How does AFCA handle a small cleaning business insurance complaint?

AFCA handles an eligible small cleaning business insurance complaint by referring the lodged complaint to the financial firm for direct resolution, then seeking settlement through negotiation or conciliation and, if needed, providing a preliminary assessment before a determination. Its online portal launched on 17 June 2024; the service is free to access, determinations bind the financial firm, and AFCA defines a small business as an organisation with fewer than 100 employees, according to AFCA’s small-business guidance (figures checked 1 October 2026).

Can a cleaning business complain to AFCA?

Start with two checks: whether your organisation meets AFCA’s small-business rules and whether the insurance product and cover are within its jurisdiction. Meeting the employee threshold does not make every insurance complaint eligible.

If you are unsure whether the complaint is within scope, AFCA recommends submitting the information anyway so it can review the matter and discuss it with you. AFCA says third-party agencies are also available if you need more support.

Does AFCA handle every cleaning insurance policy?

No. AFCA’s jurisdiction over general insurance complaints depends on the product type. It identifies the following cover as potentially within scope:

Within a Small Business Insurance Product, AFCA says it cannot consider complaints about cover for:

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

AFCA may also consider a complaint about an insurance broker’s conduct in following instructions or arranging a policy, or an insurer’s decision or conduct concerning a small-business insurance product within its scope.

The cover exclusions do not mean AFCA has no jurisdiction over every policy type. In particular, AFCA says it cannot consider Industrial Special Risks cover but may consider certain cover within an Industrial Special Risks policy. Check the exact product and cover section in your policy’s PDS before lodging.

How do I lodge and manage the complaint?

AFCA accepts complaints through several channels. If you create an account, you can use its online portal to manage the complaint throughout the AFCA process.

Use the channel that makes it easiest to provide a clear account of what happened, what outcome you want and which policy provisions are relevant. The cited AFCA material does not provide a document checklist, so confirm the current requirements on its complaint page.

What happens after AFCA receives the complaint?

1. The complaint is referred to the financial firm. AFCA asks the firm to review it and attempt direct resolution with you before AFCA considers it.

2. The financial firm works within a set timeframe. If it does not resolve the complaint within that timeframe, AFCA progresses it for further consideration. The cited AFCA material does not state the length of this timeframe.

3. AFCA seeks a settlement. If direct resolution fails, AFCA works with the parties to try to reach a settlement through methods such as negotiation and conciliation.

4. AFCA may provide a preliminary assessment. If conciliation does not resolve the complaint, AFCA may give you and the financial firm its view on the complaint’s merits.

5. AFCA may make a determination. If you reject the preliminary assessment, AFCA will make a decision called a determination. Any determination AFCA makes binds the financial firm.

What can AFCA award?

AFCA’s possible outcomes include compensation for:

• direct financial loss;
• indirect financial loss; and
• non-financial loss.

An award is not automatic. Monetary caps apply to outcomes relating to non-superannuation complaints, but the cited AFCA small-business material does not state the cap amount.

Do not confuse that cap with AFCA’s separate business-finance jurisdiction rule: for a complaint lodged on or after 1 January 2024, AFCA cannot consider a complaint about a small-business credit facility exceeding $6.3 million, whether the complainant is the borrower or guarantor. Complaints lodged before that date must be checked against the relevant version of AFCA’s Rules.

What should you check before relying on the process?

Check AFCA’s current regulator page, the financial firm’s complaint process and the policy’s PDS. In particular, confirm:

• the employee count of the organisation and its related companies;
• whether AFCA covers the product and disputed insurance section;
• the policy wording that applies to the event or decision; and
• the dates, correspondence and resolution already provided by the financial firm.

This is general information, not financial or legal advice. AFCA assesses complaints against its Rules, and an insurer or broker may interpret the policy differently.

Sources

• Small Businesses with a financial complaint | AFCA

FAQ

Is AFCA free to use?

Yes. AFCA says its service is free to access. Its complaint telephone line, 1800 931 678, is also a free call.

Does my cleaning business need fewer than 100 employees?

AFCA generally defines a small business as an organisation with fewer than 100 employees. It cannot consider a complaint where the relevant group of related companies has 100 employees or more. If staffing fluctuates around the threshold, keep evidence such as wage records from when the relevant events occurred.

Can AFCA consider a public liability or professional indemnity complaint?

AFCA says it cannot consider complaints about Legal Liability cover, including Public Liability and Products Liability, or Professional Indemnity cover within a Small Business Insurance Product. This is a cover-specific exclusion, so check the current AFCA page and the policy PDS for the exact section involved.

What happens if the financial firm will not resolve the complaint?

AFCA first asks the financial firm to attempt direct resolution. If that fails, AFCA may seek a settlement through negotiation or conciliation, provide a preliminary assessment and, if the assessment is rejected, make a determination. AFCA’s determination binds the financial firm.