Insurer Compensates Claimants in Wake of Transition Issues
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.
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.
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.
Recent consumer attention on complimentary credit card travel insurance is a timely reminder that 'included' does not always mean automatic, comprehensive or suitable for every trip. For many Australians, card-linked cover can be a useful benefit, particularly where it is backed by a reputable insurer and activated correctly. The risk is assuming it works like a standalone policy without checking the fine print. - read more
Canstar's latest travel insurance ratings have given Australian travellers another reminder that the cheapest policy is not always the best fit for a trip. With international holidays, cruises, domestic breaks and multi-destination itineraries all carrying different risks, the latest assessment reinforces the importance of weighing price against the practical strength of the cover. - read more
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
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
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
Travel plays a significant role in family bonding. There's nothing quite like exploring new places together, creating lasting memories, and experiencing adventures that will be talked about for years to come. - read more
Travel can be an exciting adventure, but it often comes with a myriad of expenses that can quickly add up. From flights and accommodations to meals and entertainment, the costs can take a toll on your budget. - read more
Traveling overseas is an exciting experience yet can be challenging, especially for Australians on a budget. With careful planning and budgeting, it is possible to make the most out of your trip without breaking the bank. This article provides valuable money-saving tips for Australians looking to explore the world on a restricted budget. - read more
Pre-existing medical conditions can affect travel insurance eligibility, pricing, exclusions and claims. Australian travellers should understand disclosure, medical assessments and policy wording before choosing cover. - read more
Travelling is one of life’s great joys, and for Australians, visa-free travel opens up a world of opportunities. The convenience and freedom that come with not needing a visa cannot be overstated. With just your passport in hand, you can explore countless destinations without the hassle of paperwork. This kind of travel liberty offers a spontaneous, exhilarating experience, allowing you to book a last-minute trip without worrying about securing a visa beforehand. - read more
Knowledgebase
Double Indemnity: A clause or provision in a life insurance policy that doubles the payout in cases of accidental death.
No comments yet. Be the first to share your thoughts.