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.
In August 2025, Hutch Underwriting unveiled a new landlord insurance product tailored for Australian residential property owners. This policy stands out by incorporating built-in cyber protection, addressing the growing digital risks landlords face in today's interconnected world. - read more
In a significant advancement for the strata insurance sector, insurtech company Cohabit has launched a digital platform designed to streamline the insurance process for strata schemes. This innovative solution enables property owners and strata managers to review and compare insurance options tailored to their specific buildings, fostering informed decision-making and enhanced transparency. - read more
Suncorp, a leading Australian insurer, has announced a strategic reclassification of its strata insurance business from consumer to commercial, signaling a concerted effort to expand its footprint in the strata insurance market. This move aligns with the company's broader strategy to enhance its commercial insurance offerings and leverage synergies within its portfolio. - read more
Consumer advocacy groups have expressed strong support for the New South Wales (NSW) Productivity and Equality Commission's recent recommendation to prohibit commission payments for strata managers and insurance brokers within the strata sector. This proposed reform is seen as a critical step toward enhancing transparency and safeguarding the interests of property owners. - read more
In February 2026, the Insurance Council of Australia (ICA) submitted four proposals to the Parliamentary Joint Committee's inquiry into small business insurance, highlighting the urgent need for reforms to enhance the resilience of Australia's 2.5 million small businesses. These enterprises, which employ nearly half of the private sector workforce, are increasingly burdened by escalating insurance premiums driven by extreme weather events, inflation, and complex regulatory requirements. - read more
The current health insurance landscape in Australia can be quite confusing for many people. With numerous options available, it’s not always clear which to choose to balance your budget with your needs. Premiums are on the rise, and Australians are becoming increasingly concerned about the costs of maintaining adequate coverage. - 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
Welcome to our discussion on basic health insurance cover, a topic that is crucial yet often overlooked in the hustle and bustle of everyday life. Navigating the world of health insurance can be daunting, but understanding your options is vital for peace of mind and financial stability. - read more
The dawn of the digital age has significantly transformed the way we approach nearly every aspect of our lives, and the domain of health insurance is no exception. With the arrival of innovative digital tools, the health insurance landscape has undergone a striking evolution, allowing for unprecedented accessibility and convenience in managing healthcare coverage. - read more
In Australia, health insurance plays a significant role in ensuring individuals can access quality medical care without incurring prohibitive costs. - read more
Knowledgebase
Grace Period: A time period after the premium is due during which an insurance policy remains in force even if the premium has not yet been paid.
