AFCA recorded 119,949 complaints in 2025-26, a record, with 36,022 about general insurance. Delay in claim handling was the most complained-about issue across every product. Some delay comes from parts and labour shortages no insurer controls. What insurers can control is whether delay is visible, explained and recorded, which is what most complaints turn on.
This article is general information, not legal or compliance advice. Check the current text of the code, standard or legislation, and take advice for your situation.
Key takeaways
- According to Insurance Business, AFCA received 119,949 complaints in 2025-26, its highest annual volume, with general insurance up 5% to 36,022.
- Delay in claim handling, service quality and claim rejection were the top three general insurance issues.
- Rejection complaints for comprehensive vehicle insurance rose 47% in 2025-26.
- AFCA links motor claim delays to "industry-wide shortages in vehicle parts and skilled labour", which claims software cannot fix.
- Insurers can reduce complaints by making delay visible, explaining it early and recording every contact.
How many insurance complaints does AFCA receive?
AFCA received 119,949 complaints across all financial products in 2025-26, the highest on record and the third year in a row above 100,000. General insurance accounted for 36,022, up 5% on the year before. Comprehensive motor insurance remained the most complained-about product, as reported by Insurance Business.
The trend has been rising for several years. According to Insurance Business, 2025-26 was AFCA's third straight year above 100,000 complaints. Insurance makes up a large share of that load.
Code breaches tell the same story. According to the Code Governance Committee, insurers reported 70,325 Code breaches in 2024-25, up 20.5%. Of those, 41,140, or 59%, were claims breaches under Part 8 of the Code.
What drives insurance claims complaints?
Delay drives claims complaints more than anything else. In 2025-26, delay in claim handling was the most complained-about issue across every financial product, according to Insurance Business. Service quality and claim rejection followed in general insurance. Rejection complaints for comprehensive vehicle insurance rose 47% in the year.
Delay is often a communication failure as much as a timing one. A claimant who hears nothing for weeks assumes nothing is happening. According to the Code Governance Committee, insurers breached the 20 business day update requirement 18,350 times in 2024-25, up 67%.
Rejection is the second driver. A claimant who does not understand why a claim was declined is more likely to dispute it. Clear reasons, given in writing with the policy wording, reduce that risk.
What causes can claims software not fix?
Claims software cannot fix shortages of parts, repairers or tradespeople. AFCA says motor claim delays are increasingly driven by "industry-wide shortages in vehicle parts and skilled labour", including in the expanding electric vehicle market. Catastrophe surges and supplier backlogs fall in the same group. No system shortens a wait for a part that is not in the country.
That matters for any honest account of complaints. A claims platform does not make a repair happen sooner when the repairer has no parts. Insurers that promise otherwise set a claimant up for disappointment.
What software can change is how the delay is handled. A claim waiting on parts can still be updated on time, explained clearly and recorded fully. AFCA's own approach to motor claim delays covers when a cash settlement may be fair if repairs stall.
How can insurers reduce claims complaints?
Insurers reduce claims complaints by making delay visible, communicated and documented. That means tracking every claim's next deadline, updating claimants before they chase, explaining delays and their causes plainly, giving written reasons for declines, and recording every contact. Most complaints turn on silence and unexplained decisions, which a team can control.
Five habits make the difference:
- Track every deadline. Know when each claim's next update or decision is due.
- Update before the claimant chases. Meet the 20 business day rule early, not late.
- Explain delay plainly. Say what is causing it and what happens next.
- Give written reasons. Set out declines against the policy wording.
- Record every contact. Show what was said and when, if the complaint reaches AFCA.
Configurable claims platforms help with the first and last of these. ClaimsGateway (claimsgateway.com) covers the claim from first notice of loss to close, so each claim's history sits in one record. The ClaimsGateway insurers page describes its approach.
Those deadlines come from the Code. The Code claims obligations guide sets out the deadlines themselves.
Frequently asked questions
How many complaints does AFCA receive about insurance?
AFCA received 36,022 general insurance complaints in 2025-26, up 5% on the year before, out of 119,949 complaints across all financial products. Comprehensive motor insurance remained the most complained-about product. Delay in claim handling was the most common issue, according to figures reported by Insurance Business.
What is the most common insurance complaint?
Delay in claim handling. In 2025-26 it was the most complained-about issue across every financial product at AFCA. In general insurance, service quality and claim rejection followed. Rejection complaints for comprehensive vehicle insurance rose 47% in the year, according to figures reported by Insurance Business.
How long does AFCA take?
It depends on the complaint. AFCA first refers most complaints back to the insurer, which has up to 30 days to resolve standard complaints directly. If that fails, AFCA's case management begins, with information requested within 7 to 21 days. Complex complaints can then go to an ombudsman or panel for decision.
What happens after an AFCA complaint?
AFCA registers the complaint and usually refers it back to the insurer to resolve directly. If it is not resolved, an AFCA case worker investigates, may negotiate or conciliate, and gives a preliminary assessment. If either party rejects that, an ombudsman, panel or adjudicator makes a decision.
How can insurers reduce complaints?
Insurers can reduce complaints by tracking every claim's deadlines, updating claimants before they chase, explaining delays plainly, giving written reasons for declines and recording every contact. Some causes, such as parts and labour shortages, are outside any insurer's control, but how delay is communicated is not.
About the author
ClaimsGateway builds cloud claims management software for insurers, underwriting agencies, brokers, TPAs and self-insured organisations in Australia and New Zealand. Every regulator figure in this article links to its source, and every vendor fact was checked on the vendor's own site on the date shown.
Related reading
- Code of Practice timeframes: a quick reference to claims deadlines.
- ASIC claims handling rules: claims handling as a financial service.
- Claims advocacy for brokers: how brokers support clients through disputes.
Sources
- Insurance Business Australia. "Insurer claim delays top complaints again as brokers report no change." 11 September 2026. https://www.insurancebusinessmag.com/au/news/claims/insurer-claim-delays-top-complaints-again-as-brokers-report-no-change-589274.aspx (reports AFCA's 2025-26 general insurance annual review)
- Insurance Business Australia. "Record AFCA complaints mask a worse story in insurer compliance data." 4 August 2026. https://www.insurancebusinessmag.com/au/news/breaking-news/record-afca-complaints-mask-a-worse-story-in-insurer-compliance-data-584812.aspx (reports AFCA's 2025-26 figures and the Code Governance Committee's 2024-25 data)
- AFCA. "AFCA complaint resolution process." Effective from 27 February 2023, as republished on dsh.gov.au. https://www.dsh.gov.au/sites/default/files/2026-02/afca-complaint-resolution-process-ocr.pdf
- AFCA. "The AFCA Approach to motor vehicle insurance claim delays." Read through search results, 24 October 2026. https://afca.org.au/media/579/download
