Your Insurer Says "Wear and Tear" — Here's How to Respond

When your insurer denies a claim citing 'wear and tear', they must prove the damage was caused by gradual deterioration rather than a sudden insured event. Under Australian insurance law, normal ageing of materials does not automatically invalidate a claim. If a covered peril like a storm caused the damage and existing wear was only a contributing factor, the claim should still be paid. Request the assessor's report and challenge the classification through IDR.

Key takeaways

• The insurer must prove the damage was caused by gradual deterioration, not just that wear existed.
• If a covered event like a storm caused the damage and wear was only incidental, the claim should be paid.
• Request the assessor's report to check whether the wear and tear finding is supported by evidence.
• Challenge the classification through IDR with your own tradesperson or expert report.

"Wear and tear" is one of the most common reasons Australian insurers give when denying or reducing a claim. It is also one of the most frequently misapplied. If your insurer has told you that your damage was caused by wear and tear rather than a sudden event, do not accept that at face value. Many of these denials can be successfully challenged with the right evidence and approach.

What "wear and tear" actually means in your policy

Most home and contents insurance policies exclude damage caused by gradual deterioration. This means damage that happens slowly over time through normal use, ageing, or lack of maintenance. Think of a tap washer that wears out, paint that fades in the sun, or carpet that thins from years of foot traffic. These are genuine examples of wear and tear, and they are legitimately excluded from most policies.

The problem is that insurers frequently stretch this exclusion well beyond its intended scope. Storm damage to an older roof, water damage in a bathroom, or cracking in walls after ground movement are all regularly attributed to "wear and tear" when they are actually caused by a sudden, insurable event.

When "wear and tear" is really "we don't want to pay"

There is a critical legal distinction between damage caused by wear and tear and damage caused by an insured event to something that has experienced normal ageing. Your roof does not need to be brand new for storm damage to be covered. Your pipes do not need to be recently installed for a burst pipe claim to be valid. Everything in a home ages. That does not mean every claim involving an older component is automatically a wear and tear issue.

Under Section 54 of the Insurance Contracts Act 1984, an insurer cannot refuse a claim solely because of an act or omission by the policyholder unless that act or omission caused or contributed to the loss. If a storm ripped tiles off your 15-year-old roof, the age of the roof did not cause the storm. The insurer may be entitled to apply betterment (reducing the payout to account for the improved condition of a replacement), but they cannot deny the claim entirely by calling it wear and tear.

How insurers build a "wear and tear" denial

Insurers typically rely on their assessor's report to support a wear and tear denial. The assessor visits your property, takes photos, and writes a report stating that the damage was caused by gradual deterioration rather than the event you claimed for. The problem is that the assessor works for the insurer, and their report often reflects what the insurer wants to hear.

Common red flags in assessor reports include vague language like "consistent with long-term degradation" without specific evidence, photos that focus on unrelated areas of ageing rather than the claimed damage, failure to consider weather data or event-specific evidence, and conclusions that ignore the timeline of when the damage actually appeared.

How to challenge a wear and tear denial

Get your own expert report

The single most effective step you can take is to get an independent expert report. Depending on your claim, this might be a building inspector, a plumber, a roofer, or a structural engineer. Ask them to inspect the damage and provide a written opinion on what caused it. An independent report that contradicts the insurer's assessor puts you in a strong position, both in an internal dispute and at AFCA.

Gather timeline evidence

If the damage appeared after a specific event (a storm, heavy rain, a heatwave), document the timeline. Get weather data from the Bureau of Meteorology for your area on the relevant dates. Take photos showing the damage as it appeared. Collect statements from neighbours or tradespeople who can confirm when the damage first became visible. The stronger your timeline evidence, the harder it is for the insurer to argue the damage was gradual.

Review the policy wording carefully

Read the exact wording of the wear and tear exclusion in your Product Disclosure Statement (PDS). Some policies exclude damage "caused by" wear and tear. Others exclude damage "arising from" or "attributable to" wear and tear. The specific wording matters because it determines how directly the wear and tear must be connected to the damage. If the primary cause was an insured event and wear and tear was only a background factor, the exclusion may not apply at all.

What the law says about wear and tear denials

Australian courts and AFCA have consistently held that insurers must not use wear and tear as a blanket exclusion to avoid paying claims. In numerous AFCA determinations, complaints have been upheld where insurers denied claims by attributing damage to wear and tear without adequate evidence, where the primary cause of the loss was an insured event, or where the insurer's assessor failed to properly investigate.

The insurer carries the burden of proof when relying on an exclusion. They must demonstrate that the exclusion applies to your specific circumstances, not simply assert it. If their evidence is thin (a brief assessor report with no independent testing or detailed analysis), you have grounds to challenge the decision.

Betterment is not the same as denial

Even if wear and tear played some role, that does not entitle the insurer to deny your claim outright. Under the principle of betterment, the insurer can reduce the payout to reflect the fact that replacing an old component with a new one puts you in a better position than before. For example, if your 20-year-old hot water system burst due to a covered event, the insurer might pay the replacement cost minus a deduction for the age of the unit. But they must still pay the claim. A flat denial dressed up as "wear and tear" when betterment is the appropriate response is worth challenging.