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

New Crane Cover Highlights the Insurance Gap for High-Risk Trades

24 Jun 2026: Paige Estritori

A new specialist insurance product for Australian crane and rigging operators is a timely reminder that not every business fits neatly into a standard policy box. ARTes Specialty, working with wholesale provider Mobius Insurance, has launched an integrated crane and rigging policy for the local market, adding to its earlier Australian offerings for commercial loggers and contractors’ plant and equipment. - read more

NSW Budget Puts Insurance Levy Pressure Back on the Table

24 Jun 2026: Paige Estritori

The latest NSW Budget has reignited debate over the Emergency Services Levy, with insurance industry concern growing that escalating collection forecasts are strengthening the case for reform. For households and businesses already managing higher premiums, the issue is more than a line item in the state accounts. It goes directly to affordability, underinsurance and whether the cost of funding emergency services is being shared fairly. - read more

NSW Insurance Levy Pressure Adds to Salon Cost Concerns

24 Jun 2026: Paige Estritori

The NSW Budget released on 23 June 2026 has put insurance affordability back in the spotlight, with updated forecasts showing emergency services levy collections are expected to be materially higher than previously projected. For beauty salon owners, skin clinics, nail technicians and mobile beauticians in NSW, the issue is not just a government finance story. - read more

Life Insurance Demand Strengthens as Businesses Reassess Protection Needs

24 Jun 2026: Paige Estritori

New market data reported by Plan For Life points to a notable rebound in parts of Australia’s life insurance sector, with individual lump sum insurance new business rising 6.7% across the 2025 calendar year and individual income protection new business increasing 8.3%. While overall risk new business was lower, that decline was attributed largely to group risk sales returning to more normal levels after earlier periods of heightened activity. - read more

New Report Highlights the Cost of Unplanned Business Succession

24 Jun 2026: Paige Estritori

A new Business Health research report has put a sharp focus on a familiar but often under-managed risk: what happens to a business if its principal suddenly dies or becomes permanently disabled. While the report is centred on Australian financial advice practices, its message applies broadly to SMEs, partnerships and owner-led companies where enterprise value is closely tied to one or two key people. - read more

Click for more Insurance News