Insurers are expected to promptly assess claims and pay those covered by the wording of the policy.

Key Timeframes & Process

• Initial response: Under the General Insurance Code of Practice, insurers promise to respond within 10 business days to advise whether they accept or deny the claim based on information provided.
• Evidence you may need: proof of ownership, photos, valuations, contracts, police/medical reports, receipts or invoices—varying by context (personal injury, burglary, business interruption, stock/inventory, catastrophic events such as flood or fire).
• Requests for more info: if further details are required, the insurer must tell the claimant what’s needed within 10 business days of receiving the claim.
• Use of experts: insurers may appoint a loss adjuster or licensed private investigator. The claimant will be notified within five business days of the appointment and updated every 20 business days on progress. An estimated decision timeframe should also be provided.
• Complex claims: timeframes can be renegotiated where complexity warrants it.
• Access to information: claimants can obtain information about them used in the assessment (unless under active investigation). Insurers must not unreasonably refuse reports used to assess the claim and should correct any identified errors promptly.
• If a claim is denied: the insurer must provide written reasons and details of dispute options, including Internal Dispute Resolution (IDR). Reports from service providers used in the decision should be supplied if requested.

Catastrophe Provisions

When the Insurance Council of Australia (ICA) declares a catastrophe, strict deadlines may be impractical due to volume.
If a property claim is finalised within one month after the event, you have 12 months from finalisation to request a review if you believe the assessment was incomplete or inaccurate—even if you signed a release.

Settling the Claim

Settlement is the agreement between insurer and insured to close the claim. Timing is critical: some matters benefit from a longer process to avoid dispute, others are best resolved early. Loss adjusters apply experience to judge when and how to close a claim effectively.

Common cues that the claim may be ready to conclude include:

• An offer on the table within the adjuster’s authority.
• A critical deadline approaching for one or both parties.
• Clear signs the other party wants to settle.
• External factors indicating the claim will likely deteriorate if delayed (e.g., time-critical decisions in business interruption claims).

At such moments, the loss adjuster should present a final proposal and secure acceptance—decisively, sensitively and effectively.

Watch: Inside the Profession