Form · Insurance Law
AFCA complaint about an insurance claim: lodgement and preparation guide
A guide to lodging an insurance complaint with the Australian Financial Complaints Authority through its online process: eligibility, time limits, what to include, the stages of AFCA's process and how to prepare the evidence.
- Kind
- Form. A form to complete, or a guide to completing an official one.
- Where it applies
- Australia
- AI use
- Yellow AI can help in set ways. A lawyer checks specific points before use.
- Law stated as at
- 17 October 2026
- Status
- Maintained. Checked against the cited sources on 17 October 2026.
- Version
- 1
- Source
- Link to the official form. Licence: © AFCA — personal and non-commercial reuse only; link only
Where this comes from
The official form is published by afca.org.au; this page is a completion guide. Last checked on 2026-10-17.
When to use it
Use after the insurer's internal dispute resolution has ended without resolution, or the IDR timeframe has passed. Do not use for private health insurance or workers compensation, which AFCA does not handle, or where the insured has started court proceedings on the same subject matter (AFCA may then exclude the complaint unless the proceedings are discontinued or, where a limitation period is about to expire, the complainant undertakes not to take further steps in them).
How AI may be used
AI may prepare a chronology and an issues summary from the claim file and IDR response, but the lawyer checks every fact, the remedy sought and the eligibility and time limit questions before lodgement.
AI may
- Prepare a dated chronology with document references from the claim file
- Summarise the insurer's reasons and the insured's responses to each
- Compile the document list for upload
AI must not
- Must not decide whether the complaint is within AFCA's jurisdiction or time limits
- Must not overstate the loss or the remedy
- Must not upload or enter personal information into tools outside the firm's approved environment
The lawyer checks
- The complaint is within time and within AFCA's jurisdiction and monetary limits
- The remedy sought is quantified and supported
- The chronology and summary match the documents
- The client understands AFCA's process and its interaction with court proceedings
Method: how the Green, Yellow and Red levels are decided. This is guidance for planning, not legal advice.
Official form
Open the official form. Always use the current version from the issuer. Licence: © AFCA — personal and non-commercial reuse only; link only.
Read the full text
The full text is for signed-in accounts. It is free. When you sign in you can:
- read the whole precedent, with its drafting notes beside it;
- copy it, or download it as a Word file or Markdown;
- add it to your firm’s knowledge base, so colleagues can find it;
- let the AI tools you connect read it from that knowledge base.
The summary, the law it rests on and the AI-use guidance above stay public. Privacy.
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