Life insurers resolved up to 95% of claims disputes, kept initial decisions in more than half of resolved accident cases and reversed outcomes in 4% of trauma complaint files last year, according to prudential data.

The Australian Prudential Regulation Authority’s life claims and dispute data covers the rolling 12-month period to last December.

Funeral cover has the highest resolution rate at 95%, followed by consumer credit insurance (94%) and accident (93%).

Disability income insurance and death had the same resolution rates, at 86%; trauma was 83%; and total and permanent disability 82%.

Original decisions were maintained in 64% of resolved accident disputes; 47% in trauma; 35% in death; 34% in TPD; 31% in funeral; 30% in disability income; and 20% in CCI.

Initial outcomes were reversed in 4% of resolved TPD disputes, similar to trauma. It was 3% for both death and disability income; 2% for accident; 1% for funeral; and nil for CCI.

The APRA data shows “incorrect original outcome” accounted for 71% of reversed decisions in resolved trauma disputes – the highest among the seven business lines.

See the data here.