1800 640 695 or (02) 8235 8777 or visit the website for more information.
NSW Fair Trading
We can help you with your consumer rights and protections under Australian Consumer Law. Learn about your consumer rights below.
If you believe an insurer has breached Australian Consumer Law, call us on 13 32 20 or make a complaint online.
Your consumer rights
Australian Consumer Law guarantees your rights when you buy goods and services. In fact, most products and services purchased after 1 January 2011 come with an automatic consumer guarantee that the product or service you purchased will work and do what you asked for. This includes insurance services.
Acceptable quality
When you engage a business to provide a service, you have the right to expect ‘acceptable quality’. Services must be:
- provided with due care or skill (taking all necessary steps to avoid loss and damage)
- fit for any specified purpose (express or implied)
- provided in a reasonable time (when no time is set).
What is ‘reasonable’ will depend on the nature of the service, the difficulty of the task and other relevant.
Remedy when things go wrong
You are entitled to an appropriate remedy from the business when the product or service you purchased does not meet one or more of the consumer guarantees.
This might be a refund, a further service to rectify the problem and in some cases, reimbursement for damages and consequential loss.
For more information, refer to ‘repairs, replacements and refunds’.
Proof of purchase and documentation
You have the right to receive proof of purchase (like an invoice, cash register receipt, handwritten receipt or lay-by agreement).
Insurance policies come in the form of a contract. Contracts usually have terms and conditions attached. It is your responsibility to be aware of these.
Advertising
Advertising can be a powerful means of persuasion, so it’s important it is truthful, accurate and easy to understand. Australian Consumer Law protects consumers from deceptive advertising claims and conduct.
Businesses are not allowed to make false or misleading representations about their products or services. This includes advertising for insurance products and services.
Any statement regarding qualifications or experience should be supported and if licensed, the licence number should be printed on any advertising. Learn more about advertising standards .
Be a savvy consumer
To avoid being under-insured in a worst-case scenario, check your cover each year when you renew or change your insurance.
Further information
Contact us
Can’t find the information you’re looking for? Call us on 13 32 20 or submit an online enquiry.
Who enforces Australian Consumer Law?
The following agencies enforce provisions relating to consumer goods and services:
- Australian Competition and Consumer Commission (ACCC)
- NSW Fair Trading, and
- other State and Territory consumer protection agencies.
The Australian Securities and Investments Commission (ASIC) is responsible for financial products and services.