A life insurer in Australia breached the Life Insurance Code of Practice by issuing unnecessary information requests and failing to meet timeframes when deciding on a customer’s TPD claim, says the Life Code Compliance Committee (LCCC).
In issuing a Notice of Determination, the committee says its assessment and investigation confirmed that a life insurer had breached its obligations to:
- Request the information that it needs as early as possible and avoid duplicate information requests
- Tell the customer about its complaint process if it is unable to make a decision on the customer’s claim within 12 months
The LCCC’s full determination explains the insurer identified it had failed to request necessary information as early as possible, and it had made a duplicate request for information.
The committee notes that as the insurer applied ‘unexpected circumstances’ to this claim, it had 12 months to reach a decision.
“When it could not meet this deadline, it also failed to give the customer details of its complaints process within the 12 months.”
The LCCC says that in response, the insurer took steps to reinforce the importance of timely and accurate information requests within the claims process.
Click here to review the full determination.