Insurer Compensates Claimants in Wake of Transition Issues

3

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
Source: Paige Estritori

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

Share this news item:

Insurance News

Clear

Australian General Insurers Report Record $7.3 Billion Profit

18 Jan 2026: Paige Estritori

The Australian general insurance sector has reported a remarkable after-tax profit of $7.3 billion for the last financial year, marking its most substantial earnings in over ten years. This significant increase is primarily attributed to a decrease in catastrophe-related losses and robust investment returns. - read more

Australian General Insurance Premiums Set to Surpass $144 Billion by 2029

18 Jan 2026: Paige Estritori

The Australian general insurance market is on a trajectory to see direct written premiums (DWP) exceed $144 billion by 2029, according to projections from data and analytics firm GlobalData. This anticipated growth is largely fueled by heightened demand for coverage in response to the increasing frequency of natural disasters. - read more

Understanding the Impact of New Regulations on Cosmetic Nurses' Insurance

18 Jan 2026: Paige Estritori

The cosmetic nursing sector in Australia has experienced significant growth, driven by increasing demand for non-surgical cosmetic procedures such as injectables and skin treatments. This expansion has led to heightened scrutiny and the introduction of new regulations aimed at ensuring patient safety and professional accountability. - read more

Health Minister Addresses Insurers' Use of Loopholes to Raise Premiums

18 Jan 2026: Paige Estritori

In December 2024, Australian Health Minister Mark Butler issued a stern warning to private health insurers regarding the use of 'underhanded' tactics to raise premiums. This statement came in response to findings that some insurers have been closing old policies and introducing more expensive ones, effectively increasing costs for consumers without transparent communication. - read more

Australia's General Insurance Market Set for Significant Growth by 2029

18 Jan 2026: Paige Estritori

Australia's general insurance industry is on a trajectory for substantial growth, with direct written premiums (DWP) projected to reach $146.9 billion by 2029. This forecast, provided by GlobalData, anticipates a compound annual growth rate (CAGR) of 9.2%, rising from $103.1 billion in 2025. - read more

Hutch Underwriting's New PI Insurance: Comprehensive Protection for Tradies

18 Jan 2026: Paige Estritori

Hutch Underwriting has recently unveiled a revamped professional indemnity (PI) insurance policy specifically designed for Australian tradespeople. This new offering aims to provide comprehensive coverage by integrating advice, design, and incidental cyber exposures into a single solution. - read more

Viz and Ivory Insurance Join Forces to Deliver Customised Tradie Insurance

18 Jan 2026: Paige Estritori

In a significant development for Australia's trades sector, digital agency Viz has partnered with Ivory Insurance to offer specialised insurance coverage tailored for tradies and small business owners. This collaboration aims to address the unique risks faced by professionals in various trades, providing comprehensive protection and peace of mind. - read more

Introducing Trade Pack: Hutch Underwriting's Streamlined Insurance for Tradies

18 Jan 2026: Paige Estritori

Hutch Underwriting has launched Trade Pack, a new insurance solution designed to meet the diverse needs of Australian tradespeople while minimizing administrative complexities. This offering is tailored for trades such as bricklayers, carpenters, landscapers, painters, and shop fitters, providing a streamlined approach to insurance coverage. - read more

Steadfast Unveils Prevail: A New Era in High Net Worth and Farm Insurance

17 Jan 2026: Paige Estritori

In a significant development for the Australian insurance landscape, Steadfast has announced the launch of Prevail, a new specialist agency designed to cater to high net worth individuals and the farming sector. This initiative brings together three well-established underwriting agencies-Mansions, Dawes, and Argis-under a unified brand, aiming to provide comprehensive and tailored insurance solutions. - read more

Harland Green Launches Comprehensive All-Risk Insurance for Large-Scale Farms

17 Jan 2026: Paige Estritori

Harland Green, a newly established Lloyd's coverholder, has introduced an all-risk farm insurance package specifically designed for large commercial farming operations in Australia. This initiative aims to address the complex and evolving needs of the agricultural sector by offering comprehensive coverage that encompasses various aspects of farm operations. - read more

Click for more Insurance News