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

Suncorp Enhances Financial Resilience with AU$2.4 Billion Reinsurance Agreement
Suncorp Enhances Financial Resilience with AU$2.4 Billion Reinsurance Agreement
12 Jun 2026: Paige Estritori
Suncorp, a leading Australian insurer, has recently secured a substantial reinsurance agreement valued at AU$2.4 billion over a five-year period. This strategic move is designed to bolster the company's financial resilience and stability in the face of increasing natural hazard costs and a competitive insurance market. - read more
APRA Enforces AU$2 Million Capital Add-On for Sovereign Insurance Australia
APRA Enforces AU$2 Million Capital Add-On for Sovereign Insurance Australia
12 Jun 2026: Paige Estritori
The Australian Prudential Regulation Authority (APRA) has recently imposed an additional AU$2 million capital requirement on Sovereign Insurance Australia (SIA). This decision comes in response to identified deficiencies in SIA's risk management framework and operational risk management practices. - read more
Mecon Enhances Construction Insurance Coverage to $120 Million
Mecon Enhances Construction Insurance Coverage to $120 Million
12 Jun 2026: Paige Estritori
In a significant development for Australia's construction industry, Mecon, a specialist in construction insurance, has announced an increase in its underwriting capacity. Effective from March 10, 2026, Mecon now offers coverage up to $120 million for single projects under its material damage and public liability policy sections. This marks a substantial rise from the previous limit of $50 million. - read more
Mirabelle Unveils Lloyd's-Backed Insurance for Australia's Renewable Energy Sector
Mirabelle Unveils Lloyd's-Backed Insurance for Australia's Renewable Energy Sector
12 Jun 2026: Paige Estritori
Mirabelle Underwriting, a specialist in construction and engineering insurance, has launched a new product tailored for renewable energy operations in Australia. This initiative, backed by Lloyd's capacity, aims to address the specific risks associated with the rapidly expanding renewable energy sector. - read more
ASIC Initiates Legal Action Against RACQ for Misleading Renewal Notices
ASIC Initiates Legal Action Against RACQ for Misleading Renewal Notices
12 Jun 2026: Paige Estritori
The Australian Securities and Investments Commission (ASIC) has commenced Federal Court proceedings against the Royal Automobile Club of Queensland (RACQ), alleging that the insurer disseminated more than 500,000 misleading insurance renewal notices to its customers. This action underscores the regulator's commitment to ensuring transparency and fairness within the insurance sector. - read more


Household Insurance Articles

Protecting Your Home: The What, Why, and How of Home Insurance
Protecting Your Home: The What, Why, and How of Home Insurance
As Australians, our homes are often at the heart of our livelihoods and hold significant emotional and financial value. Protecting this important asset is more than just a precaution; it's a necessary step in safeguarding our future. Home insurance acts as a shield against unpredictable events that can have devastating effects on our property and peace of mind. Whether it's from natural disasters or unforeseen accidents, the significance of home insurance cannot be understated. - read more
The Essential Guide to Comprehensive Household Coverage in Australia
The Essential Guide to Comprehensive Household Coverage in Australia
Comprehensive household coverage, often referred to as home insurance, is a policy designed to protect your home and its contents against a wide array of risks. This type of coverage typically includes protection against natural disasters, theft, vandalism, and various unforeseen events. In simple terms, it's the safety net that ensures peace of mind should the unexpected happen to your property or possessions. - read more
10 Common Household Insurance Policies: What Aussie Families Need to Know
10 Common Household Insurance Policies: What Aussie Families Need to Know
Household insurance is an essential aspect of financial planning for Australian families. It provides peace of mind and financial protection in case of unexpected events such as natural disasters, theft, or accidents. Given the unpredictable nature of life, having the right insurance policy can safeguard your home and its contents, ensuring that you are not left in a financial bind when disaster strikes. - read more
How to File a Home Insurance Claim in Australia - A Step by Step Guide
How to File a Home Insurance Claim in Australia - A Step by Step Guide
Experiencing damage or loss to your home can be a stressful and overwhelming experience. However, having home insurance provides a safety net for homeowners who need to file a claim. - read more
10 Tips for Lowering Your Home and Contents Insurance Premiums
10 Tips for Lowering Your Home and Contents Insurance Premiums
One of the best ways to lower your home and contents insurance premiums is to shop around for the best deal. Insurance companies often have varying rates, discounts, and offers that could save you a significant amount of money. Start by researching different insurance providers and their policy offerings. Make sure to compare not only pricing but also features, coverages and deductible amounts. - read more

Knowledgebase
Deductible:
The amount you must pay out-of-pocket for expenses before your insurance company covers the remaining costs.