Insurer Compensates Claimants in Wake of Transition Issues

3

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
Source: Paige Estritori

Please Note: If this information affects you, seek advice from a licensed professional.

Share this news item:

Insurance News

Clear

IAG Highlights Climate Change's Impact on Home Insurance Costs

19 Feb 2026: Paige Estritori

Insurance Australia Group (IAG), a leading insurer in Australia, has recently raised concerns about the escalating costs of home insurance premiums, attributing this trend to the increasing frequency and severity of climate-related weather events. The company emphasizes that without immediate and concerted efforts to address climate change, homeowners should anticipate continued rises in insurance costs. - read more

Insurance News to Host Third Annual Conference in Sydney

19 Feb 2026: Paige Estritori

Insurance News has announced its third annual conference, scheduled to take place in Sydney on March 19, 2026. This full-day event aims to provide attendees with comprehensive insights into current market trends, industry pressures, and emerging opportunities within the insurance sector. - read more

Extreme Weather Events Lead to $3.5 Billion in Insured Losses in 2025

19 Feb 2026: Paige Estritori

The Insurance Council of Australia (ICA) has reported that extreme weather events in 2025 resulted in nearly $3.5 billion in insured losses from 264,000 claims. This significant financial impact underscores the growing challenges posed by climate-related disasters to the insurance industry and policyholders. - read more

IAG's Commitment to Improved Flood Response Following Parliamentary Inquiry

19 Feb 2026: Paige Estritori

Insurance Australia Group (IAG), the parent company of well-known brands such as NRMA Insurance, CGU, and WFI, has expressed its support for the recent parliamentary inquiry report examining insurers' responses to the 2022 major floods. The report, released by the House of Representatives Standing Committee on Economics, outlines 86 recommendations aimed at enhancing communication, support, and overall outcomes for customers affected by severe weather events. - read more

Australian Insurers Leverage AI for Enhanced Efficiency and Service

19 Feb 2026: Paige Estritori

In the dynamic landscape of the Australian insurance industry, companies are increasingly turning to artificial intelligence (AI) to bolster efficiency and elevate customer service. This strategic shift aims to address the multifaceted challenges posed by economic fluctuations, climate change, and evolving consumer expectations. - read more

Click for more Insurance News