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Exclusions, conditions drive early AFCA complaints

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Claim denials due to exclusions and conditions topped the list of general insurance matters reported to the Australian Financial Complaints Authority (AFCA) in its first month of operation.

AFCA says it received 209 complaints on those issues, followed by 181 on claim amounts, 179 on delays and 159 on other claim denial disputes. Service quality dissatisfaction led to 53 complaints.

General insurance was the second-biggest complaint area, representing 21% of cases, behind credit issues on 45%.

By provider type, banks prompted 2367 complaints, followed by general insurers with 1159 and credit providers with 1040.

AFCA launched at the start of last month, taking over from the Financial Ombudsman Service (FOS), Credit and Investments Ombudsman and the Superannuation Complaints Tribunal.

Complaints to the authority across all sectors soared 47% after an information campaign to alert consumers to the new one-stop shop, but general insurance bucked the trend.

“The number of complaints made to AFCA [last month] against general insurers has decreased slightly, by 5%, when compared to complaints made to FOS in October,” a spokesman told

“This is consistent with the decrease in the overall numbers of complaints received by AFCA about general insurance products and follows the trend FOS saw in general insurance over the last six months of operation.”

AFCA received more than 13,000 phone inquiries last month, with 6522 complaints from consumers and small businesses.

CEO and Chief Ombudsman David Locke says streamlined processes and systems performed well: 80% of complaints were lodged online and 15% of those received last month have been finalised.

“AFCA provides quick and easy access to fair resolutions,” he said. “This is part of our role in rebuilding trust in the financial services sector,” he said.

Fewer than 6% of licensee members had a complaint lodged against them last month.