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Claims-handling drives rise in code breaches

Insurers committed 21 “significant” breaches of the General Insurance Code of Practice last financial year, according to the Code Compliance Committee.

Thirteen of these breaches led to combined payments of $767,659 to 19,444 affected customers, the committee says in its annual report.

Overall, 267 breaches were identified by the Financial Ombudsman Service (FOS), up from 78 the previous year.

Most involved claims-handling – particularly failure to notify consumers of their right to information and review following denial of claims.

FOS reached agreement with insurers on corrective action for the significant breaches, and no enforcement action was needed.

Some 187 claims-handling breaches were addressed by giving consumers the required information, either alone or with improvements to procedures and remedial training.

The report notes several areas for review and improvement as the industry changes over to its new code. They include claims denials, claims-handling and dispute resolution.

The Insurance Council of Australia launched the revised General Insurance Code of Practice on July 1 this year, but insurers need not comply until July 1 next year.

The independent Corporate Governance Committee will replace the Code Compliance Committee. Provisions on financial hardship and timeframes for claims and complaints have been clarified, a new website will be launched and the code has been rewritten in plain English.

Three people have been appointed to ICA’s new corporate governance committee. The consumer representative is Legal Aid NSW Senior Solicitor Julie Maron and the new insurer representative is Ian Berg, who retired this year as VP Australia with FM Global and previously served on the ICA board for five years.

Former Australian Public Service commissioner Lynelle Briggs is the new independent chairman.