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.
CHU, Australia's leading strata insurance underwriting agency, has released its 2025 State of the Strata Market report, providing a comprehensive analysis of the current state of the industry. The report offers valuable insights into premium movements, the impact of weather events, regulatory developments, and emerging risks affecting strata insurance. - read more
The Insurance Council of Australia (ICA) has recently called for substantial reforms to Victoria's strata legislation, citing a direct correlation between inadequate governance and escalating insurance premiums for residents. With approximately one in five Victorians residing in strata-titled properties, the need for effective management and oversight has become increasingly critical. - read more
In a significant move to address the longstanding issue of insurance affordability in Northern and Regional Queensland, Sure Insurance has announced an increase in its residential strata insurance coverage from $5 million to $20 million. This strategic enhancement aims to provide body corporates and lot owners with more competitive premium options and improved access to essential insurance services. - read more
In a significant shift within the Australian business landscape, artificial intelligence (AI) has ascended to the top of the risk agenda for local enterprises. According to Allianz's annual global risk survey, 61% of Australian executives now identify AI as their primary concern, marking the first instance where this technology has led the risk list in Australia. This represents a substantial leap from its eighth-place ranking in the previous year. - read more
The Australian Securities and Investments Commission (ASIC) has unveiled its enforcement priorities for 2026, placing a significant emphasis on the insurance sector. Key areas of focus include failures in insurance claims and complaints handling, as well as misleading pricing practices that may impact Australians' cost of living. - read more
Australian general insurers have reported a significant after-tax profit of nearly AUD 2.3 billion for the third quarter of 2025, marking an increase from approximately AUD 2.1 billion in the same period of 2024. This uptick reflects a combination of rising premium revenues and a reduction in claims, contributing to the industry's robust financial performance. - read more
In recent developments, Australian insurance companies are facing heightened scrutiny from both government officials and consumer advocacy groups due to substantial increases in insurance premiums. This comes in the wake of the industry reporting record profits, raising questions about the fairness and transparency of pricing strategies. - read more
Australian homeowners are confronting substantial increases in home insurance premiums, driven by a combination of more frequent extreme weather events and escalating building costs. Recent data indicates that the average annual premium for new home and contents policies has risen by 14%, equating to an additional $343 per year for policyholders. - read more
The Australian government has initiated an investigation into the practices of the insurance industry following a surge in consumer complaints regarding significant premium increases and concerns over transparency and fairness. This move comes as policyholders report steep hikes in their insurance costs, with some experiencing increases of up to 600% without clear explanations from their insurers. - read more
AUSactive, Australia's leading body for the exercise and active health sector, has recently introduced a new insurance product tailored specifically for fitness professionals. This initiative aims to provide enhanced protection while offering more affordable premiums compared to existing market options. - 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
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, 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
Welcome to the world of farming, where the fruits of your labor are as tangible as the soil you till. But just as the land is subject to the whims of nature, so too is the business of agriculture. This is where farm insurance becomes essential. Farmers face a set of challenges and uncertainties unlike any other industry, primarily due to the unpredictable forces of weather. - 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
In the dynamic world of Australian agriculture, farm equipment plays a crucial role in the day-to-day operations of farms. From tractors to harvesters, having the right machinery means managing your farm more efficiently. However, the high value of this equipment makes it essential to protect it adequately through insurance. - 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
Welcome to the defining era where technology and agriculture entwine, bringing forth the digital farmer's era. With the evolution of agribusiness in the tech age, comes an array of new tools, opportunities, and risks. As a custodian of the earth and steward of the latest innovations, safeguarding your digital farm is just as crucial as nurturing your crops and livestock. - read more
For Australian farmers, livestock is more than just a vital asset; it's the heartbeat of their livelihood. In a land where the sunburnt plains are as relentless as they are beautiful, protecting your herd isn't just a duty; it's a necessity. That's where livestock insurance comes into play—a shield against the unpredictability of Mother Nature. - read more
Australian farmers face a unique set of challenges due to the vast and varied climate conditions that sweep across the continent. From the scorching heat and prolonged droughts of the Outback to the tropical storms and torrential rains of the northern regions, weather-related risks are an integral part of agricultural life in Australia. - read more
Need a Quote?
Start your free farm insurance quote comparison here.
Knowledgebase
Insurance Deductible: That part of an insurance claim that must be paid by an insured person before the the balance is paid by the insurer.