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

Bali Flight Disruptions Put Natural Disaster Cover in the Spotlight

04 Aug 2026: Paige Estritori

Renewed flight disruption around Bali has put natural disaster cover back in focus for Australian travellers, after volcanic ash activity in Indonesia again showed how quickly a straightforward holiday can become a logistical and financial problem. When airlines delay, cancel or reroute services, travellers may face extra accommodation, meals, transport, missed tours and rearranged connections, often before they have a clear answer on what their insurer will pay. - read more

Why Cruise Holidays Need a Closer Look at Travel Insurance

28 Jul 2026: Paige Estritori

Recent consumer guidance has put cruise holidays back under the travel insurance microscope, with Australian travellers being reminded that a cruise is not always treated the same way as a standard land-based trip. While many people assume a general policy will automatically protect them once they board, cruise travel can involve its own conditions, limits and exclusions. - read more

Overseas Medical Emergency Puts Travel Insurance Back in Focus

21 Jul 2026: Paige Estritori

A recent Australian travel insurance case has offered a sharp reminder that the most expensive travel risk is often the one no traveller expects. According to Finder, an Australian woman who became seriously ill while 19 weeks pregnant in Mallorca faced medical costs of more than $40,000 after being taken to hospital by ambulance. The ambulance component alone reportedly reached $12,000, with the remaining costs linked to hospital admission, testing and treatment. - read more

Bali Theft Warnings Highlight a Bigger Travel Insurance Question

14 Jul 2026: Paige Estritori

Recent reports of phone and jewellery snatch-thefts in popular Bali tourist areas have put personal belongings back in the travel insurance spotlight. For Australians heading to Indonesia, the issue is not simply whether a stolen phone can be claimed. It is whether the policy they choose properly matches the risks they are most likely to face while away. - read more

School Holiday Travel Highlights a New Test for Insurance Cover

05 Jul 2026: Paige Estritori

Australia’s winter school holiday rush has put travel insurance back in the spotlight, with families heading to Bali, Fiji and Thailand, skiers travelling to New Zealand and domestic holidaymakers chasing either snow or sunshine closer to home. But this year’s peak period is unfolding against a more unsettled backdrop: geopolitical tension, airspace closures, airline disruption and a growing expectation that insurers should do more than reimburse costs after the event. - read more

Click for more Insurance News