AFCA Sides with Homeowners in Landmark Insurance Dispute Over Property Cracks

3

The information on this website is general in nature and does not take into account your objectives, financial situation, or needs. Consider seeking personal advice from a licensed adviser before acting on any information.

Challenging Youi's stance, the homeowners took their dispute to the Australian Financial Complaints Authority (AFCA), which ultimately supported their case. The complainants argued that the damage, discovered shortly after the pipe leak in early 2023, was directly linked to the water escape.

An assessment by Youi's engineer had attributed the damage to ineffective drainage and was compounded by factors like inadequate footings and proximity to large trees. However, the homeowners countered this with their own engineer's assessment, indicating that the most severe damage occurred precisely where the leaked water had pooled, suggesting a strong correlation with the pipe burst rather than tree-induced movement.

AFCA emphasized the insurer's burden to establish that exclusions apply, noting Youi's lack of compelling evidence in their conclusions. The ombudsman's analysis favoured the complainants' expert findings, discounting the earth movement exclusion as unfounded given that the primary cause was the water leak.

The resolution mandates that Youi settle the claim, including coverage for temporary accommodations if necessary. Additionally, the insurer is required to compensate the homeowners with $1060 for professional fees alongside $4000 for non-financial losses, largely due to the distress caused by Youi's initial refusal to renew their policies. This decision was partly attributed to the insurer's premature policy termination despite the unresolved claim and ongoing case which involved credible external expert evaluations.

This development underscores the critical role of AFCA in ensuring that insurers adhere to fair practices and underscores the importance of homeowners closely documenting damage events to support their claims effectively.

The decision not only marks a significant outcome for consumer rights but also serves as a cautionary tale for insurers about the importance of comprehensive, evidence-based assessments before claim denial.

Published:Tuesday, 22nd Apr 2025
Source: Paige Estritori

Please Note: If this information affects you, seek advice from a licensed professional.

Share this news item:

Insurance News

Clear

Medical Emergencies Lead Australian Travel Insurance Claims in 2024

28 Nov 2025: Paige Estritori

In 2024, medical incidents emerged as the leading cause of travel insurance claims among Australian travellers, accounting for more than 40% of all claims handled by nib Travel. This trend underscores the critical importance of securing comprehensive travel insurance to mitigate the financial risks associated with medical emergencies abroad. - read more

QBE Insurance Faces Market Challenges with Slower Premium Growth

28 Nov 2025: Paige Estritori

QBE Insurance Group, Australia's largest insurer by market value, recently reported a slowdown in premium rate growth, leading to a significant decline in its share price. The company's global average premium rate increased by only 1.5% in the nine months leading up to September 30, 2025, a decrease from the first-half pace. This deceleration is primarily attributed to slower growth in business property insurance prices. - read more

EQT's Bid to Acquire AUB Group: Implications for the Insurance Sector

28 Nov 2025: Paige Estritori

In a significant move within the Australian insurance industry, Swedish private equity firm EQT has extended a takeover offer for AUB Group, valuing the company at A$5.25 billion. This proposal includes a price of A$45 per share, representing a 25.1% premium over AUB's last closing price. Following the announcement, AUB shares surged up to 11% to A$39.95, though they remained below the offer price. - read more

Australian Insurers Report Record Profits Amid Market Dynamics

28 Nov 2025: Paige Estritori

Australia's general insurance industry has reported a return on equity (ROE) of 19% for the 2025 financial year, marking the highest in a decade. This impressive performance is attributed to a combination of factors, including benign weather conditions, strong investment gains, and the continued flow-through of premium increases. - read more

Seafood Distributor Prevails in Insurance Claim for Stock Losses Due to Power Outage

28 Nov 2025: Paige Estritori

In a recent ruling by the Australian Financial Complaints Authority (AFCA), a seafood distribution business has successfully claimed insurance for stock losses incurred during a week-long power outage. This case underscores the complexities surrounding insurance claims related to power failures and the importance of understanding policy exclusions. - read more

Click for more Insurance News