Insurer Compensates Claimants in Wake of Transition Issues
Insurer Compensates Claimants in Wake of Transition Issues
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:
| Decline in Life and Income Protection Insurance Premiums Benefits Australians 24 Nov 2025: Paige Estritori Recent data indicates a notable decline in life and income protection insurance premiums across Australia, providing consumers with more affordable coverage options. According to the latest Direct Life Insurance Report from Rainmaker Information, direct life premiums have decreased by 7% since 2024. Similarly, direct income protection premiums have seen significant reductions, with average premiums for waiting periods of 30 days and 90 days decreasing by 12% and 13%, respectively. - read more |
| TAL's Health Sense Plus Now Covers Income Protection Policies 24 Nov 2025: 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 |
| Marsh and Tokio Marine Kiln Introduce Port Disruption Insurance Amid Global Shipping Challenges 24 Nov 2025: Paige Estritori In response to escalating global shipping challenges, leading broker Marsh and Lloyd's underwriter Tokio Marine Kiln have launched a pioneering business interruption insurance specifically designed for ports. This innovative product aims to mitigate the financial impact of trade disruptions caused by various factors, including geopolitical tensions and operational strikes. - read more |
| Allianz Australia's Strategic Expansion: RAA Insurance Acquisition 24 Nov 2025: Paige Estritori In a significant move within the Australian insurance sector, Allianz Australia has successfully completed the acquisition of RAA Insurance for $642 million. This strategic acquisition, approved by the competition regulator on June 12, 2025, marks a substantial expansion of Allianz's footprint in the South Australian market. - read more |
| How Income Protection Insurance Can Safeguard Your Financial Future Income protection insurance is a type of insurance policy designed to replace a portion of your income if you are unable to work due to illness or injury. This financial safety net can help cover essential living expenses, such as mortgage repayments, utility bills, and daily costs, ensuring you maintain your standard of living during tough times. - read more
|
| The Single Parent’s Guide to Securing Your Child’s Financial Future Single parenting brings with it a mosaic of responsibilities and challenges, not least of which is securing a stable financial future for your child. The rollercoaster of raising a child alone often means that planning for the future can take a back seat to the day-to-day demands of parenting. Unexpected illnesses and injuries can compound these challenges, causing stress to multiply and plans to go awry. - read more
|
| Understanding Life Insurance: How to Get the Best Online Quotes The digital age has fundamentally transformed how we approach almost every aspect of our lives, including the way we shop for life insurance in Australia. Gone are the days when one had to schedule meetings with insurance agents or flip through pamphlets to understand life insurance policies. Today, obtaining life insurance quotes online has become the norm, offering a hassle-free and incredibly accessible platform for individuals to safeguard their financial future. - read more
|
| Income Safety Net: How to Choose the Right Income Protection for Your Lifestyle In the face of life's unpredictable twists and turns, few things are as disconcerting as the possibility of suddenly losing your ability to earn an income due to illness. Such events are often unexpected and can have significant financial repercussions that interrupt not only your flow of daily life but also compromise your future plans. - read more
|
A professional who analyzes the financial costs of risk and uncertainty using mathematics, statistics, and financial theory.