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

Australian Insurers Anticipate Earnings Decline Following Record Highs Australian Insurers Anticipate Earnings Decline Following Record Highs
11 Mar 2026: Paige Estritori

In the 2024-25 financial year, Australia's general insurance sector achieved a remarkable return on equity (ROE) of 19%, marking the highest profitability in a decade. This exceptional performance was driven by robust underwriting results, substantial investment returns, and a period of relatively mild natural disaster activity. However, industry experts caution that such elevated earnings are unlikely to persist. - read more
Significant Drop in Australian Commercial Insurance Rates in Late 2025 Significant Drop in Australian Commercial Insurance Rates in Late 2025
11 Mar 2026: Paige Estritori

In the fourth quarter of 2025, Australia's commercial insurance sector experienced a notable 12% decline in rates, marking the most substantial reduction among the eight regions monitored by Marsh Risk's Global Insurance Market Index. This decrease follows an 11% drop in the preceding quarter, indicating a sustained trend of rate reductions in the Australian market. - read more
Australian Insurers Adapt Strategies in Response to Emerging Challenges Australian Insurers Adapt Strategies in Response to Emerging Challenges
11 Mar 2026: Paige Estritori

The Australian insurance industry is currently navigating a complex landscape marked by rising operational costs, escalating cybersecurity threats, and a competitive talent market. These challenges are prompting insurers to reassess and reshape their strategic priorities to sustain growth and profitability. - read more
Significant Increase in Health Insurance Premiums Set for April 2026 Significant Increase in Health Insurance Premiums Set for April 2026
11 Mar 2026: Paige Estritori

Australian health insurance policyholders are bracing for a substantial increase in premiums, with rates set to rise by 4.41% from April 1, 2026. This adjustment represents the most significant annual hike since 2017, when premiums increased by 4.84%. - read more


Life Insurance Articles

How Tradespeople Can Maximize Tax Deductions Through Insurance How Tradespeople Can Maximize Tax Deductions Through Insurance
Tradespeople work hard to earn their income, often facing unique expenses that can impact their bottom line. Understanding and maximizing tax deductions is crucial for minimizing these costs and keeping more of what they earn. By making informed decisions about expenses, tradespeople can significantly reduce their taxable income. - 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
Why Every Australian Needs Income Protection Insurance Why Every Australian Needs Income Protection Insurance
Income protection insurance is designed to provide financial support if you are unable to work due to illness or injury. It ensures that you continue to receive a portion of your income, allowing you to cover your living expenses and maintain your standard of living during difficult times. - read more
Life After You: Planning Ahead With Quality Life Insurance for Your Family Life After You: Planning Ahead With Quality Life Insurance for Your Family
Life insurance is a fundamental component of a robust financial plan, yet its significance is often underestimated. It serves as a safety net, ensuring that your loved ones are financially secure in the event of your absence. Understanding life insurance is the first step towards safeguarding your family’s future. - 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
Insurable Interest:
A financial or other kind of interest in the insured item or person, necessary for a valid insurance contract.