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
Sources

Please Note: If this information affects you, seek advice from a licensed professional.

Share this news item:

Insurance News

Clear

Allianz Partners Highlights Risks of Travelling Uninsured

20 Mar 2026: Paige Estritori

Recent research conducted by the Insurance Council of Australia (ICA) and the Department of Foreign Affairs and Trade (DFAT) has unveiled a concerning trend: approximately 14% of Australian travellers embark on international journeys without any form of travel insurance. This statistic has prompted Allianz Partners to urge Australians to reconsider the importance of securing adequate coverage before travelling abroad. - read more

Rising Medical Costs Lead to Surge in High-Value Travel Insurance Claims

20 Mar 2026: Paige Estritori

Southern Cross Travel Insurance (SCTI) has reported a notable rise in high-cost travel insurance claims, underscoring the escalating medical expenses faced by Australian travellers abroad. The insurer's most expensive claim last year amounted to $672,630, a 259% increase compared to the previous year's highest claim. - read more

Australian Travel Insurers Extend Support During Middle East Conflict

20 Mar 2026: Paige Estritori

In response to the ongoing conflict in the Middle East, Australian travel insurers have mobilised additional resources to support customers impacted by the situation. The Insurance Council of Australia (ICA) announced that insurers are providing dedicated 24/7 assistance, coordinating medical care, and prioritising support for those in affected regions. - read more

The Financial Perils of Travelling Uninsured: A Wake-Up Call for Australians

12 Mar 2026: Paige Estritori

Recent research has unveiled a concerning trend: 14% of Australian travellers embark on international journeys without any form of travel insurance. This statistic is even more alarming among younger travellers under 30, with nearly one in four opting to travel uninsured. Such decisions expose individuals to significant financial risks, especially when unforeseen events occur abroad. - read more

Allianz Australia Penalised for Misleading Travel Insurance Information

04 Mar 2026: Paige Estritori

In a significant ruling, the Supreme Court of New South Wales has imposed fines totaling $16.8 million on Allianz Australia Insurance and its subsidiary, AWP Australia, for disseminating misleading information about their travel insurance products between 2016 and 2018. This decision underscores the critical importance of transparency and accuracy in the insurance sector. - read more

Click for more Insurance News