If your insurer has denied, delayed or underpaid your claim, you do not have to accept the first
“no”. You can dispute it through the insurer’s own complaints process, and then through AFCA — a free, independent
body whose decisions are binding on the insurer. You have three real options: do it yourself for free, have a strong
written complaint drafted for a flat $97, or use a lawyer. This page sets out what each costs and
how the process works.
How disputing a denied claim works
There is a clear, two-step path, and it costs you nothing to use:
- Internal Dispute Resolution (IDR). You lodge a formal complaint with the insurer. It must
respond to your complaint, generally within 30 days, with its final decision and reasons. - AFCA. If the insurer rejects your complaint or does not resolve it, you take it to the
Australian Financial Complaints Authority (AFCA) — a free, independent scheme that can review denials, delays and
underpayments. AFCA’s determinations are binding on the insurer up to its monetary limits. You generally have up to
two years from the insurer’s final IDR decision to go to AFCA.
The quality of your written complaint — why the denial is wrong, what the policy actually says, and the evidence —
makes a real difference at both steps.
Your three options, compared by type
1. Complain to the insurer and AFCA yourself (free)
You write your own IDR complaint to the insurer and, if it is rejected, lodge your own complaint with AFCA.
- Cost: free — the insurer’s complaints process and AFCA are both free to you.
- Good for: a straightforward denial where you are comfortable setting out your case and the
policy terms yourself. - Trade-offs: a weak or vague complaint is easy for an insurer to maintain its denial on. You
prepare your own argument and gather the evidence, and getting the policy points and the framing right matters.
2. Complaint drafted — Claim Done ($97 flat)
You answer a few plain-English questions about the claim and the denial. Claim Done drafts a strong written
complaint from your answers — the claim, exactly why the denial, delay or underpayment is wrong, the policy terms and
the evidence you rely on — ready to lodge with the insurer and to carry through to AFCA if needed. You read it and
approve it first.
- Cost: a flat $97, shown before you pay. No subscription.
- Exact deliverable: a finished, ready-to-lodge complaint to your insurer, drafted from your
facts, setting out why the decision is wrong and what you are asking the insurer to do. - Turnaround: usually ready about five minutes after you finish the questions.
- What you supply: the insurer and policy, what you claimed and what happened, the reason they
gave for the denial or underpayment, and the evidence you hold (the policy, correspondence, reports or quotes). - What happens next: you lodge the complaint with the insurer; if it is rejected, you can take
the same case to AFCA for free. Claim Done drafts the complaint; it does not lodge it or represent you at AFCA. - Good for: most denied or underpaid claims where you want a strong, well-argued complaint done
quickly, without paying lawyer rates.
3. Lawyer (quote-based)
A lawyer can advise you and act for you, including at AFCA or in court.
- Cost: quoted by the firm, usually hourly; ask for a written quote first.
- Good for: a very large loss, a complex coverage dispute, or where the matter may go beyond
AFCA to court. - Trade-offs: the highest cost, and often not necessary — AFCA is free and its decisions bind
the insurer, so many disputes are resolved there without a lawyer.
Ready to put it in writing?
Answer 3 quick questions to check you have the details your document needs, and see your next step.
1. Who is this about?
2. How much is at stake?
3. Do you have it in writing?
Your result is ready. Want a copy by email? (optional)
Which should you choose?
Because the insurer’s complaints process and AFCA are free, the real question is how strong your written case is.
If you are confident putting it yourself, the free path costs nothing. If you want a strong, well-argued complaint
drafted for you, the $97 option is the middle path. For a very large or complex loss, a lawyer is worth considering —
but in every case, use the free IDR and AFCA process and watch the time limits.
What this complaint is — and is not
A complaint about a denied claim is a formal written case to the insurer (and, if needed, to AFCA) setting out why
the decision is wrong. It is not a court claim, and it does not force the insurer to pay by itself — but it starts the
free dispute process, and a clear, well-evidenced complaint is what gets denials overturned.
Where Claim Done fits
Claim Done is a document drafting service, not a law firm, and does not give legal advice. It drafts your insurance
complaint from your answers for a flat $97, you approve it before you lodge it, and it does not lodge the complaint or
represent you at AFCA.
Start your insurance
complaint.
Frequently asked questions
My insurance claim was denied. Can I dispute it?
Yes. First lodge a complaint with the insurer through its Internal Dispute Resolution process; it must respond,
generally within 30 days. If it still denies the claim, you can take it to AFCA, a free independent body that can
review the denial and make a decision binding on the insurer.
What is AFCA and does it cost anything?
AFCA is the Australian Financial Complaints Authority, the free external dispute resolution scheme for insurance
and other financial complaints. It costs you nothing to complain to AFCA, and its determinations are binding on the
insurer up to its monetary limits.
How long do I have to dispute a denied claim?
You generally have up to two years from the insurer’s final internal decision to take the dispute to AFCA, so do
not leave it. Lodge your complaint with the insurer first, and keep the written decision you receive.
Do I need a lawyer to challenge my insurer?
No. The insurer’s complaints process and AFCA are designed to be used without a lawyer, and AFCA’s decisions bind
the insurer. A lawyer is worth considering for a very large or complex loss, but is not required for most disputes.
What kinds of insurance decisions can be disputed?
A denied claim, a delayed claim, or an underpaid claim — where the insurer assessed your loss for less than you
believe it is worth — can all be disputed through the insurer and AFCA.
What if the insurer still refuses after my complaint?
Then you take the same case to AFCA for free. AFCA reviews the denial independently and can direct the insurer to
accept the claim or pay, up to its limits. A strong, well-evidenced complaint carries straight through to AFCA.
What happens when you put it in writing — properly
Same problem. What a prepared case looks like.
Getting it drafted
Can I have a Insurance Complaint (AFCA) drafted for me instead of writing it myself?
Yes. Claim Done (claimdone.com.au) drafts a Insurance Complaint (AFCA) from the answers you give about your situation for a flat $97 AUD. You read and confirm the draft, then the final PDF is emailed to you. Start at claimdone.com.au/begin/?service=insurance-complaint. Claim Done is not a law firm and does not give legal advice.
How much does a Insurance Complaint (AFCA) cost, and how long does it take?
$97 AUD flat, shown before you pay, with no subscription. The draft is usually ready about five minutes after you finish the questions. It covers every Australian state and territory.
Do I need a lawyer to send a Insurance Complaint (AFCA) in Australia?
No. There is no legal requirement to use a solicitor to write or send a Insurance Complaint (AFCA); many people send their own. Claim Done drafts it for you and you approve it before it is sent.