Compare Life Insurance :: News
SHARE

Share this news item!

Insurer Compensates Claimants in Wake of Transition Issues

Insurer Compensates Claimants in Wake of Transition Issues

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
Source: Paige Estritori

Share this news item:

Insurance News

AMA Advocates for Regulatory Reforms to Curb Health Insurers' Market Power AMA Advocates for Regulatory Reforms to Curb Health Insurers' Market Power
14 Feb 2026: Paige Estritori

The Australian Medical Association (AMA) has recently highlighted concerns regarding the substantial market power wielded by private health insurers and its potential adverse effects on patient care and healthcare costs. In a position statement released on 4 February 2026, the AMA emphasised the need for regulatory reforms to prevent insurers from exploiting their dominant positions in the healthcare sector. - read more
Declining Value in Private Health Insurance: AMA Calls for Urgent Reforms Declining Value in Private Health Insurance: AMA Calls for Urgent Reforms
14 Feb 2026: Paige Estritori

Recent findings from the Australian Medical Association (AMA) reveal a concerning trend in the private health insurance sector: Australians are facing higher premiums while experiencing diminishing returns on their policies. The AMA's latest Private Health Insurance Report Card, released on 5 December 2025, highlights the urgent need for reforms to address these issues. - read more
Private Health Insurers Under Fire for Premium Increases Despite Government Warnings Private Health Insurers Under Fire for Premium Increases Despite Government Warnings
14 Feb 2026: Paige Estritori

Private health insurers in Australia are facing mounting criticism for implementing significant premium increases, despite explicit warnings from the Health Minister. This development has sparked concerns about the affordability of healthcare and the practices employed by insurers to maximise profits. - read more
AIA Australia's Commitment to Mental Health: City2Surf Partnership AIA Australia's Commitment to Mental Health: City2Surf Partnership
14 Feb 2026: Paige Estritori

In August 2025, AIA Australia, a leading life, health, and wellbeing insurer, took a significant step in addressing the nation's mental health crisis by partnering with the City2Surf event in Sydney. This collaboration aimed to raise both funds and awareness for mental health, a pressing issue that has seen a notable increase in related insurance claims over recent years. - read more


Life Insurance Articles

Income Protection: How to Safeguard Your Earnings in Uncertain Times Income Protection: How to Safeguard Your Earnings in Uncertain Times
In the landscape of personal financial planning, income protection insurance emerges as a critical safeguard against the unpredictable nature of life's many uncertainties. As we navigate through economic turbulence and job market volatility, the importance of income protection becomes ever more apparent. This type of insurance serves as a financial backstop, designed to provide a stable flow of income when you're unable to work due to sickness or injury. - read more
Understanding Various Life Insurance Types: Which One is Right for You? Understanding Various Life Insurance Types: Which One is Right for You?
Financial security is one of the most important aspects of modern family life. Ensuring that loved ones are protected and well-supported in the event of an untimely death is a fundamental concern for many Australians. - read more
Income Protection Insurance vs. Total Permanent Disability: What’s the Difference? Income Protection Insurance vs. Total Permanent Disability: What’s the Difference?
When life throws unexpected challenges your way, being financially prepared can make all the difference. This is where Income Protection Insurance and Total Permanent Disability (TPD) Insurance come into play. These two types of insurance provide a crucial safety net, ensuring that you and your family remain financially stable even when you're unable to work due to illness or injury. - read more
Life Insurance Audit: Regular Check-Ups for Your Policy's Health Life Insurance Audit: Regular Check-Ups for Your Policy's Health
Life insurance serves as a crucial safety net, guarding your loved ones against the unforeseen. Just as you would take care of your health through regular check-ups, it is equally important to ensure that your life insurance policy remains in sound condition to provide the necessary protection. - read more


Start Here !
life insurance
Apply now for your free Insurance assessment and price comparisons!

Start Here

Life Cover Amount:
Postcode:


All quotes are provided free and without obligation. We respect your privacy.
Knowledgebase
Insurance:
In law and economics, insurance is a form of risk management primarily used to hedge against the risk of potential financial loss.