We are a proud member of the Financial Services Online network!
Connect with us on your favourite social media platform for the latest financial news, views, tips, tricks, resources and information.
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:
"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
| Home Parking Dilemma Leads to Insurance Dispute Loss 09 Sep 2024: Paige Estritori A homeowner's struggle with her narrow driveway has culminated in the rejection of her car theft claim, illustrating the critical importance of adhering to insurance policy stipulations. - read more |
| Insurance Claim Rejected After Flight Crew Timing Violation 09 Sep 2024: Paige Estritori A traveler who faced a canceled flight due to the flight crew reaching their legal working hour limits will only receive partial reimbursement for his expenses. This ruling came from an official complaints authority. - read more |
| Allianz's Payout Reduction Approved in Car Claim Dispute 05 Sep 2024: Paige Estritori In a landmark decision, the Australian Financial Complaints Authority has ruled in favor of Allianz, allowing the insurer to significantly reduce its payout for a car damage claim due to a misdescribed vehicle model. - read more |
| Zurich Welcomes Fresh Leadership in Risk Management for ANZ Region 05 Sep 2024: Paige Estritori In a dynamic move, Zurich Financial Services Australia has named David Wainwright as the new Chief Risk Officer for the Australia and New Zealand region. This follows the retirement announcement of the current CRO, Jaimie Sach, a veteran with a distinguished 30-year career in the wealth management sector. - read more |
| How to Assess Your Risk Exposure and Select the Right Indemnity Coverage Professional indemnity insurance stands as a pivotal safeguard for Australian professionals navigating the intricacies of liability in their work life. This form of insurance is designed to protect professionals against legal costs and claims for damages arising from acts, omissions, or breaches of professional duty in the course of their practice. Whether it's due to an honest mistake or an unforeseen error, the ramifications of such professional oversights can be financially crippling. - read more
|
| Understanding Liability Insurance: A Must-Read for Australian Small Business Owners Liability insurance is a form of insurance designed to offer protection against claims resulting from injuries and damage to people or property. It covers legal costs and any payouts for which the insured party would be responsible if found legally liable. Intended to protect against claims resulting from injuries and damage to other people or property, liability insurance is critical for small businesses as it shields them from potentially crippling legal expenses. - read more
|
| Critical Risk Management Strategies for Every Australian Tradesman Welcome to the crucial world of risk management for Australian tradesmen. Whether you're a seasoned professional or just starting, understanding and mitigating the inherent risks in the trades industry is paramount to both the safety and sustainability of your business. This article intends to guide you through the world of risk management, emphasizing the pivotal role of liability insurance. - read more
|
| Public Liability Insurance Claims: What to Expect and How to Prepare When it comes to navigating the complex waters of insurance, understanding public liability insurance claims is crucial for businesses and individuals alike. Public liability insurance serves as a safeguard, protecting against the financial repercussions that arise from accidents or injuries that occur on your premises or through your operations. In this introductory section, we will delve into the essence of public liability insurance and underline its significance. - read more
|
|
Professional Indemnity vs Public Liability: What's the Best Choice for Your Small Business? As a small business owner, understanding the intricacies of liability insurance is pivotal to safeguarding the fruit of your hard work. Insurances such as professional indemnity and public liability are not just safety nets; they are vital components that can mean the difference between bouncing back and closing down following unforeseen legal hurdles. - read more
|
|
Understanding Product Liability Insurance in Australia: A Business Owner's Guide 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
|
|
How to Lower Public Liability Insurance Premiums Without Sacrificing Coverage In the ever-evolving landscape of Australian commerce, business insurance stands as a crucial bulwark, safeguarding enterprises against unforeseen financial perils. Recognizing this, our in-depth exploration begins with an overview of the monumental role business insurance plays for Australian companies, both large and small. It's a cornerstone for risk management, providing business owners with peace of mind as they navigate the intricacies of their industries. - read more
|
|
The Impact of Environmental Liability on Australian Business Operations In today's ever-evolving business landscape, the significance of environmental sustainability and legal accountability is increasingly paramount. Australian enterprises, in particular, are encountering a growing need to understand and manage environmental liability. This reality not only influences corporate image but also carries substantial financial and legal ramifications. - read more
|