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

Share this news item:

Insurance News

Clear

Australian Travel Insurers Extend Support During Middle East Conflict

28 Mar 2026: Paige Estritori

In response to the escalating conflict in the Middle East, Australian travel insurers have mobilised additional resources to support affected travellers. The Insurance Council of Australia (ICA) announced that insurers are providing dedicated 24/7 assistance, coordinating medical care, and prioritising support for those in impacted regions. - read more

Rising Domestic Travel Claims Reveal Insurance Coverage Gap

28 Mar 2026: Paige Estritori

Southern Cross Travel Insurance (SCTI) has reported a notable gap between Australians' attitudes towards domestic travel insurance and the claims being paid. In the first eight and a half months of 2025, SCTI settled over $240,000 in claims for local and interstate trips. Despite this, only about 41% of Australians consider travel insurance a high priority for domestic trips, compared to 76% for international travel. - read more

RACV Advises Travellers to Review Insurance Amid Rising Flight Cancellations

28 Mar 2026: Paige Estritori

Australian travellers are facing ongoing flight disruptions, with cancellation rates climbing above long-term averages. According to the latest data from the Bureau of Infrastructure, Transport and Regional Economics (BITRE), the national flight cancellation rate reached 2.6% in February 2025, exceeding the long-term average of 2.2%. On-time performance for both arrivals and departures also fell below historical benchmarks. - read more

Upcoming 4.41% Increase in Australian Private Health Insurance Premiums

28 Mar 2026: Paige Estritori

Starting 1 April 2026, Australians will face an average increase of 4.41% in private health insurance premiums, marking the most significant rise since 2017. This adjustment comes in the wake of escalating healthcare costs and increased utilisation of health services. - read more

Climate Change Drives US$2.9 Billion in Insured Losses for Australian Insurers in 2025

28 Mar 2026: Paige Estritori

In 2025, Australian insurers faced significant financial challenges due to climate-related catastrophes, with insured losses totalling an estimated US$2.9 billion. This substantial figure underscores the escalating impact of climate change on the insurance industry and the broader economy. - read more

Premium Affordability and Cybersecurity Emerge as Leading Concerns for Australian Insurers in 2026

28 Mar 2026: Paige Estritori

As the Australian insurance industry progresses through 2026, it faces a trio of significant challenges: escalating premium costs, increasing cyber threats, and a tightening labour market. These issues are reshaping the sector's priorities and strategies. - read more

Insurtech Australia Criticizes ASIC's Efforts to Spur Insurance Innovation

28 Mar 2026: Paige Estritori

The Australian Securities and Investments Commission's (ASIC) Enhanced Regulatory Sandbox (ERS), introduced in 2020 to facilitate financial innovation, has been deemed ineffective in fostering advancements within the insurance sector. Insurtech Australia (IA) has expressed concerns that, despite ASIC's genuine efforts, the ERS has not significantly impacted the insurance industry or the insurtech ecosystem. ([insurancenews.com.au](https://www.insurancenews.com.au/insurtech/asic-s-insurance-innovation-initiatives-ineffective?utm_source=openai)) - read more

Australian Commercial Insurance Rates Experience Significant Decline

28 Mar 2026: Paige Estritori

The Australian commercial insurance market has witnessed a notable decline in premium rates, with a 12% drop recorded in the fourth quarter of 2025. This marks the largest decrease among the eight regions monitored by Marsh Risk's Global Insurance Market Index. ([insurancenews.com.au](https://www.insurancenews.com.au/the-broker/australia-leads-way-as-commercial-rate-slide-continues?utm_source=openai)) - read more

Soaring Insurance Premiums Impact Hospitality Businesses

28 Mar 2026: Paige Estritori

The Australian hospitality industry is currently grappling with a significant surge in insurance premiums, a trend driven by a combination of increased claim frequencies and heightened risk factors. This escalation in costs poses a substantial financial burden on restaurant and café owners, many of whom are already contending with slim profit margins. - read more

Hospitality Industry Records Alarming Business Failure Rate

28 Mar 2026: Paige Estritori

Recent data from Restaurant & Catering Australia (R&CA) reveals a concerning trend: the hospitality sector has experienced a 10.4% closure rate among foodservice businesses over the past year, marking the highest failure rate across all industries in the country. This statistic underscores the pressing challenges faced by restaurant and café owners, including escalating operational costs, labour shortages, and evolving consumer behaviours. - read more

Click for more Insurance News