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

Surging Insurance Costs Pose Challenges for Australian Retirees Surging Insurance Costs Pose Challenges for Australian Retirees
08 Apr 2026: Paige Estritori

Recent reports indicate a significant increase in insurance premiums across Australia, with some policies experiencing hikes of up to 18%. This surge is placing considerable financial pressure on retirees, many of whom are on fixed incomes and find it challenging to accommodate these rising costs. - read more
AMA Calls for Urgent Reforms in Private Health Insurance Sector AMA Calls for Urgent Reforms in Private Health Insurance Sector
08 Apr 2026: Paige Estritori

The Australian Medical Association (AMA) has released a report indicating that private health insurance is increasingly failing to deliver value for money. The report highlights that premiums have risen sharply, outpacing inflation and wage growth, while nearly 70% of policies now contain exclusions for specific treatments or conditions. - read more
APRA Freezes Unjustified Premium Hikes in Commercial Auto Insurance APRA Freezes Unjustified Premium Hikes in Commercial Auto Insurance
07 Apr 2026: Paige Estritori

The Australian Prudential Regulation Authority (APRA) has recently implemented emergency measures to address significant premium increases in the commercial auto insurance sector. This intervention comes in response to widespread industry concerns over substantial rate hikes that threaten the financial stability of transport operators across the nation. - read more
Federal Court Upholds Denial of Truck Driver's Insurance Claim Federal Court Upholds Denial of Truck Driver's Insurance Claim
07 Apr 2026: Paige Estritori

In a recent legal development, the Federal Court of Australia dismissed an appeal by a logging truck driver, Mr. Bradley Henschke, concerning his insurance claim through the Australian Retirement Trust. The case, Henschke v Australian Retirement Trust [2026] FCA 80, highlights the critical importance of understanding the specifics of insurance coverage within superannuation accounts. - read more


Life Insurance Articles

How to Navigate Life Insurance Claims: Maximizing Your Benefits Successfully How to Navigate Life Insurance Claims: Maximizing Your Benefits Successfully
As we traverse the unpredictable journey of life, the assurance of a safety net can provide unparalleled peace of mind. Life insurance stands as a stalwart guardian in times of loss, ensuring that the financial implications do not add to the emotional burden of bereavement. Understanding the intricacies of life insurance claims is not merely a recommendation—it is a necessity for those looking to fully harness their policy's potential. - read more
Deciphering Your Policy: A Beginner's Guide to Insurance Terminology Deciphering Your Policy: A Beginner's Guide to Insurance Terminology
Welcome to the world of insurance – a domain where words like 'deductible' and 'premium' can significantly impact your financial protection and peace of mind. As a beginner, grasping the basics of insurance terminology is the first step towards making informed decisions about the policies that safeguard your assets and future. In this guide, we will embark on a journey through the language of insurance, which can often seem as complex as the policies themselves. - read more
Understanding the Role of Life Insurance in Your Estate Plan Understanding the Role of Life Insurance in Your Estate Plan
Estate planning is a critical process that often goes overlooked, but it's essential for securing the financial future of your loved ones and ensuring your assets are distributed according to your wishes. It involves the careful organization and protection of an individual’s estate to minimize uncertainties and facilitate the smooth transfer of assets after their passing. While it may seem complex, understanding the basics of estate planning is necessary for every Australian adult, regardless of wealth. - read more
Illness and Your Finances: Strategies for Continuous Income Flow Illness and Your Finances: Strategies for Continuous Income Flow
When illness strikes, the impact on your finances can be as significant as on your health. Maintaining continuous income flow during such times is crucial for financial stability. - 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
Deductible:
The amount you must pay out-of-pocket for expenses before your insurance company covers the remaining costs.