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

Why Battery Freight Is Becoming a Truck Insurance Issue

10 Sep 2026: Paige Estritori

Recent transport and insurance industry attention on lithium-ion battery safety is a timely warning for Australian truck operators. The issue is no longer limited to consumer products catching fire in homes or warehouses. Batteries now move through freight networks in tools, scooters, e-bikes, electronics, spare parts and energy storage equipment, and that creates a different risk profile for carriers, depots and subcontracted linehaul work. - read more

Why Premium Differences Matter When Choosing Income Protection

09 Sep 2026: Paige Estritori

Recent income protection cost commentary has put a practical issue back in front of Australian workers: two policies that appear similar at first glance can carry very different long-term costs. For people relying on their income to meet mortgage repayments, rent, school fees, business expenses or family commitments, the premium is important, but it should not be viewed in isolation. - read more

Cyber Risk Is Blurring the Lines for Professional Indemnity Cover

09 Sep 2026: Paige Estritori

Recent insurance market commentary has again highlighted a growing challenge for Australian professional service firms: cyber incidents are no longer just an IT problem. When a system outage, data handling error, failed implementation, software defect or poor security recommendation causes a client financial loss, the dispute can quickly move into professional indemnity territory. - read more

Why Skipping Travel Insurance Can Be a Costly Saving

09 Sep 2026: Paige Estritori

Recent consumer reporting has again highlighted a familiar travel risk: some Australians are looking for savings by travelling without insurance, or by choosing the cheapest cover without checking whether it suits the trip. With airfares, accommodation and day-to-day holiday costs still stretching household budgets, it is understandable that travellers are scrutinising every expense. The problem is that travel insurance is often treated as optional until something goes wrong. - read more

Cyber Underinsurance Is Becoming a Bigger SME Risk

09 Sep 2026: Paige Estritori

Fresh industry attention on cyber underinsurance is a timely reminder that many Australian small and medium businesses are still treating digital risk as an IT problem rather than a balance sheet risk. As more trading, payments, customer records, bookings and supplier relationships move online, a cyber incident can quickly become a cash flow, legal, operational and reputational event. - read more

Click for more Insurance News