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

WFI Insurance and Rural Aid Join Forces to Assist Farmers in Crisis WFI Insurance and Rural Aid Join Forces to Assist Farmers in Crisis
02 Feb 2026: Paige Estritori

In a significant move to bolster support for Australia's agricultural sector, WFI Insurance has announced a formal partnership with Rural Aid, a leading rural relief charity. This collaboration is set to provide much-needed assistance to farmers and rural communities affected by recent natural disasters, including the devastating bushfires in Victoria and severe weather events in Queensland. - read more
Elders Insurance Warns Farmers of Escalating Summer Storm Threats Elders Insurance Warns Farmers of Escalating Summer Storm Threats
02 Feb 2026: Paige Estritori

As the Australian summer approaches, Elders Insurance is calling on farmers to brace for an anticipated increase in storm-related damages. Recent claims data reveals a concerning trend, with summer months accounting for nearly half of all storm-related farm insurance property claims over the past two years. - read more
AFCA Observes Significant Increase in General Insurance Complaints AFCA Observes Significant Increase in General Insurance Complaints
01 Feb 2026: Paige Estritori

The Australian Financial Complaints Authority (AFCA) has reported a 17% increase in general insurance complaints for the year ending June 30, 2025, totalling 34,231 cases. This uptick is primarily attributed to issues surrounding add-on covers and delays in motor vehicle insurance claims. - read more
APRA's Findings: Stability in PI Claims and Decreasing Premiums APRA's Findings: Stability in PI Claims and Decreasing Premiums
01 Feb 2026: Paige Estritori

The Australian Prudential Regulation Authority (APRA) has released its latest National Claims and Policies Database, providing valuable insights into the professional indemnity (PI) insurance sector for the 2022 underwriting year. The data indicates that PI claims payments for non-facility business remained relatively stable at $1.111 billion, a slight increase from $1.109 billion in the previous year. - read more


Life Insurance Articles

Separating Fact from Fiction: The Myths of Income Insurance Revealed Separating Fact from Fiction: The Myths of Income Insurance Revealed
Have you ever thought about how you would manage financially if you couldn't work due to an illness or injury? Income protection insurance is designed to replace a significant portion of your income if you find yourself unable to earn for an extended period. It's an essential safety net, providing peace of mind and financial stability during times of uncertainty. - read more
Life Insurance Essentials: Protecting Your Growing Aussie Family Life Insurance Essentials: Protecting Your Growing Aussie Family
Life insurance remains one of the most crucial considerations for new parents aspiring to provide a secure future for their growing families. The arrival of a child marks a transformative moment, redefining priorities and responsibilities. At its core, life insurance is a safety net, designed to offer financial protection and stability to loved ones in the event of an unforeseen tragedy. - read more
A Comprehensive Guide to Income Protection Insurance in Australia A Comprehensive Guide to Income Protection Insurance in Australia
Income protection insurance is a type of insurance policy that provides financial support if you're unable to work due to illness or injury. It offers a replacement income, usually up to 75% of your normal wage, helping you maintain some level of income during tough times. - read more
Loss of income insurance: Case Study Loss of income insurance: Case Study
Rebecca is a single, self-employed graphic designer who works from home. Aged in her mid-30s, she has monthly commitments of a mortgage and car payments and the usual living expenses. - 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
Elimination Period:
The time period between an injury and the receipt of benefit payments from an insurer, particularly in disability insurance.