Insurer Compensates Claimants in Wake of Transition Issues
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.
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.
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
In 2024, medical incidents emerged as the leading cause of travel insurance claims among Australian travellers, accounting for more than 40% of all claims handled by nib Travel. This trend underscores the critical importance of securing comprehensive travel insurance to mitigate the financial risks associated with medical emergencies abroad. - read more
Qantas Travel Insurance has been recognised in the 2024 Mozo Experts Choice Awards for Travel Insurance, showcasing its exceptional value for their Annual Multi Trip Travel Insurance policy. - read more
Recent findings from the PwC Insurance Banana Skins Survey reveal that Australian insurers are lagging behind their global counterparts in preparedness for emerging risks, particularly in the realms of cybersecurity and artificial intelligence (AI). This survey, encompassing insights from 698 insurance executives across 42 territories, highlights a concerning trend for the Australian insurance sector. - read more
Insurance Australia Group (IAG) has recently highlighted the escalating impact of climate change on home insurance premiums across the nation. The insurer's latest report indicates that the increasing frequency and severity of weather events are contributing to higher costs for homeowners seeking coverage. - read more
Australia's insurance industry has reported a substantial after-tax profit of $6.1 billion for the year 2024, marking a significant increase from the five-year average of $2 billion. This remarkable financial performance is primarily attributed to strategic premium adjustments and a period of relatively mild weather conditions. - read more
Recent findings from the PwC Insurance Banana Skins Survey reveal that Australian insurers are trailing behind their global counterparts in risk preparedness. The survey, which gathered insights from 698 insurance executives across 42 territories, indicates that Australian insurers scored 6.6% lower on the Preparedness Index compared to the global average. - read more
Australia's insurance sector has reported a substantial after-tax profit of $6.1 billion for the year 2024, according to KPMG's annual review. This figure is three times higher than the five-year average of $2 billion, highlighting a significant financial upturn for the industry. - read more
Consumer advocacy group Choice has released a report indicating that several Australian insurers have implemented substantial increases in home insurance premiums over the past year. Notably, Kogan, RAC, and Honey have raised their average premiums by more than 30%, significantly outpacing the industry average increase of 16%. - read more
RACQ Insurance has recently announced the cessation of coverage for rideshare and food delivery vehicles, effective from November 3, 2023. This decision stems from a notable increase in claims associated with these services, prompting the insurer to reassess its offerings. - read more
Agroforestry is a transformative approach to land management that integrates trees into agricultural landscapes. In Australia, where farmers contend with variable climates and environmental challenges, agroforestry offers a resilient pathway to productivity and sustainability. - read more
As the backbone of Australian agriculture, farm equipment plays an essential role in day-to-day operations across our expansive and diverse landscapes. From the vast wheat belts to the tropical fruit farms, machinery ensures efficiency and productivity in the face of constant challenges. But with reliance on such equipment comes significant risk—the financial burden of damage or loss can be devastating to a farmer's livelihood. - read more
Farming is a vital industry in Australia, requiring significant investment in equipment, crops, livestock, and labour. As with any major investment, protecting it is crucial. That's where farm insurance comes in. - read more
Australian farmers face an array of natural disasters that can threaten livelihoods and disrupt the delicate balance of agricultural ecosystems. From devastating bushfires and droughts to powerful storms and floods, these catastrophic events pose serious risks to the farming community. Understanding and preparing for these forces is not just about survival; it's about building a sustainable future for farms across the continent. - read more
Farming is much more than an occupation; it's a way of life and a heritage that often spans generations. In today's ever-evolving agricultural landscape, embracing modern practices while preserving your farm's future has never been more crucial. Estate planning emerges as a pivotal strategy for safeguarding your agricultural legacy, ensuring that your hard-earned investments and the land you hold dear are passed on according to your wishes. - read more
Hobby farming has become increasingly popular in Australia, with many individuals and families embracing the joys of growing their own produce, raising livestock, and enjoying a rural lifestyle. Whether it's a small vegetable garden, a few chickens, or a larger mixed farming operation, hobby farms offer both relaxation and a connection to nature. - read more
Crop insurance is a type of insurance policy designed to protect farmers from the financial losses that arise from damages to their crops. This could be due to various risks, including adverse weather conditions, pests, and diseases. - read more
Risk management is the practice of identifying, assessing, and prioritizing risks followed by coordinated efforts to minimize, monitor, and control the probability or impact of unfortunate events. In farming, risk management involves various strategies to protect the financial health and operational stability of the farm. - read more
Farming in Australia is not just a job, it's a way of life. However, it’s also a livelihood that comes with its own unique set of risks. From unexpected weather events to machinery breakdowns, the life of an Australian farmer is fraught with uncertainties. - read more
Farming, at its core, is an enterprise fraught with uncertainty. Weather calamities, pests, diseases, and fluctuating market conditions can all impact the output and quality of produce. This is where crop insurance proves its worth, serving as a safety net for farmers against the myriad risks they face each season. - read more
Need a Quote?
Start your free farm insurance quote comparison here.
Knowledgebase
Reinsurance: Insurance that an insurance company purchases from another insurance company to mitigate risk.