Can a Carpenter Business Make an AFCA Complaint About Its Insurer?

Yes—an eligible carpenter business can make an AFCA complaint about its insurer’s decision or conduct. According to the Australian Financial Complaints Authority (AFCA), its usual small-business test is fewer than 100 employees, but AFCA cannot consider a complaint if the relevant group of related companies has 100 employees or more; its service is free to access. Figures checked 1 October 2026.

Does your carpenter business meet AFCA’s small-business test?

AFCA generally defines a small business as an organisation with fewer than 100 employees. Its position depends on the business structure and, importantly, any relevant related-company group.

The related-company caveat is not optional: the usual employee test does not override AFCA’s rule that it cannot consider a complaint where the relevant group of related companies has 100 employees or more.

Which insurance complaints can AFCA consider?

AFCA’s jurisdiction depends on the insurance product and the cover involved. It may consider an insurer’s decision or conduct concerning an eligible small-business insurance product, as well as an insurance broker’s conduct in following instructions or arranging a policy.

The cover types AFCA may consider complaints about include:

• Computer and electronic breakdown: breakdowns of computers and other electronic equipment.
• Fire or accidental damage: loss or damage caused by fire or an accident.
• Glass: glass breakage, including shop fronts.
• General property: damage to business property or work tools.
• Loss of profits or business interruption: an event that prevents the business from operating.
• Medical indemnity: specified claims arising from an act, error or omission connected with professional services.

AFCA says it cannot consider complaints about cover under a Small Business Insurance Product in relation to:

• Contractors All Risks;
• Fidelity Guarantee;
• Legal Liability, including Public Liability and Products Liability;
• Professional Indemnity; and
• Industrial Special Risks.

That does not necessarily mean AFCA has no jurisdiction over every part of an excluded policy type. AFCA says it may consider certain cover within an Industrial Special Risks policy.

For a carpenter business, a dispute about damaged tools may concern general property cover, while an event that prevents operations may concern business interruption cover. A Public Liability issue falls within AFCA’s listed exclusions. Check the policy’s PDS as well as AFCA’s current scope before lodging a complaint.

How do you make a free AFCA complaint?

AFCA’s service is free to access. It launched its online complaints portal on Monday 17 June 2024, and a person who creates an account can use the portal to manage the complaint throughout the AFCA process.

AFCA lists Live Chat availability as Monday to Friday, 8am–6pm. Its telephone availability is 8am–6pm AEDT/AEST, Monday to Friday.

Licensed financial services providers in Australia must belong to AFCA and participate in its process. AFCA provides an online search tool for checking whether a financial firm is a member. Businesses needing more support can also contact a third-party agency.

How long does the insurer have to respond?

AFCA says the financial firm must follow a set timeframe. The cited AFCA guidance does not state a standard period in days, so do not assume one: check the timeframe stated by AFCA or in the firm’s correspondence.

After a complaint is lodged:

• AFCA refers it to the financial firm.
• AFCA asks the firm to review the complaint and attempt direct resolution.
• If the firm does not resolve it within its timeframe, AFCA progresses the complaint for further consideration.
• If direct resolution fails, AFCA works with the parties to seek a settlement using methods such as negotiation and conciliation.
• AFCA may provide the complainant and financial firm with a preliminary assessment of the complaint’s merits.
• If the complainant rejects that preliminary assessment, AFCA makes a determination.

An AFCA determination is binding on the financial firm. If a complaint does not meet the requirements of AFCA’s Rules, AFCA will direct the complainant to other sources of help.

Can AFCA compensation exceed the business’s loss?

AFCA outcomes can include compensation for direct financial loss, indirect financial loss and non-financial loss. Compensation is not automatic; it depends on the complaint and AFCA’s determination.

Monetary caps apply to outcomes relating to non-superannuation complaints. The cited guidance confirms that a cap applies but does not state its current dollar amount, so check AFCA’s current rules rather than assume a figure. An AFCA monetary-limits notice published 6 January 2021 explains that the changes applied to complaints received from 1 January 2021 and that the Rules require limits to be adjusted every three years.

A separate jurisdictional exclusion applies to small-business credit facilities. AFCA cannot consider a complaint about a facility exceeding $6.3 million when the complaint is lodged on or after 1 January 2024, whether the complainant is the borrower or guarantor. Complaints lodged before 1 January 2024 must be checked against the relevant version of AFCA’s Rules.

What should you check before lodging?

If you are unsure whether the dispute is within AFCA’s scope, AFCA recommends submitting the information anyway so it can review the complaint and discuss it with you.

Before lodging:

• check the current AFCA regulator page for scope, cover types and limits;
• read the policy PDS and the insurer’s decision or correspondence;
• keep records supporting the complaint and alleged loss; and
• if employee numbers fluctuate near the threshold, retain evidence such as wage records covering the relevant events.

This is general information, not financial or legal advice. Check the current regulator page and your policy’s PDS before making a decision.

Sources

• Small Businesses with a financial complaint | AFCA
• AFCA complaint monetary limits updated | Australian Financial Complaints Authority (AFCA)

FAQ

What if the business or related-company group has 100 employees?

AFCA’s usual small-business definition requires fewer than 100 employees. It also says it cannot consider a complaint if the relevant group of related companies has 100 employees or more.

What evidence is needed if employee numbers fluctuate?

AFCA may require substantiation of employee numbers when the events giving rise to the complaint occurred. Wage records are an example of evidence AFCA may request.

Can AFCA consider a public liability complaint?

AFCA lists Legal Liability, including Public Liability and Products Liability, among the cover types it cannot consider under a Small Business Insurance Product. Check the PDS because an excluded cover does not necessarily remove AFCA jurisdiction over every part of a policy.

Is making an AFCA complaint free?

AFCA’s service is free to access. Its complaint channels include online, Live Chat, email, telephone and post, and AFCA’s telephone line is a free call.

Does AFCA publish a standard insurer response time?

The cited AFCA guidance says the financial firm has a set timeframe, but it does not give a standard number of days. If the firm does not resolve the complaint within its timeframe, AFCA will progress it for further consideration.