Insurer Compensates Claimants in Wake of Transition Issues
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.
On September 2, 2024, an insurer has been mandated to compensate over 900 policyholders due to its failure to adhere to claims processing time frames outlined in the Life Insurance Code of Practice.
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.
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.
New Zealand’s latest insurance dispute figures are a timely warning for anyone relying on personal cover to protect their household income. The Insurance & Financial Services Ombudsman Scheme reported that, for the year ended 30 June 2026, health insurance became the largest category of disputes it investigated for the first time, with health disputes up 91 percent and 833 dispute investigations completed across all categories. - read more
The 2026 National Truck Accident Research Centre major incident report gives Australian truck operators a useful, if challenging, snapshot of where serious heavy vehicle risk is changing. Released in October 2026 and based on de-identified NTI-insured heavy vehicle major-loss claims, the report points to progress on distraction and fatigue, while also highlighting renewed concern about inappropriate speed and following distance. - read more
A federal parliamentary inquiry into small business insurance has pushed back its reporting timetable, extending the wait for recommendations on insurance affordability, availability and regulation. Insurance News reported on 27 October 2026 that the inquiry, which had been expected to report that day, now intends to table its final report by 26 February 2027 after receiving extensive evidence from across the market. - read more
Australia’s proposed overhaul of the General Insurance Code of Practice has moved from consultation to regulator review, with the Insurance Council of Australia lodging a strengthened code with ASIC on 22 October 2026. For shop owners, this is not an instant change to policy terms, but it is a significant development in how insurers may be expected to handle claims, complaints, vulnerability and customer communication in the next phase of the market. - read more
New research from specialist insurer CFC, reported on 26 October 2026, has put a sharper number on a problem many Australian small businesses already sense: cyber risk is moving faster than insurance take-up. CFC’s local findings indicate seven in 10 Australian SMEs surveyed experienced a cyber incident in the past three years, while standalone cyber policy uptake is still estimated at only 10% to 15%. - read more
Financial security is a cornerstone of peace of mind, particularly when life is known for its unpredictability. This introductory section sheds light on the vital nature of income protection insurance and its role in safeguarding Australians' financial well-being. Ensuring continual financial inflow during times of illness or injury not only offers stability but also protects one's standard of living. - read more
Financial security is crucial in today's unpredictable world, where unexpected events can disrupt the stability and comfort of our daily lives. For Australians, protecting one's income and lifestyle from unforeseen circumstances is a key component of personal finance. - read more
Welcome to the world of insurance – a domain where words like 'deductible' and 'premium' can significantly impact your financial protection and peace of mind. As a beginner, grasping the basics of insurance terminology is the first step towards making informed decisions about the policies that safeguard your assets and future. In this guide, we will embark on a journey through the language of insurance, which can often seem as complex as the policies themselves. - read more
Welcome to our comprehensive guide on securing your financial future in Australia. In a world of uncertainties, income protection insurance plays a critical role in maintaining your financial security and peace of mind. - read more
Income protection insurance in Australia is subject to rules covering insurer stability, product disclosure, sales conduct, claims handling and dispute resolution. Understanding the roles of APRA, ASIC, AFCA and key policy documents can help you compare cover more confidently. - read more
Knowledgebase
Liability Insurance: Insurance that provides protection from claims arising from injuries or damage to other people or property
No comments yet. Be the first to share your thoughts.