How long does an insurance claim take Australia

Car insurance

Avoid surprises when you claim on your car insurance

Table of Contents Show

1. Gather information about the accident
2. Check what you can claim for
3. Check if you have to pay an excess
4. Make a claim
5. After you make a claim
How to lodge a dispute
Exceptional circumstances
Use of external experts in claims assessment

3 minutes

You can claim on your car insurance when you've suffered any loss or damage that your policy covers.

When you have a car accident, contact your insurer as soon as possible. Some policies have time limits for claiming. Also ask them if you're entitled to any emergency benefits, for example, free car hire or accommodation.

1. Gather information about the accident

To make a claim, you have to meet the terms and conditions of your policy.

If your accident involved another car, your insurer may ask for details of the other driver, including:

contact details (name, address, phone number)
drivers licence and car registration
insurance company
car make, colour and model

Your insurer may also ask for:

the location of the accident
a description of what happened and any damage to cars or property (plus photos)
a police report number (if the police attended or you reported your car stolen or damaged)
details of the tow truck company (if one attended)
contact details of any witnesses

2. Check what you can claim for

Check your policy to find out what you can claim for. For example, if you have third party insurance, you can only claim for damage to other cars.

Also check if there are any exclusions to your cover. You may not be covered if the person driving your car was under the influence of alcohol or drugs, or if your car was unregistered.

3. Check if you have to pay an excess

Generally, you have to pay an excess when you make a claim whether you're at fault or not. Some policies will waive the excess in limited circumstances.

Check your policy’s Product Disclosure Statement (PDS) for the excess amount and conditions where it might be waived.

4. Make a claim

There are different rules and processes for claiming. Check the claims process on your insurer’s website.

If you do decide to claim, you'll need to fill out a claim form. You may be able to do this with your insurer over the phone or online.

Ask your insurer if you can start a claim to find out how much the repairs will cost. Then you can decide if it's worth going ahead. For example, if the damage is minor, the repairs may cost less than your excess.

If the other party has admitted it was their fault, their insurer may pay for your costs.

The General Insurance Code of Practice sets out what insurers should do to handle claims. If they do not meet these standards you can complain to the insurer.

5. After you make a claim

After you've made your claim, the insurer must contact you within 10 business days. They may accept or reject your claim, or ask for more information.

If they reject your claim, they must do this in writing.

Your insurer may contact any other drivers, their insurers, and any witnesses who saw the accident.

They may also investigate to confirm the details of what happened and who was at fault.

If you're not happy with how your insurer has handled your claim, make a complaint to their Internal Dispute Resolution team. If you are still not happy, contact the Australian Financial Complaints Authority (AFCA).

Alisha was not at fault, but still has to pay her excess

Alisha's car was hit by a person driving a stolen car, who drove off after the accident.

Alisha contacts her insurer to make a claim. They tell her she will have to pay the excess, even though the damage wasn't her fault.

Alisha checks her policy. She finds a condition stating she has pay the excess if the 'at fault' party can't be found.

Insurance claims can take a long time to finalise when you’re waiting for a decision to be made by the insurance company. Here we explain your rights in terms of information that you can request and how to lodge a dispute if that is required.

EXAMPLE CASE

Karen was involved in an accident where she was not the at-fault driver. She is claiming on the at-fault driver’s insurance policy. She’s called, and nothing. Weeks go by. Someone always promises to call back but never does. They want more information and documents. Karen is not pleased.

So what should Karen do?

Lodge a dispute! Karen has been waiting for more than three weeks, but after two she could have lodged a dispute. Insurers don’t like disputes, so it’ll put your case on someone’s desk to hurry it along. There are also rules for how long an insurer can take to make a decision on a claim.

How to lodge a dispute

If we are handling your case, we can deal with this on your behalf. If you’re going it alone, here’s the process.

Step 1: Internal dispute resolution

Every insurance company has a dispute’s handling department. You can call the insurer and lodge a dispute, telling them you have a dispute or complaint regarding the delay on your claim. The General Insurer Code of Practice dictates that insurers have 15 business days to respond to your dispute.

If they need further information or documentation, then they must request it from you and decide on another timeframe within which to settle the dispute. If you can’t reach an agreement, you can lodge a complaint with the Australian Financial Complaints Authority (AFCA – formerly the Financial Ombudsman Service or FOS).

