Insurer Compensates Claimants in Wake of Transition Issues
Insurer Compensates Claimants in Wake of Transition Issues
3
The information on this website is general in nature and does not take into account your objectives, financial situation, or needs. Consider seeking personal advice from a licensed adviser before acting on any information.
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.
Insuregroup, a specialist insurance brokerage serving Australia's transport and logistics sector, has recently announced a significant milestone: processing over 10,000 insurance policies since its inception, with a 25% increase in policy volume over the past year. This growth underscores the escalating demand for comprehensive truck insurance solutions tailored to the unique needs of Australian freight operators. - read more
Envest Group, a prominent player in Australia's insurance sector, has announced the launch of TLI Underwriting, a new agency dedicated to providing specialized insurance solutions for heavy motor fleet operators. This strategic move aims to address the unique challenges faced by larger transport businesses in Australia. - read more
The Australian Securities and Investments Commission (ASIC) has commenced legal action against QBE Insurance, alleging that the insurer misled more than 500,000 customers regarding premium discounts over a five-year period. This development has significant implications for the Australian insurance industry, particularly for policyholders seeking transparency and fairness in premium calculations. - read more
In 2025, Australia's construction insurance market has experienced a significant shift, with premiums decreasing across various lines due to intensified competition among insurers. This trend is particularly beneficial for tradespeople, commonly known as 'tradies,' who are witnessing more affordable coverage options. - read more
In the bustling world of small businesses, the phrase 'expect the unexpected' captures the essence of entrepreneurship. While you can plan for success, unforeseen risks are always lurking around the corner. That's where the importance of insurance comes into play. It acts as a safeguard, protecting the lifeblood of your business against potential perils. - read more
Public liability insurance is a key consideration for business owners in Australia. This type of insurance helps protect businesses against claims made by third parties for injuries or property damage. But what exactly does it do? In simple terms, public liability insurance covers legal costs and expenses, as well as any damages awarded, if your business is found liable for an incident. - read more
As a business owner in Australia, navigating the complexities of protecting your company is crucial, with product liability insurance being an essential aspect to consider. This type of insurance is designed to shield businesses from financial losses that may arise if a product they manufacture, supply, or sell causes harm to a consumer or damages property. - read more
Liability insurance is a type of coverage designed to protect you from claims arising out of injuries or damages to other people or property. For freelancers, who often juggle multiple projects and clients, liability insurance can offer a safety net that reduces financial risk and instability. - read more
Start Here !
Knowledgebase
Umbrella Policy: An additional insurance policy that provides extra liability coverage beyond the limits of the insured's primary policies.
