Insurer Compensates Claimants in Wake of Transition Issues

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.

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
Author: Paige Estritori

Please Note: We do not endorse any specific products or companies. Some content is sourced from third parties, including press releases, and may not be independently verified for accuracy or completeness.

Share this news item:

Insurance News

Clear

Rising Insurance Costs Threaten Australian Small Businesses

13 Apr 2026: Paige Estritori

Small business insurance premiums in Australia have surged by up to 60% since 2019, rendering coverage increasingly unaffordable for many enterprises. The Insurance Council of Australia attributes this escalation to outdated liability laws, escalating legal costs, and governmental red tape. - read more

Significant Decline in Australian Commercial Insurance Rates in Late 2025

13 Apr 2026: Paige Estritori

In the fourth quarter of 2025, Australian commercial insurance rates experienced a notable decline, with prices dropping by 12%. This marks the most significant decrease among the eight regions monitored by Marsh's Global Insurance Market Index. The primary driver behind this trend is heightened competition within the market, as international insurers have expanded their presence, providing additional capacity that has contributed to the rate reductions. - read more

Queensland Small Businesses Struggle with Escalating Insurance Costs

13 Apr 2026: Paige Estritori

Insurance affordability has emerged as one of the most pressing challenges facing small businesses across Queensland and increasingly across Australia. A recent submission by Business Chamber Queensland to the Parliamentary Joint Committee on Corporations and Financial Services outlines why insurance products are not keeping pace with the realities small businesses face, and what can change. - read more

Harland Green Unveils All-Risk Farm Insurance for Large-Scale Operations

13 Apr 2026: Paige Estritori

In a significant development for Australia's agricultural sector, Harland Green, a newly established Lloyd's coverholder, has introduced an all-risk farm insurance package tailored for large commercial farming operations. This initiative seeks to address the complex and often underserved insurance needs of substantial agribusinesses. - read more

Click for more Insurance News