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.
Queensland trade businesses have received a welcome measure of cost certainty, with WorkCover Queensland’s average premium rate to remain unchanged for the 2026-27 financial year. The rate will stay at $1.343 per $100 of wages, marking the second consecutive year without an increase. - read more
Artificial intelligence is no longer a side project for technology teams. Fresh industry reporting on Clyde & Co’s Corporate Risk Radar 2026 points to a sharp rise in concern among business leaders, with technology risk now being treated as a core governance, regulatory and reputational issue. For Australian consultants, advisers, designers, engineers, accountants, marketers and other professional service providers, that shift has direct implications for risk management and professional indemnity cover. - read more
Vero has launched a new residential strata insurance product that could prove important for schemes finding it difficult to secure suitable cover, particularly in higher-risk northern markets. The product, introduced on 22 June 2026, is initially available in selected postcodes across Far North Queensland, from Bundaberg North, and Darwin, with a staged national rollout planned over the next year. - read more
Artificial intelligence is quickly moving from experiment to everyday business tool, and a new global risk study suggests business leaders are starting to recognise the size of the shift. The latest Corporate Risk Radar research from Clyde & Co found technology risk has climbed sharply in the minds of senior decision-makers, with AI now linked not only to IT security but also governance, regulation, reputation and third-party dependency. - read more
Australian travellers with pre-existing medical conditions have been given a timely reminder to look beyond price when arranging travel insurance, with recently updated consumer guidance placing renewed emphasis on disclosure, medical assessments and policy wording. - 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
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
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
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
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
Knowledgebase
Insurance Underwriter: An insurance company, a financial institution that sells insurance.
No comments yet. Be the first to share your thoughts.