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

Preparing for Summer Storms: Elders Insurance's Advice to Farmers

01 Jan 2026: Paige Estritori

As the Australian summer approaches, Elders Insurance has issued a cautionary advisory to farmers, emphasising the heightened risk of storm-related damages during this season. Recent data indicates a significant increase in insurance claims due to summer storms, underscoring the need for proactive measures to safeguard agricultural assets. - read more

New Partnership Offers Insurance Savings for Sustainable Farmers

01 Jan 2026: Paige Estritori

In a significant move towards promoting sustainable agriculture, WFI Insurance has partnered with AgCarE to offer premium reductions to farmers who achieve AgCarE certification. This collaboration aims to enhance financial, environmental, and social outcomes for Australian farmers and rural communities. - read more

IAG Highlights Climate Change's Impact on Rising Insurance Costs

01 Jan 2026: Paige Estritori

Insurance Australia Group (IAG) has issued a warning to Australians, indicating that home insurance premiums are expected to rise due to the increasing frequency and severity of extreme weather events, a trend attributed to climate change. This development underscores the pressing need for both mitigation and adaptation strategies to address the evolving risks. - read more

WFI Insurance and Farmsafe Australia Join Forces to Boost Farm Safety Standards

24 Dec 2025: Paige Estritori

In a significant move to enhance safety within the Australian agricultural sector, WFI Insurance has partnered with Farmsafe Australia. This collaboration is designed to raise awareness about farming hazards and advocate for the adoption of safer work practices among farmers. - read more

Argis Underwriting Partners with Pacific International to Expand Farm Insurance Offerings

24 Dec 2025: Paige Estritori

Argis Underwriting has announced a new partnership with Newcastle-based Pacific International Insurance, enabling the company to resume offering farm insurance coverage across Australia. This development comes after Argis ceased providing new business and renewal terms on its Farm Extra Insurance in April, following the conclusion of a five-year arrangement with HDI Global Specialty. - read more

WFI Insurance Reports Significant Decline in Farm Liability Claims

24 Dec 2025: Paige Estritori

WFI Insurance has reported a notable decrease in farm liability claims across most categories, signaling a positive trend in safety practices within the Australian agricultural sector. The insurer observed a 75% reduction in falls from height over the past year, alongside a 30% decline in impact injuries, marking the lowest level in four years. - read more

Click for more Insurance News