Disputes & Litigation
Insurance disputes can involve policy interpretation, non-disclosure allegations, claim handling, exclusions or the value of a claim. The relevant policy version and insurer's stated reasons are the starting point for an assessment.
General information only — not legal advice. This Australian overview is not a statement of every state or territory’s law. Check the jurisdiction and current requirements with an appropriately qualified adviser.
A loss occurring during a policy period does not automatically establish cover. Internal review, AFCA and litigation may be available in different circumstances. Ask how a proposed settlement, release or repair arrangement could affect the remaining dispute before accepting it.
Organise the following material you already lawfully hold. This is a preparation list, not a complete evidentiary requirement. Ask the verified adviser what they need and how to send it securely.
Keep originals and dates intact. Use a short initial enquiry for a conflict and suitability check before sending sensitive documents.
Bring the policy version, claim correspondence, decision and reasons. Ask the adviser to identify whether the problem concerns cover, evidence, the amount offered or handling of the claim. A useful first output distinguishes policy interpretation from a complaint or possible legal proceeding and identifies any unresolved factual questions.
A broker’s summary, renewal schedule and full policy wording are different records. Do not assume an exclusion or benefit can be assessed from the product name alone.
Which policy provisions and factual issues drive this decision, and what review pathway is available?
Ask the adviser to explain the assumptions behind the answer, any missing information and what would change the proposed next step. You can request an initial assessment without assuming that full representation is included.
AFCA publishes information about insurance complaints and its scope. Check whether it can consider your issue and ask about the relationship to any other process. A lawyer can advise on your individual position; a directory cannot determine eligibility.
Compare the defined work and exclusions, not just the initial price. Ask about GST, third-party expenses, later stages and what happens if the scope changes. Our legal fees guide explains useful questions, and the comparison worksheet helps record proposals.
For a related legal task, read tpd & superannuation claims. Use both sets of preparation questions if your enquiry spans the two tasks.
Define the work before comparing the fee
A disagreement is easier to explain when you separate the facts, the result sought and the process already underway. Ask about the scope of an assessment before assuming litigation is the proposed next step.
Mention connected issues when you enquire. One engagement may not cover every part of your situation.
Use these primary resources for background and current pathways. A state-specific resource is an example for that jurisdiction, not a rule for all Australia. Broad regulator and tribunal links do not establish your eligibility or a legal entitlement.
Financial complaint jurisdiction, eligibility and process must be checked.
Our document lists, questions and examples are original editorial preparation prompts. Follow the relevant authority for current requirements and seek individual advice before acting.
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