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

TAL's Health Sense Plus Now Covers Income Protection Policies TAL's Health Sense Plus Now Covers Income Protection Policies
19 Jan 2026: Paige Estritori

In a significant development for policyholders, TAL has expanded its Health Sense Plus program to encompass income protection (IP) policies. This initiative, effective from August 8, 2025, aims to incentivise proactive health management by offering premium discounts to clients who engage in preventative health checks. - read more
New Legislation Prohibits Life Insurers from Using Genetic Test Results New Legislation Prohibits Life Insurers from Using Genetic Test Results
19 Jan 2026: Paige Estritori

The Australian government has enacted legislation prohibiting life insurers from using the results of genetic tests to refuse coverage or increase premiums. This landmark decision aims to eliminate genetic discrimination and encourage individuals to undergo potentially life-saving genetic testing without fear of financial repercussions. - read more
Markel Insurance Expands into Australian Marine Market with New Leadership Markel Insurance Expands into Australian Marine Market with New Leadership
19 Jan 2026: Paige Estritori

Markel Insurance has announced the appointment of Tim Wills as Head of Marine for Australia, marking a significant expansion into the country's marine insurance sector. Based in Sydney, Wills will spearhead the introduction of Markel's marine products, starting with marine cargo insurance. - read more
Pelagic Risk Services Strengthens Marina Support with Gold Sponsorship Pelagic Risk Services Strengthens Marina Support with Gold Sponsorship
19 Jan 2026: Paige Estritori

Pelagic Risk Services, a specialist marine insurance broker, has elevated its commitment to the marina industry by upgrading from Silver to Gold Sponsorship with the Marina Industries Association (MIA). This move underscores Pelagic's dedication to supporting marinas across Australia through enhanced financial contributions and the provision of exclusive risk management resources. - read more


Life Insurance Articles

Life Insurance: How much is enough? Life Insurance: How much is enough?
When considering life insurance, you're planning and preparing for an event that most of us would rather not think about. But life insurance represents a critical step in managing your personal finances and ensuring your family's well-being. - read more
Self-Employed? Here's How to Determine Your Income Insurance Coverage Needs Self-Employed? Here's How to Determine Your Income Insurance Coverage Needs
In recent times, the allure of being your own boss has led to a significant shift towards self-employment in Australia. This growing trend reflects a desire for greater flexibility and autonomy in one's career. However, amidst this independence lie uncertainties and financial risks unique to those who venture out on their own. - read more
Why life insurance is a necessity in tough times Why life insurance is a necessity in tough times
With household budgets under pressure ... and consumer confidence weak, many families are wondering whether life insurance is worth the expense. Or maybe it is something they can do without? - read more
Keeping Your Family Protected: The Importance of Adequate Health Insurance Coverage Keeping Your Family Protected: The Importance of Adequate Health Insurance Coverage
The modern Australian family faces a dynamic and ever-evolving set of health needs, with access to quality healthcare remaining a cornerstone of managing our wellbeing. As these needs shift through the different stages of life, the assurance of having a safety net in place can provide unparalleled peace of mind. It's this sense of security that makes adequate health insurance coverage indispensable in today's fast-paced society. - 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 Policy Excess:
The amount you will have to contribute when you make a claim.