asic’s work so far · asic has conducted the first stage of an industry-wide review of claims...

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1 Life insurance claims ASIC’s work so far ASIC has conducted the first stage of an industry-wide review of claims handling. It covers three distribution channels: group cover through superannuation, individual cover sold by advisors and individual cover sold directly to consumers without advice. The scope Our review focused on 5 life insurers, representing over 90% of the market by premiums collected. Our review focused on a time period of 3 years, from 1 January 2013 to 31 December 2015. We reviewed four main types of life insurance products: Life Trauma Income Protection Total & Permanent Disability (TPD) The detail We completed our review in six months. We conducted detailed reviews of 5,438 life insurance disputes collected from six different sources, including ASIC. We collected and conducted a detailed review of approximately 17,000+ lines of data and 192,000+ data points. We conducted a targeted review of Product Disclosure Statements and policy documents, including policy definitions across all life insurers. We attended 50+ meetings with life insurers, industry experts, consumer advocates and other key stakeholders. Areas of further work life insurers have initiated 15+ independent reviews of claims handling. The results from these reviews will help inform our further work. Actions to raise standards 1. Public reporting of life insurance claims. 2. Strengthen the regulatory framework for claims handling. 3. Strengthen the dispute resolution framework for claims handling. 4. Follow up ASIC surveillances and reviews. 5. Strengthen industry standards and practices.

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Page 1: ASIC’s work so far · ASIC has conducted the first stage of an industry-wide review of claims handling. It covers three distribution channels: group cover through superannuation,

1

Life insurance claimsASIC’s work so far

ASIC has conducted the first stage of an industry-wide review of claims handling. It covers three distribution channels: group cover through superannuation, individual cover sold by advisors and individual cover sold directly to consumers without advice.

The scope

Our review focused on5 life insurers, representing over 90% of the market by

premiums collected.

Our review focused on a time period of 3 years, from 1 January 2013 to

31 December 2015.

We reviewed four main types of life insurance products:

Life Trauma

Income Protection

Total & Permanent Disability (TPD)

The detail

We completed our review in six months.

We conducted detailed reviews of 5,438 life insurance disputes

collected from six different sources, including ASIC.

We collected and conducted a detailed review of

approximately 17,000+ lines of data and 192,000+ data points.

We conducted a targeted review of Product Disclosure Statements and policy documents, including policy definitions across all life insurers.

We attended 50+ meetings with life insurers, industry experts,

consumer advocates and other key stakeholders.

Areas of further work

life insurers have initiated 15+ independent reviews of claims handling. The results from these reviews

will help inform our further work.

Actions to raise standards

1. Public reporting of life insurance claims.

2. Strengthen the regulatory framework for claims handling.

3. Strengthen the dispute resolution framework for claims handling.

4. Follow up ASIC surveillances and reviews.

5. Strengthen industry standards and practices.

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