Ombudsman Orders Higher Compensation From Insurer Over Mould Dispute
Ombudsman Orders Higher Compensation From Insurer Over Mould Dispute
The information on this website is general in nature and does not take into account your objectives, financial situation, or needs. Consider seeking personal advice from a licensed adviser before acting on any information.
The Australian Financial Complaints Authority (AFCA) has directed insurance provider Hollard to enhance its compensation payout to a homeowner following a failed attempt to remediate mould contamination in the owner’s property.
Despite previous repair efforts by Hollard, lingering mould issues persisted, prompting further disputes.
The homeowner, dissatisfied with earlier repair efforts concluded in May 2023, cited an expert analysis revealing ongoing mould contamination. The analysis detailed "moisture migration" from damp materials on the ground floor contributing to mould growth on the upper levels of the home. A mycologist’s inspection in August 2023 uncovered significant fungal spore concentrations throughout the property, including in the insulation and air-conditioning system.
Subsequent investigations indicated elevated spore levels within key areas such as a bedroom and bathroom. The mycologist conclusively stated that the property was not adequately remediated for mould.
Hollard refuted these findings, asserting repair work was satisfactory and contested the reliability of the homeowner's assessments, which were conducted six to ten weeks after Hollard’s expert, WEC, had reportedly verified the mould issues as resolved. Hollard suggested that any ongoing mould presence could be attributed to external factors, such as the homeowner’s pets or workers.
Conversely, the AFCA panel criticised Hollard’s WEC findings for their lack of specificity, primarily relying on generalized airborne mould testing. In contrast, the complainant's experts provided more comprehensive evaluations evidencing persistent mould issues.
The AFCA noted a contradiction in Hollard’s stance, linking the return of mould to non-claimable factors, as this was not in alignment with its own investigations which attempted to undermine the homeowner's findings of mould.
The authority concluded that Hollard had inadequately addressed the mould issue, likely exacerbated by insufficient containment and delays, allowing its spread to the upstairs area of the property.
In light of these findings, AFCA recommended a fair resolution involving a cash settlement to encompass a renewed scope of works with a 15% contingency increase. Moreover, Hollard is required to fund alternative accommodation while the property remains uninhabitable, compensate for any damage from its repair work, and cover the homeowner’s expert costs.
Additionally, Hollard has been mandated to pay a total of $5,400 in damages-$2,500 for the unresolved mould issue and $2,900 for failing to adhere to an earlier AFCA dispute outcome.
Please Note: We do not endorse any specific products or companies. Some content is sourced from third parties, including press releases, and may not be independently verified for accuracy or completeness.
The Australian Prudential Regulation Authority (APRA) and the Australian Securities and Investments Commission (ASIC) have jointly called on life insurers to take decisive action to address mounting sustainability pressures in the Total and Permanent Disability (TPD) insurance market. This appeal follows a high-level industry roundtable discussion involving senior executives from 19 insurers and reinsurers, as well as representatives from Treasury and the Council of Australian Life Insurers (CALI). - read more
Recent data from the Australian Prudential Regulation Authority (APRA) reveals a significant concentration of disputes in the life insurance sector, with Total and Permanent Disability (TPD) and disability income insurance (DII) claims accounting for 88% of all disputes. This trend underscores the pressing need for both insurers and policyholders to closely examine the factors contributing to these disputes and seek solutions to enhance the claims process. - read more
Recent findings from the Life Insurance Code Compliance Committee (Life CCC) have revealed a concerning 67% increase in violations related to the timely payment of income protection benefits during the 2024-25 financial year. This surge has raised alarms about the industry's adherence to its own standards and the impact on policyholders. - read more
In a recent joint CEO roundtable, the Australian Prudential Regulation Authority (APRA) and the Australian Securities and Investments Commission (ASIC) highlighted the pressing need for life insurers to take decisive action to address sustainability challenges in the Total and Permanent Disability (TPD) insurance market. - read more
Recent findings from the Life Insurance Code Compliance Committee (Life CCC) have revealed a 67% increase in violations related to timely income protection payments. This surge raises significant concerns about insurer compliance and the impact on customers who rely on these benefits during challenging times. - read more
Health insurance is a crucial aspect of financial planning for individuals and families alike. It provides protection against unexpected medical costs and ensures that you have access to necessary healthcare services when you need them most. - read more
Affordable health insurance refers to insurance plans that offer necessary health coverage at a price within one's financial means. These plans aim to balance cost with the quality of care, providing essential services without excessive financial burden. The goal is to make healthcare accessible to a wider population, ensuring that everyone can maintain their health without going into debt. - read more
With healthcare being a critical aspect of every family's well-being in Australia, securing the right family health insurance is not just a necessity but a responsibility. Recognizing the importance of this safety net is the first step towards safeguarding the future health needs of your loved ones. Balancing comprehensive coverage against affordable premiums can seem overwhelming with a multitude of plans available. - read more
Health insurance is a critical part of maintaining your well-being and financial stability. In Australia, understanding the basics of health insurance can help you make informed decisions that protect you during unforeseen medical events. - read more
Welcome to our discussion on basic health insurance cover, a topic that is crucial yet often overlooked in the hustle and bustle of everyday life. Navigating the world of health insurance can be daunting, but understanding your options is vital for peace of mind and financial stability. - read more
Knowledgebase
Copayment: A fixed amount you pay for a covered healthcare service, usually when you receive the service.
No comments yet. Be the first to share your thoughts.