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Replacement Cost:
The amount it would cost to replace or rebuild an insured asset with one of similar kind and quality, without depreciation.

 
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Indemnity vs. Liability Insurance: Understanding the Differences Indemnity vs. Liability Insurance: Understanding the Differences
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Expert Tips for Comparing and Buying the Right Professional Indemnity Insurance Expert Tips for Comparing and Buying the Right Professional Indemnity Insurance
Professional indemnity insurance is an essential safeguard for practitioners and businesses that provide expert advice or services. This type of insurance helps to protect professionals against legal costs and claims for damages from an act, omission, or breach of professional duty in the course of their work. For Australian professionals, where litigation is increasingly common, it's a pivotal component of risk management. - read more
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Professional Indemnity Insurance (PII) remains one of the keystones of risk management for professionals across Australia. Yet, misconceptions and lack of awareness can lead to inadequate coverage, leaving individuals and businesses vulnerable in a litigious environment. - read more
The Growing Importance of Cyber Insurance in Protecting Professional Practices The Growing Importance of Cyber Insurance in Protecting Professional Practices
The professional services industry has undergone a significant transformation in recent years, largely due to the integration of digital technology into everyday business operations. From cloud computing to mobile applications, the digital landscape for professional practices has expanded, offering new avenues of efficiency and connectivity. - read more
Indemnity vs. Liability Insurance: Understanding the Differences Indemnity vs. Liability Insurance: Understanding the Differences
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Mitigating Risks: Why Indemnity Insurance is Essential for Your Business Mitigating Risks: Why Indemnity Insurance is Essential for Your Business
Indemnity insurance may sound like complex legalese, but at its core, it's a straightforward and crucial protection for businesses of all types and sizes. Simply put, it's a form of insurance that shields a business from bearing the full brunt of financial losses due to lawsuits or claims made against it. - read more

 

 
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Insurer Compensates Claimants in Wake of Transition Issues

Insurer Compensates Claimants in Wake of Transition Issues

Insurer Compensates Claimants in Wake of Transition Issues?w=400
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.

Published:Wednesday, 4th Sep 2024
Source: Paige Estritori

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Insurance News

Autonomous Cars: Navigating the New Claims Terrain Autonomous Cars: Navigating the New Claims Terrain
10 Sep 2024: Paige Estritori

The rapid evolution of automobile technology, particularly in autonomous vehicles, is poised to reshape the insurance landscape significantly, according to insights from Howden Re. Reinsurers need to anticipate a more complex claims environment that requires advanced strategies to effectively manage the potential complexities. - read more
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Home Parking Dilemma Leads to Insurance Dispute Loss Home Parking Dilemma Leads to Insurance Dispute Loss
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A homeowner's struggle with her narrow driveway has culminated in the rejection of her car theft claim, illustrating the critical importance of adhering to insurance policy stipulations. - read more
Insurance Claim Rejected After Flight Crew Timing Violation Insurance Claim Rejected After Flight Crew Timing Violation
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A traveler who faced a canceled flight due to the flight crew reaching their legal working hour limits will only receive partial reimbursement for his expenses. This ruling came from an official complaints authority. - read more
Allianz's Payout Reduction Approved in Car Claim Dispute Allianz's Payout Reduction Approved in Car Claim Dispute
05 Sep 2024: Paige Estritori

In a landmark decision, the Australian Financial Complaints Authority has ruled in favor of Allianz, allowing the insurer to significantly reduce its payout for a car damage claim due to a misdescribed vehicle model. - read more

 
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