Insurer Compensates Claimants in Wake of Transition Issues

3

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
Source: Paige Estritori

Please Note: If this information affects you, seek advice from a licensed professional.

Share this news item:

Insurance News

Clear

Rural Affinity and Munich Re Strengthen Agricultural Insurance in Australia

09 Jan 2026: Paige Estritori

In a significant development for Australia's agricultural sector, Rural Affinity has renewed its partnership with Munich Re Specialty - Global Markets under a new five-year agreement. This collaboration, which began in 2006, is set to enhance the availability and scope of agricultural insurance products across the country. - read more

WFI Insurance Highlights Significant Drop in Farm Liability Claims

09 Jan 2026: Paige Estritori

WFI Insurance has reported a notable decrease in farm liability claims across most categories, signaling a positive trend in safety practices within the Australian agricultural sector. The insurer observed a 75% reduction in falls from height over the past year, alongside a 30% decline in impact injuries, marking the lowest level in four years. - read more

Elders Insurance Highlights Increased Summer Storm Risks for Farmers

09 Jan 2026: Paige Estritori

Elders Insurance is urging Australian farmers to prepare for another damaging summer, with claims data revealing the scale and financial impact of storm activity across the country's agricultural regions. Analysis of storm-related farm insurance property claims over the last two years indicates that summer accounts for the highest number of claims nationally. - read more

Insuregroup Achieves Significant Milestone in Truck Insurance Policies

09 Jan 2026: Paige Estritori

Insuregroup, a specialist insurance brokerage serving Australia's transport and logistics sector, has recently achieved a significant milestone by processing over 10,000 insurance policies since its inception. This accomplishment includes a 25% year-on-year increase in policy count, highlighting the escalating demand for comprehensive truck insurance solutions among Australian freight operators. - read more

Queensland Aligns with National Heavy Vehicle Regulator

09 Jan 2026: Paige Estritori

In a significant move towards regulatory consistency, Queensland has transferred its heavy vehicle compliance responsibilities to the National Heavy Vehicle Regulator (NHVR). This transition aligns Queensland with New South Wales, Victoria, South Australia, Tasmania, and the Australian Capital Territory, all of which have already integrated their heavy vehicle regulations under the NHVR's oversight. - read more

Click for more Insurance News