Insurer Compensates Claimants in Wake of Transition Issues

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 Life Code Compliance Committee reported that the insurer failed to meet the necessary timelines for handling claims, resulting in 3580 breaches between November 2022 and August last year. This failure predominantly affected policyholders with income protection and total permanent disability coverage from a superannuation fund.

The issue arose following the insurer and the fund's decision to transfer claims processing responsibilities from a third-party service provider back to the insurer. The transition period saw numerous staffing issues at the third-party organization, which critically hampered its ability to meet the code's stipulated time frames for claims processing, the committee's investigation revealed.

The committee's findings indicated that the insurer violated several provisions of the claims handling process defined in the code. Specifically, the insurer failed to:

• Inform customers about the claims process within 10 business days;
• Provide updates on the progress of claims every 20 working days;
• Notify customers in advance when their income protection claim payments were nearing their end.

"Insurers must ensure their change management plans allocate adequate resources to meet service standards and prescribed time frames," the determination stated. "Utilizing effective risk mitigation strategies is crucial in countering potential issues, thereby protecting against disruptions and safeguarding customer interests during transitions."

Post-transition, the insurer took over claims management on July 1 of the previous year and initiated several steps to bolster compliance with the code. The company formed new teams and conducted training focusing on code requirements and system utilization.

"The insurer has augmented its oversight of claims processing by increasing case conferencing, setting up weekly performance tracking, and holding monthly governance meetings," the determination noted. "These improvements led to noticeable increases in compliance rates regarding time frame obligations, which became more stable starting in December."

These measures indicate significant shifts in how the insurer manages and processes claims, fostering better service standards and accountability.

Published:Wednesday, 4th Sep 2024
Author: Paige Estritori

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.

Share this news item:

Insurance News

Clear

NSW Productivity Commissioner Advocates for Immediate Ban on Strata Manager Commissions

22 Apr 2026: Paige Estritori

In a significant development for New South Wales' housing sector, Productivity Commissioner Peter Achterstraat has called for the prompt elimination of commissions received by strata managers. This recommendation aims to bolster transparency and affordability within the state's burgeoning strata housing market. - read more

CHU's 2025 Strata Market Report: Stability in Strata Insurance Amid Rising House Insurance Costs

22 Apr 2026: Paige Estritori

In its recently released 2025 State of the Strata Market report, CHU, Australia's leading strata insurance underwriting agency, provides an insightful analysis of the current landscape of strata insurance. The report underscores a notable stability in strata insurance premiums, which have seen a modest increase of 2.8% over the past year, rising from $954 to $981 per lot annually. This increment is significantly lower than the 14% surge observed in house insurance premiums during the same period. - read more

Insurance Council of Australia Advocates for Strata Law Reforms to Mitigate Rising Premiums in Victoria

22 Apr 2026: Paige Estritori

The Insurance Council of Australia (ICA) has recently called for comprehensive reforms to Victoria's strata legislation, highlighting that inadequate governance and deferred maintenance are contributing to escalating insurance premiums for the state's strata property owners. This appeal underscores the pressing need for legislative updates to enhance the management and maintenance of strata-titled properties. - read more

Strengthening Small Business Resilience: ICA's Call for Insurance Reforms

22 Apr 2026: Paige Estritori

In a recent submission to the Parliamentary Joint Committee's inquiry into small business insurance, the Insurance Council of Australia (ICA) has highlighted the pressing need for reforms to enhance the resilience of Australia's 2.5 million small businesses. These enterprises, which employ nearly half of the private sector workforce, are facing mounting challenges due to escalating insurance premiums and evolving risks. - read more

Deloitte's Vision for the Future: 2026 Insurance Industry Predictions

22 Apr 2026: Paige Estritori

Deloitte has released its 'Growth in Insurance Series: Insurance Predictions 2026,' offering insights into the transformative trends expected to shape the Australian insurance industry. The report identifies eight key predictions that insurers should consider to remain competitive and responsive to the evolving market landscape. - read more

Click for more Insurance News