Updated 13 November 2026. General information for people in Australia, not advice about your situation.
Short version: complain to the insurer in writing first. If you're not happy with their final answer, or they don't answer within 30 days, take it to the Australian Financial Complaints Authority (AFCA). It's free. You usually have two years from the insurer's final response.
1. Get the reasons in writing
Ask for the decision letter and the exact policy wording they relied on. Ask for copies of any reports they used, such as assessor, medical or investigator reports. You're entitled to know why.
2. Make a formal complaint
Write to the insurer's complaints team (often called internal dispute resolution or IDR). Say you're making a complaint, what you disagree with and what you want. Attach your evidence. For most complaints they have 30 calendar days to give a final response. Super funds have 45.
3. Take it to AFCA
AFCA handles insurance, super, banking and credit disputes. It costs you nothing and its decisions bind the insurer if you accept them. Most complaints have to be lodged within two years of the insurer's final response. Some super complaints, such as death benefit decisions, have much shorter limits.
When a lawyer is worth it
- The claim is large, such as TPD, income protection, a house fire or a business claim.
- The insurer says you didn't disclose something when you took out the policy.
- Fraud is alleged.
- The amount is above AFCA's limits, or you need to go to court.
Many insurance and TPD lawyers work on a no win no fee basis.
What to gather
- Your policy schedule and the product disclosure statement for the date of the event.
- Every email and letter, plus notes of calls with dates.
- Photos, quotes, medical reports and receipts.
Quick answers
How long does an insurer have to respond to a complaint?
For most complaints the insurer must give a final response within 30 calendar days. Super funds have 45 days.
Is AFCA free?
Yes. AFCA is free for consumers and small businesses. Most complaints must be lodged within two years of the financial firm's final response.