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

APRA's 2026 Insurance Summit: Tackling Climate Risks and Affordability

16 Jun 2026: Paige Estritori

The Australian Prudential Regulation Authority (APRA) is set to host the 2026 AFR Insurance Summit on June 16 at The Fullerton Hotel in Sydney. This pivotal event will bring together industry leaders to address pressing issues within Australia's insurance sector, with a particular emphasis on climate-related risks, insurance affordability, and maintaining public trust. - read more

Dynamic Insurance's Legal Action Against Major Insurers

16 Jun 2026: Paige Estritori

Dynamic Insurance Services has initiated legal proceedings against Steadfast Group, QBE Insurance, and Allianz Australia Insurance, alleging coordinated actions that restricted its access to essential insurance products. The lawsuit, filed in March 2026, claims that these companies engaged in practices that adversely affected Dynamic's business operations. - read more

IAG's June 2026 Distribution on Hybrid Capital Notes

16 Jun 2026: Paige Estritori

Insurance Australia Group Limited (IAG) has announced a quarterly distribution on its ASX-listed hybrid capital notes (IAGPF), reflecting the company's ongoing commitment to its capital management strategy. For the quarter ending June 14, 2026, IAG will pay a distribution of AUD 1.6605 per note, based on an annualized rate of 6.6603% after adjustment for franking. This payment is scheduled for June 15, 2026, with the record date set for June 3, 2026. - read more

APRA's Intervention: Freezing Unjustified Premium Hikes in Commercial Auto Insurance

15 Jun 2026: Paige Estritori

In March 2026, the Australian Prudential Regulation Authority (APRA) took decisive action to address significant premium hikes in the commercial auto insurance sector. Responding to widespread industry concerns, APRA issued emergency regulations to freeze unjustified baseline premium increases exceeding 25%, pending external review. This intervention aims to protect independent transport operators and logistics enterprises from immediate financial strain. - read more

Soft Market Conditions Persist in Australian Commercial Insurance Through First Half of 2026

15 Jun 2026: Paige Estritori

The Australian commercial insurance market has maintained its soft stance through the first half of 2026, characterized by competitive pricing, expanded insurer capacity, and broad underwriting appetites. This trend, detailed in the latest Insurance Market Trends and Outlook report released by EBM Insurance & Risk on 11 May 2026, reflects a market shaped by heightened competition and stabilizing reinsurance conditions. - read more

Click for more Insurance News