If a complaint has not been resolved within 45 days from the first time you raised the dispute, you can lodge a complaint at AFCA. In this case, the insurer’s internal disputes resolution team must keep you updated at least every 10 business days.

Step 2: AFCA complaints

All insurance companies must be a member of an external dispute resolution scheme, like AFCA. We can help you lodge a complaint with AFCA or see the AFCA website.

Exceptional circumstances

There are some circumstances where a delay may be allowed, which are known as exceptional circumstances. Exceptional circumstances include:

The claim relates to an extraordinary catastrophe or disaster, which will be declared by the Board of the Insurance Council of Australia
Fraud is involved or suspected to be involved in the claim
You fail to respond to the reasonable requests by the insurer for more information or documents
The insurer has trouble communicating with you regarding the claim due to circumstances beyond the insurer’s control
You ask for a delay in the claims process for some reason

Use of external experts in claims assessment

Experts must provide a final report to the insurer within 12 weeks of the request being made. If the report does not materialise in this time, the insurer will keep you updated. You can request all reports, which must be sent to you within 10 business days.

If a claim is being investigated, the insurer may not release information, but may not do so ‘unreasonably’.

Claiming interest on your payout

If you believe the insurance company is unreasonably delaying your claim, ultimately you may be able to seek interest payments. We can help you with your claim.

Call us, free, to discuss your case and see if we can help you.

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What you need to know

You can make a car insurance claim for any loss or damage, so long as your policy covers you.
Contact your insurer as soon as it is safe to let them know what has happened.
If you are in a car accident with another driver, you will need to get a few details from them.

There are a lot of details to exchange in the event of an accident, so try familiarising yourself with the following details. Take them down on your phone or have some pre-filled forms in the car to make life easier.

Name
Time, date and location of the incident
Contact number
Address

Vehicle registration
License number
Details of their CTP insurer and policy
A brief description of what happened

Get photo evidence

Take picture and video evidence with your phone at the scene – this makes sure your insurer has all they need to successfully process your claim.

Here's a checklist of what you'll need

Information about the driver
A description of what happened
A police report number (if the police were at the incident)
Contact details of any witnesses

Get in touch with your insurer as soon as possible to let them know that you were involved in a car accident and what happened. If you have comprehensive car insurance, you might be entitled to a hire car or accommodation, depending on what happened. They can also let you know if you need to pay an excess.

You can usually do this in one of the following ways

Online or using an app
Over the phone
In the mail or in person

According to the General Insurance Code of Practice, your insurance provider has 10 business days from the day they receive your claim to respond with the outcome. If they need more time to decide, they will let you know in advance.

Legal Aid recommends that you write a letter after the accident to let the other driver know you intend to make a claim against them.

This is a good idea if it's going to take a while to receive a repair quote. The other driver should then pass the letter on to their insurer – provided they have cover – unless they would rather pay for the damages personally.

You should then spend time getting at least two quotes for the cost of repairs so as to show they are fairly priced. Make photocopies of the quotes and keep hold of the originals. You should also add on any additional costs to do with the accident, such as towing costs.

There usually isn't a fixed deadline for car insurance claims as some damage settlements can take years to be finalised. This means that while insurers don't generally set a time limit, they depend on your full cooperation, so you should let them know if you've been in an accident as soon as possible.

The main exception is with injury claims, which are dealt with through CTP insurance and can sometimes be sorted in as little as a month. This is to ensure injured people get the benefits they are entitled to as soon as possible.

There are often time limits with your Police Event Number. If you need to report the accident to the police, this usually has to be done within 28 days in most states.

If you don't follow the terms and conditions of your insurance policy, then insurers may reject your car insurance claim. Look for:

Benefits. A common trap is to assume that a policy covers something when it doesn't. For example, you will probably need a comprehensive car insurance policy if you want to claim certain variety of types of damage, and cannot assume that you are covered for anything in specific.
Exclusions. These are conditions where the policy will not pay out. Exclusions will typically apply for driving under the influence and otherwise being reckless behind the wheel, but there may be more specific ones such as exclusions for accidents that occur within a certain distance of your home, or beyond a certain amount.
Your obligations. Not getting unapproved repairs and not offering to settle damage with other parties are two common obligations you will encounter in car insurance policies. Not following these can be used as valid grounds to decline a claim.

If you are not happy with how your insurer has handled your claim, and after going through your PDS believe you are in the right, then you can contact the Australian Financial Complaints Authority (AFCA) for a resolution.

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