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Zurich penalised over claim denials

Zurich has been penalised more than $37,000 over alleged failures handling two trauma insurance claims.

The company discovered errors during a quality assurance review and reported them to the Australian Securities and Investments Commission, which issued infringement notices.

Zurich declined the two trauma insurance claims, which both related to melanomas, in May last year and told the policyholders their medical conditions were excluded.

“ASIC alleges that these statements were false or misleading as the policy terms applicable to the trauma cover held by the policyholders did not exclude their medical conditions and they were entitled to a benefit payment,” the regulator said.

Zurich paid the $37,560 of infringement penalties this month. The insurer has also paid the policyholders’ benefit entitlements, with interest.

Payment of an infringement notice is not an admission of guilt or liability, the ASIC notices to Zurich state.

Insurance claims handling became a regulated financial service in 2022 and ASIC has said it will prioritise the area.

“Insurance claims handling was a 2024 enforcement priority and failures by insurers to deal fairly and in good faith with customers is a 2025 enforcement priority,” the regulator said.