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

nib Health Insurance Premiums to Rise by 5.79% in 2025
nib Health Insurance Premiums to Rise by 5.79% in 2025
05 Jan 2026: Paige Estritori
nib holdings limited has announced an average increase of 5.79% in health insurance premiums, effective from 1 April 2025. This adjustment reflects the insurer's response to escalating healthcare costs and heightened utilisation of medical services. - read more
Enhancing Digital Integration: ADHA's Plan for Allied Health Professionals
Enhancing Digital Integration: ADHA's Plan for Allied Health Professionals
05 Jan 2026: Paige Estritori
The Australian Digital Health Agency (ADHA) has introduced the National Allied Health Digital Uplift Plan, a strategic initiative designed to bolster the digital capabilities of allied health professionals across the nation. This plan aims to facilitate seamless sharing of health information among practitioners, patients, and multidisciplinary care teams, thereby enhancing the quality and efficiency of patient care. - read more
Strengthened Legal Safeguards for Whistleblowers in the Health Sector
Strengthened Legal Safeguards for Whistleblowers in the Health Sector
05 Jan 2026: Paige Estritori
Recent amendments to the National Law have introduced robust legal protections for whistleblowers within the health sector, marking a significant advancement in promoting transparency and accountability. These changes criminalise any form of retaliation against individuals who report misconduct, including the use of non-disclosure agreements (NDAs) to suppress such disclosures. - read more
AUSactive and Private Healthcare Australia Join Forces to Enhance Preventive Health Coverage
AUSactive and Private Healthcare Australia Join Forces to Enhance Preventive Health Coverage
05 Jan 2026: Paige Estritori
In a significant move towards integrating fitness services into health insurance coverage, AUSactive has partnered with Private Healthcare Australia (PHA) to drive reforms in the private health insurance sector. This collaboration seeks to expand access to evidence-based preventive health services, including Pilates, Yoga, Tai Chi, and structured exercise programs delivered by accredited professionals. - read more
FITREC and Marsh Collaborate to Provide Comprehensive Insurance Solutions for Fitness Professionals
FITREC and Marsh Collaborate to Provide Comprehensive Insurance Solutions for Fitness Professionals
05 Jan 2026: Paige Estritori
FITREC has announced a strategic partnership with Marsh, a leading insurance broker, to offer enhanced insurance solutions tailored specifically for fitness professionals. This collaboration aims to provide comprehensive coverage options that address the unique risks associated with the fitness industry. - read more
Click for more Insurance News


Life Insurance Articles

How to Compare Income Protection Insurance for Self-Employed Australians
How to Compare Income Protection Insurance for Self-Employed Australians
For self-employed Australians, the financial stability provided by consistent income is the backbone of both personal and business success. Unlike traditional employees, who might have access to sick leave or employer-sponsored disability benefits, self-employed individuals are solely responsible for their financial security in the event of illness or injury. This is where income protection insurance steps in as a crucial safeguard. - read more
How Accidental Income Protection Insurance Can Provide Peace of Mind
How Accidental Income Protection Insurance Can Provide Peace of Mind
Accidental income protection insurance is a type of policy that provides financial support if you are unable to work due to an accident. Unlike regular income protection insurance, which can cover illnesses and injuries, this specific insurance focuses solely on accidents. - read more
From Illness to Injury: Understanding the Scope of Income Protection Insurance
From Illness to Injury: Understanding the Scope of Income Protection Insurance
In the uncertain times we face today, where both health and economic climates are unpredictable, safeguarding your financial stability becomes paramount. This is where income protection insurance steps in as an essential safety net. For many Australian families, it's the buffer that ensures life's financial commitments are met, even when ability to work is compromised. - 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
5 Key Factors to Consider When Shopping for Income Protection in Australia
5 Key Factors to Consider When Shopping for Income Protection in Australia
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


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
Proximate Cause:
The primary cause of loss in an insurance claim, which sets in motion a chain of events leading to the damage or injury.

Quick Links: | Income Insurance | Income Protection Insurance | Income Insurance For Self-employed | Income Insurance Quotes | Best Income Insurance Australia | Income Insurance For Employees | Income Insurance Comparison | Income Protection For Contractors | Temporary Income Protection | Income Replacement Insurance | Income Protection Policy
This website is owned and operated by Clark Family Pty Ltd (ACN 010 281 008) as Trustee for the Clark Family Trust (ABN 35 957 893 714), 43 Larch Street Tallebudgera QLD 4228. Clark Family Pty Ltd is an Authorised Representative (AR 1298860) of Unique Group Broker Services Pty Ltd (AFSL 509434) for financial product referrals and an Authorised Credit Representative (ACR 401491) of Saccasan Pty Ltd (ACL 386297). Check our licensing details on the ASIC registers: Clark Family Pty Ltd ACR, Clark Family Pty Ltd AR, Saccasan Pty Ltd, Unique Group Broker Services.
IMPORTANT: We do not provide financial product advice or credit assistance. We act solely as an introducer and refer enquiries to licensed third-party intermediaries, insurers, and lenders - with whom you can then deal directly. We may receive a fee or commission from these third parties in consideration for the referral. Before any action is taken to obtain a product or service referred to by this website, advice should be obtained (from either the third party to whom we refer you or from another qualified intermediary) as to the appropriateness of obtaining those products having regard to your objectives, financial situation and needs. Whilst we have our own process for validating the legitimacy of our referral partners, you should always verify the credentials of your financial adviser before proceeding with recommendations that they may present. Visit the ASIC website for further information.