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
Source: Paige Estritori

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

Share this news item:

Insurance News

Strengthening Agricultural Insurance: Rural Affinity and Munich Re's Renewed Partnership
Strengthening Agricultural Insurance: Rural Affinity and Munich Re's Renewed Partnership
10 Feb 2026: Paige Estritori
Rural Affinity has renewed its partnership with Munich Re Specialty - Global Markets under a new five-year agreement, continuing a collaboration that began in 2006. This renewed alliance aims to support Rural Affinity's efforts to expand its agricultural insurance offerings across Australia and introduce new products leveraging technology and innovation. - read more
AFCA Mandates Insurer Payout for Engine Overheating Incident
AFCA Mandates Insurer Payout for Engine Overheating Incident
10 Feb 2026: Paige Estritori
The Australian Financial Complaints Authority (AFCA) has recently ruled in favour of a truck owner whose insurance claim was initially denied following an engine overheating incident. This decision underscores the complexities surrounding insurance claims related to driver negligence and mechanical failures. - read more
AFCA Supports Insurer in Truck Theft Claim Denial
AFCA Supports Insurer in Truck Theft Claim Denial
10 Feb 2026: Paige Estritori
The Australian Financial Complaints Authority (AFCA) has recently upheld an insurer's decision to deny a truck theft claim, citing misrepresentation of the insured's insurance history. This ruling highlights the critical importance of accurate disclosure when obtaining insurance coverage. - read more
AFCA Sides with Freight Company in Dangerous Goods Disclosure Case
AFCA Sides with Freight Company in Dangerous Goods Disclosure Case
10 Feb 2026: Paige Estritori
The Australian Financial Complaints Authority (AFCA) has recently ruled in favour of a freight company in a dispute over the disclosure of transporting dangerous goods. This decision provides valuable insights into the obligations of transport companies regarding insurance disclosures. - read more
Australian Insurers Falling Behind in Risk Preparedness
Australian Insurers Falling Behind in Risk Preparedness
10 Feb 2026: Paige Estritori
Recent findings from PwC's Insurance Banana Skins Survey highlight a concerning trend: Australian insurers are trailing their global counterparts in risk preparedness. The survey, which gathered insights from 698 insurance executives across 42 territories, indicates that Australian insurers scored 6.6% lower on the Preparedness Index compared to the global average. - read more


Life Insurance Articles

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
Income Protection vs. Life Insurance: What's Best for You?
Income Protection vs. Life Insurance: What's Best for You?
Financial protection is an essential aspect of sound financial planning. It ensures that you and your family are safeguarded against unexpected events that could lead to financial hardship. Two common types of financial protection are income protection insurance and life insurance. - read more
Income Protection vs. Total Permanent Disability: Which Is Right for You?
Income Protection vs. Total Permanent Disability: Which Is Right for You?
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
Income Protection Insurance and Tax Benefits: What You Should Know
Income Protection Insurance and Tax Benefits: What You Should Know
Income protection insurance is a type of cover designed to provide you with a safety net if you are unable to work due to illness or injury. By offering regular payments that replace a portion of your income, it helps ensure that you can maintain your lifestyle and cover essential expenses during challenging times. - read more
Deciphering Your Policy: A Beginner's Guide to Insurance Terminology
Deciphering Your Policy: A Beginner's Guide to Insurance Terminology
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


Start Here

Monthly Income Benefit:
Postcode:

All quotes are provided free and without obligation by a Specialist from our National Broker referral panel. See our Privacy Statement for more details.


Knowledgebase
Whole Life Insurance:
A type of life insurance that provides coverage for the insured's entire lifetime, with a savings component that builds cash value.