Household 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
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:

Rate this article

0 Comments

No comments yet. Be the first to share your thoughts.

Insurance News

New APRA Data Reinforces the Need to Review Income Protection Cover
New APRA Data Reinforces the Need to Review Income Protection Cover
29 Jul 2026: Paige Estritori
APRA’s latest life insurance performance data has put income protection back under the spotlight, with disability income products continuing to be one of the more closely watched areas of the sector. While the broader life insurance industry has been showing signs of improved stability, the update reinforces that policies designed to replace income after illness or injury remain sensitive to claims experience, pricing, and changing work and health trends. - read more
Why Severe Weather Readiness Matters for Boat Owners
Why Severe Weather Readiness Matters for Boat Owners
29 Jul 2026: Paige Estritori
Australia’s latest severe weather preparedness messaging from the insurance sector is a timely reminder that boat owners face a different risk profile to many households. Storms, flood surge, hail, cyclonic winds and marina damage can all affect vessels well before a skipper has a chance to move them. For owners in Queensland, New South Wales, Western Australia and the Northern Territory in particular, the lead-up to summer is not just a maintenance checkpoint; it is a financial protection checkpoint. - read more
What Rising Insurance Disputes Mean for Small Businesses
What Rising Insurance Disputes Mean for Small Businesses
29 Jul 2026: Paige Estritori
Recent industry reporting on the latest insurance complaints environment points to a clear message for Australian small businesses: the hardest part of insurance is often not buying a policy, but relying on it when something goes wrong. Disputes continue to arise around claim delays, declined claims, settlement amounts, policy exclusions and communication breakdowns between customers and insurers. - read more
Rising Insurance Disputes Show Why Claims Service Matters
Rising Insurance Disputes Show Why Claims Service Matters
29 Jul 2026: Paige Estritori
Australia’s latest financial dispute data has put insurance claims handling back in the spotlight, with consumers and small businesses continuing to seek outside help when problems with insurers cannot be resolved directly. The trend is a timely reminder that an insurance policy should be assessed not only on premium, but also on how clearly it explains cover, how exclusions work, and how effectively claims are managed when pressure is highest. - read more
What Cosmetic Treatment Scrutiny Means for Beauty Business Cover
What Cosmetic Treatment Scrutiny Means for Beauty Business Cover
29 Jul 2026: Paige Estritori
Australian beauty businesses offering higher-risk aesthetic treatments are facing another reminder that compliance is now a front-of-house issue, not just a back-room admin task. Recent beauty industry reporting has focused on the continued scrutiny of cosmetic injectables, skin procedures and treatment advertising, with regulators expecting clearer consent, accurate marketing and suitable clinical oversight where health-related services are provided. - read more


Household Insurance Articles

How Often Should You Review and Update Your Household Insurance Policy?
How Often Should You Review and Update Your Household Insurance Policy?
It’s easy to think of household insurance as something you purchase once and forget about. However, this approach can leave you vulnerable to unexpected risks. Your home and its contents change over time, and so do your insurance needs. - read more
How Much Should You Budget for Insurance in Australia?
How Much Should You Budget for Insurance in Australia?
Welcome to the comprehensive guide on navigating the diverse world of insurance in Australia. Whether you're safeguarding your personal assets or protecting your business interests, insurance plays a pivotal role in financial security. In this introductory section, we'll explore why budgeting for insurance is crucial for Australians, delve into the various types of insurance available, and illustrate how insurance should integrate into your broader financial planning strategy. - read more
5 Essential Tips to Understand Your Home Insurance Policy in Australia
5 Essential Tips to Understand Your Home Insurance Policy in Australia
Choosing the right home insurance policy is akin to laying a safety net beneath your most valuable investment. With the Australian climate presenting a unique set of challenges, from bushfires to flooding, ensuring you have comprehensive cover isn't just a luxury—it's a necessity. The right policy serves as an armor, protecting your sanctuary against the unexpected onslaughts of nature and misfortune. - read more
Building Your Safety Net: Understanding Total Replacement Cover
Building Your Safety Net: Understanding Total Replacement Cover
For many Australians, their home is their castle, their sanctuary, and most significantly, their largest investment. Safeguarding this asset against unpredictable events is not merely a consideration—it's a necessity. That's where Total Replacement Cover comes into play. But what does this term really mean, and why is it paramount when it comes to choosing a home insurance policy? - read more
What to Look for When Choosing a Home and Contents Insurance Policy
What to Look for When Choosing a Home and Contents Insurance Policy
Home and Contents Insurance is a type of insurance policy that covers any damage or loss that may occur to your property, as well as the contents within it. This can include damages caused by fire, flood, theft and other unforeseen circumstances. In Australia, Home and Contents Insurance is of utmost importance due to the increasing rates of natural disasters such as bushfires and floods. - read more

Knowledgebase
Term Life Insurance:
A type of life insurance policy that provides coverage for a specified period, such as 10 or 20 years.