Insurer Compensates Claimants in Wake of Transition Issues
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.
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.
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.
NorthStandard, a prominent global marine insurer, has announced a 5% increase in Protection and Indemnity (P&I) premiums, effective from 20 February 2026. This decision reflects the company's response to ongoing market unpredictability and associated risks. - read more
In a landmark decision, Australia's High Court has unanimously ruled that Protection and Indemnity (P&I) insurers cannot limit their liability for wreck removal and pollution clean-up claims. This ruling emerged from the case involving Standard Club UK Ltd, the P&I insurer for CSL Australia, following a 2022 collision at the Port of Devonport, Tasmania. - read more
Severe Tropical Cyclone Narelle, which struck Northern Australia in March 2026, has brought to the forefront the escalating challenges in securing marine hull insurance in regions like Northern Queensland and Western Australia. The cyclone's path, impacting both the Northern Territory and the northwest of Western Australia, exemplifies the increasing volatility of weather patterns and their profound implications for the marine insurance sector. - read more
Vero's recently released 2026 SME Insurance Index has brought to light significant disparities in risk management practices between small and large Australian businesses. The survey, encompassing over 1,500 enterprises, underscores the pressing need for enhanced risk strategies among small and micro businesses to bolster their resilience in an increasingly volatile economic landscape. - read more
The Australian commercial insurance landscape has sustained its soft market conditions through the first half of 2026, characterised by competitive pricing, expanded underwriting capacity, and heightened competition among insurers. This environment presents both opportunities and considerations for businesses seeking to optimise their insurance portfolios. - read more
Choosing the right family health insurance can feel like navigating a maze. With so many options and factors to consider, it's no wonder many Australians find the process overwhelming. The stakes are high, as the wrong choice could not only impact your family's access to healthcare but also strain your finances. - read more
In today's rapidly changing health insurance landscape in Australia, keeping track of costs and coverage can be daunting. Many Australians find themselves grappling with high premiums that seem to increase year after year. - read more
In the realm of securing one’s health and wellbeing, navigating the Australian health insurance landscape can be as critical as the care received. It stands as a complex tapestry, woven with policies, premiums, and government incentives, affecting individuals and families nationwide. - read more
Finding affordable health insurance can be a daunting task, particularly in a landscape as diverse as Australia’s. With a myriad of options available, it's crucial to understand the financial support mechanisms in place that can ease the burden of healthcare costs. One such mechanism is the health fund rebate, a key feature of the Australian health insurance system designed to make healthcare more accessible. - read more
Private health insurance is an essential consideration for many Australians. It provides peace of mind, knowing that you and your family have access to the best possible healthcare when needed. - read more
Knowledgebase
Underwriting: The process by which an insurer determines the risk of insuring a client and decides the terms of coverage.
No comments yet. Be the first to share your thoughts.