Under the General Insurance Code of Practice, an insurer that subscribes to the Code should decide a claim within four months of receiving it, or within 12 months where an extraordinary catastrophe, suspected fraud or an unresponsive claimant applies. Along the way it must say what information it needs within 10 business days and update you at least every 20 business days. An insurance claim delay beyond those points is itself a ground for complaint, first to the insurer and then to AFCA.
The clock the Code sets
Most general insurers in Australia subscribe to the General Insurance Code of Practice, published by the Insurance Council of Australia. The Code is a set of service commitments rather than legislation. The current version was last updated in October 2023, and a redraft went out for public consultation in June and July 2026, so some figures may change later. These are the ones that apply to a claim lodged today.
| Stage | Code timeframe |
|---|---|
| Telling you what information it needs, and whether an assessor will be appointed | Within 10 business days of receiving the claim |
| Telling you an assessor or loss adjuster has been appointed, and their role | Within 5 business days of the appointment |
| Progress updates while the claim is open | At least every 20 business days |
| External expert reports | Experts are asked to report within 12 weeks of engagement |
| Decision once all information is in and enquiries are complete | Within 10 business days |
| Overall decision | Within 4 months of receiving the claim |
| Advance payment where you show urgent financial need | Within 5 business days |
Two rows do most of the work. The four month limit is the outer boundary for an ordinary claim. The 20 business day update rule is what you quote when weeks pass in silence. If the insurer misses the four month mark, the Code requires it to write to you about its complaints process.
When four months becomes twelve
The Code allows a decision to take up to 12 months in a defined set of circumstances: the claim arises from an event declared an extraordinary catastrophe, the insurer reasonably suspects fraud, you have not responded to its reasonable requests, communication has been disrupted by something outside the insurer’s control, or you asked for the delay yourself. The Code also lets the insurer agree a different timetable with you where a claim is complex.
The catastrophe exception matters in Melbourne every storm season. Thousands of claims reach the same insurers and trades at once, and the Code accepts that assessments take longer. If a property claim from a declared catastrophe is finalised within one month of the event, you can ask for it to be reviewed within 12 months of finalisation, even if you signed a release.
Why claims stall
Delay is rarely one decision. It is a chain of small waits: a document request that arrives in three parts, an assessor booked a fortnight out, a scope of works the insurer’s estimate disagrees with, an expert report that takes the full 12 weeks. Each wait sits inside its own Code timeframe while the whole claim drifts past four months.
The complaint data shows how common this is. In its preliminary figures for 2025-26, released on 4 August 2026, AFCA reported 36,022 general insurance complaints, up 5 per cent on the year before, and listed delay in claim handling first among the top three issues across all financial products, ahead of service quality and claim rejection. The same release noted that 43 per cent of general insurance complaints were resolved before a formal decision.
Delay also costs the policyholder. Damage left open gets worse, and a business interruption indemnity period keeps running from the date of the loss whether or not the property claim has been decided. The sooner a loss is notified, the sooner each of these clocks starts.
What the regulator did about it
In a case brought by ASIC and announced on 9 October 2026, the Federal Court ordered an insurer to pay a penalty of 2 million dollars over its handling of one home claim. The claim followed storm damage to a roof in regional Victoria in October 2021. ASIC’s media release records that the insurer accepted the claim, did not obtain a recommended structural engineering assessment until August 2022, did not reach a final decision until April 2023, and then rejected the claim after a 15 month delay. The house became uninhabitable in the meantime. The court found a breach of the duty of utmost good faith under the Insurance Contracts Act 1984, which ASIC described as the first civil penalty against an insurer on that ground.
ASIC has named claims and complaints handling failures by insurers as an enforcement priority for 2026. The practical point for a policyholder is that an unexplained insurance claim delay is now something the insurer has to account for, not something you have to absorb.
What to do when your claim is taking too long
- Check your own side first. An unanswered request for a quote, a bank statement or a signed form stops the Code clock, because the 12 month extension covers a claimant who has not responded. Send what is outstanding in one go and keep a copy.
- Ask for the timetable in writing. The Code entitles you to know what the insurer needs, whether an assessor has been appointed and who, and when the next update is due. Put the questions in an email so the dates are on record.
- Ask for an advance if money is urgent. Where you show urgent financial need, the Code requires the insurer to fast track the claim and make an advance payment within five business days. Temporary accommodation and emergency repairs are the usual reasons.
- Lodge a formal complaint with the insurer. Head the email with the word complaint, set out the dates, and say what outcome you want. The Code requires a decision within 30 calendar days, with updates at least every 10 business days. If the insurer cannot meet that, it must tell you why in writing and point you to AFCA.
- Take it to AFCA. AFCA is free for consumers and small businesses and deals with how a claim was handled, not only whether it was paid. The Code lets you go to AFCA at any time, including when the 30 days pass without a decision. Keep every email, photo and receipt.
What FRS does: when a claim we have lodged runs past a Code timeframe, we follow it up with the dates in hand and name the commitment the insurer has missed. We check that the insurer’s requests have been met, press for the assessor’s report and the scope of works, and prepare the complaint if the claim still does not move. On a business pack or a home and contents claim, the aim is a decision inside the Code’s timeframes rather than a complaint after them.
To report a loss or ask about a claim already lodged, see our claims page.
Frequently asked questions
How long does an insurer have to decide a claim in Australia?
Under the General Insurance Code of Practice, a subscribing insurer should decide a claim within four months of receiving it. The limit extends to 12 months for claims from an extraordinary catastrophe, suspected fraud, an unresponsive claimant or a delay you asked for. Once all information is in and enquiries are complete, the decision is due within 10 business days.
What counts as an unreasonable insurance claim delay?
Any gap longer than the Code allows: no list of requirements within 10 business days of lodging, no update for more than 20 business days, or no decision at four months without a written explanation. Shorter gaps can still be unreasonable where the insurer has everything it needs and the claim is not moving, and you can complain about them.
Can I complain to AFCA before the insurer rejects my claim?
Yes. AFCA deals with the handling of a claim as well as its outcome, and delay in claim handling was the issue it listed first for 2025-26. Lodge a written complaint with the insurer first. If there is no decision within 30 calendar days, or the insurer is not engaging, you can take the complaint to AFCA at no cost.
Does a catastrophe declaration change how long my claim can take?
It can. Where an event is declared an extraordinary catastrophe under the Code, the decision limit moves from four months to 12. The 20 business day update rule still applies. If a property claim from a declared catastrophe is finalised within one month of the event, you can ask for a review within 12 months, even after signing a release.
Questions about your own cover? Call 03 7046 3766 on weekdays between 9:30am and 6pm, or send us an enquiry.
