Income Insurance Online :: News
SHARE

Share this news item!

Insurer Compensates Claimants in Wake of Transition Issues

Insurer Compensates Claimants in Wake of Transition Issues

Insurer Compensates Claimants in Wake of Transition Issues?w=400

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.

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:

Rate this article

0 Comments

No comments yet. Be the first to share your thoughts.

Insurance News

APRA Enforces Additional Capital Requirement on Sovereign Insurance Australia
APRA Enforces Additional Capital Requirement on Sovereign Insurance Australia
13 Jun 2026: Paige Estritori
The Australian Prudential Regulation Authority (APRA) has imposed an additional $2 million capital requirement on Sovereign Insurance Australia (SIA), citing significant deficiencies in the insurer's risk management framework and regulatory reporting practices. This action underscores the critical importance of robust risk management within the insurance industry. - read more
Soft Market Conditions Persist in Australian Commercial Insurance Through H1 2026
Soft Market Conditions Persist in Australian Commercial Insurance Through H1 2026
13 Jun 2026: Paige Estritori
The Australian commercial insurance market has maintained its soft stance throughout the first half of 2026, presenting advantageous conditions for buyers. This trend is characterized by stable or declining premiums, expanded insurer capacity, and increased competition across various insurance lines. - read more
2026-27 Federal Budget: Key Impacts on the Australian Insurance Industry
2026-27 Federal Budget: Key Impacts on the Australian Insurance Industry
13 Jun 2026: Paige Estritori
The Australian Government's 2026-27 Federal Budget, presented by Treasurer Jim Chalmers, introduces several measures with direct implications for the insurance sector. These initiatives aim to address challenges such as property insurance costs and underinsurance, while certain omissions have raised questions within the industry. - read more
NRMA's Departure from Farm Insurance: What It Means for Australian Farmers
NRMA's Departure from Farm Insurance: What It Means for Australian Farmers
12 Jun 2026: Paige Estritori
In a significant shift within the Australian insurance landscape, NRMA has announced its withdrawal from the farm insurance market, ceasing the sale of new policies as of July 1, 2025. This decision affects both hobby and commercial farm insurance policies, leaving many farmers in search of alternative coverage options. - read more
Achmea and Protected Cropping Australia Join Forces to Support Greenhouse Farmers
Achmea and Protected Cropping Australia Join Forces to Support Greenhouse Farmers
12 Jun 2026: Paige Estritori
Achmea Farm Insurance and Protected Cropping Australia (PCA) have announced a strategic partnership aimed at bolstering risk mitigation and resilience within Australia's protected cropping sector. This collaboration seeks to empower greenhouse and glasshouse growers by providing tailored insurance solutions and fostering knowledge exchange on best practices. - read more


Life Insurance Articles

Why Income Protection Insurance Is Essential for Australians
Why Income Protection Insurance Is Essential for Australians
Income protection insurance is a type of personal insurance that provides financial support if you are unable to work due to illness or injury. It ensures that you continue to receive a portion of your income, helping you manage daily expenses and financial commitments during recovery. - read more
Navigating Pre-existing Conditions in Income Protection Insurance
Navigating Pre-existing Conditions in Income Protection Insurance
Income protection insurance is a safeguard that provides individuals with financial stability in the event they are unable to work due to illness or injury. This type of insurance typically replaces a significant percentage of the insured's income, ensuring that their financial commitments can still be met during periods when they cannot earn an income through employment. - read more
How to Avoid Common Mistakes When Filing an Insurance Claim
How to Avoid Common Mistakes When Filing an Insurance Claim
Filing an insurance claim in Australia can be a daunting process, especially if you are not familiar with the necessary steps and requirements. Claiming insurance is crucial when you need financial support, whether due to a natural disaster, accident, or another unexpected event. - read more
Separating Fact from Fiction: The Myths of Income Insurance Revealed
Separating Fact from Fiction: The Myths of Income Insurance Revealed
Have you ever thought about how you would manage financially if you couldn't work due to an illness or injury? Income protection insurance is designed to replace a significant portion of your income if you find yourself unable to earn for an extended period. It's an essential safety net, providing peace of mind and financial stability during times of uncertainty. - read more
Finding Accidental Coverage When Comprehensive Income Protection Isn't an Option
Finding Accidental Coverage When Comprehensive Income Protection Isn't an Option
Income protection is an integral part of maintaining your financial security, especially in the event that unforeseen illnesses or injuries prevent you from working. Enabling you to receive a percentage of your regular income, this type of insurance provides a safety net, ensuring that you can continue to cover your living expenses and financial obligations whilst recovering. - read more

Knowledgebase
Term Life Insurance:
A type of life insurance policy that provides coverage for a specified period, such as 10 or 20 years.