Storm Damage Claims: What Your Insurer Must Cover

Under Australian home insurance policies, your insurer must cover damage caused by storms, including wind, hail, rain, and lightning. Insurers cannot deny storm damage claims simply because your property had pre-existing wear, provided the storm was the proximate cause of the damage. If your claim is denied or underpaid, you have the right to request the assessor's report and dispute the decision through IDR and AFCA at no cost.

Key takeaways

• Storm damage (wind, hail, rain, lightning) is covered by standard home insurance policies in Australia.
• Pre-existing wear does not automatically invalidate a storm damage claim if the storm was the proximate cause.
• Request the assessor's report under section 7.8 of the Code of Practice. You are entitled to a copy.
• If your insurer underpays or denies the claim, dispute through IDR and escalate to AFCA at no cost.

After a severe storm tears through your property, the last thing you expect is your insurer pushing back on your claim. But storm damage disputes are among the most common insurance complaints in Australia. Insurers frequently argue that damage was caused by poor maintenance rather than the storm itself. Understanding what your policy actually covers, and how to challenge a denial, can make all the difference.

What counts as storm damage under your policy

Most home and contents insurance policies cover loss or damage caused by storm, which typically includes wind, rain, hail, lightning, and thunderstorms. The key phrase is "caused by." Your insurer must pay for damage that results from a storm event, including water damage from rain entering through storm-damaged roofing, structural damage from high winds, fallen trees, and hail damage to roofs, gutters, and external surfaces.

However, the definition of "storm" matters. Insurers and the Australian Financial Complaints Authority (AFCA) generally consider a storm to involve abnormal weather conditions, not just ordinary rainfall. This is where Bureau of Meteorology (BOM) data becomes critical to your claim.

How insurers use maintenance exclusions to deny claims

The most common reason insurers deny storm damage claims is the maintenance exclusion. Almost every Product Disclosure Statement (PDS) contains a clause excluding damage caused by wear and tear, gradual deterioration, or lack of maintenance. Insurers use this exclusion to argue that your roof was already deteriorating before the storm, or that water entered through areas you should have maintained.

Here is what many policyholders do not realise: these maintenance exclusions often contain important provisos that insurers overlook or fail to apply correctly. For example, many PDS documents state that the exclusion does not apply to ensuing damage caused by an insured event such as a storm, even if the property was already in a state of disrepair. Others limit the exclusion to damage that would have occurred regardless of whether the storm happened at all.

Section 54 of the Insurance Contracts Act 1984 also provides important protections. This section prevents insurers from refusing a claim based on something the policyholder did or failed to do, unless the insurer can show that the act or omission actually caused or contributed to the loss. In practice, this means your insurer cannot simply point to a worn roof tile and deny the entire claim. They need to demonstrate that the lack of maintenance, not the storm, was the real cause of the damage.

The dominant cause test: storm vs wear and tear

When storm damage and pre-existing deterioration both play a role, the question becomes: what was the dominant cause of the loss? This is known as the dominant cause test, sometimes referred to as the proximate cause test.

If a storm is the dominant cause of the damage, your claim should be accepted, even if the property had some pre-existing wear. For instance, if a severe hailstorm cracks roof tiles that were 15 years old but otherwise functional, the storm is the dominant cause. The fact that the tiles were not brand new does not give your insurer grounds to deny the claim.

Insurers sometimes conflate age with deterioration, but AFCA has consistently found that age alone does not establish that damage was caused by wear and tear rather than a storm event. A roof that is old is not necessarily a roof that has failed due to lack of maintenance. Your insurer must provide evidence of actual deterioration, not simply point to the age of the materials.

Why Bureau of Meteorology data matters

Bureau of Meteorology (BOM) records are one of the most important pieces of evidence in a storm damage dispute. BOM data can confirm whether a significant weather event occurred in your area on the relevant date, including recorded wind speeds, rainfall intensity, and hail observations.

If your insurer argues that the weather conditions were not severe enough to cause the damage, BOM data can directly refute that claim. Conversely, if BOM records show only light rain on the day in question, your insurer may have a stronger argument that the damage was not storm-related.

You can request BOM weather observations for your area, and you should do so early in the claims process. If your claim is disputed, having this data ready strengthens your position considerably. AFCA regularly relies on BOM data when assessing whether a storm event was capable of causing the claimed damage.

What AFCA considers in storm damage disputes

If your insurer denies your storm damage claim and the internal dispute resolution process does not resolve the matter, you can escalate to AFCA free of charge. When assessing storm damage complaints, AFCA typically considers several key factors.

• Whether a storm event occurred at the relevant time and location, supported by BOM data and other evidence
• The condition of the property before the storm, including any inspection reports, photographs, or maintenance records
• Whether the insurer's assessment properly applied the dominant cause test rather than simply attributing damage to age or general condition
• Whether the PDS exclusion for maintenance was applied correctly, including any provisos or qualifications that limit the exclusion
• Whether the insurer complied with its obligations under the General Insurance Code of Practice, including conducting a fair and timely investigation
• Whether the insurer's appointed assessor had appropriate qualifications and conducted a reasonable on-site inspection

AFCA has overturned many insurer decisions where the insurer relied too heavily on age or general condition without properly establishing that the damage was unrelated to the storm. The authority has also been critical of insurers who fail to obtain their own BOM data or who rely on desktop assessments without physically inspecting the property.

Your rights under the General Insurance Code of Practice

The General Insurance Code of Practice requires your insurer to handle claims promptly, fairly, and transparently. Under the Code, your insurer must give you clear reasons for any claim denial, provide copies of reports relied upon in making the decision (such as assessor or expert reports), and allow you to respond to any adverse information before a final decision is made.

If your insurer has denied your storm damage claim without providing the assessor's report, or without explaining specifically why the maintenance exclusion applies to your situation, they may have breached their Code obligations. You are entitled to request all documents and reports that formed the basis of the decision under Section 75 of the Insurance Contracts Act 1984.

Practical steps if your storm damage claim is denied

• Request a copy of the assessor's report and any expert opinions your insurer relied on when making its decision
• Obtain BOM weather data for your area on the date of the storm to confirm the severity of the weather event
• Gather your own evidence, including photographs of the damage, quotes from licensed tradespeople, and any maintenance records you hold
• Review the specific wording of the maintenance exclusion in your PDS, paying close attention to any provisos or qualifications that limit when the exclusion can be applied
• Lodge an internal dispute (also called a complaint) with your insurer, clearly explaining why you believe the dominant cause of the damage was the storm
• If the internal dispute is not resolved in your favour, escalate to AFCA within the required timeframes

How The Fair Claims Co can help

Preparing a strong dispute submission takes time, attention to detail, and a solid understanding of insurance law and AFCA processes. The Fair Claims Co specialises in preparing professional dispute documents and AFCA submissions for policyholders dealing with denied or underpaid storm damage claims. We review your PDS wording, gather and organise supporting evidence, apply the relevant legal tests including the dominant cause analysis, and put together a clear, well-structured case on your behalf. If your storm damage claim has been denied or underpaid, we can help you challenge that decision.