BT Financial Group (BTFG) has reported that an external review of 141 denied Total and Permanent Disability (TPD) claims has found the group acted appropriately and no claim had been incorrectly denied.
The review, conducted by an independent legal firm with further oversight from EY, found there was no material or systemic issues within BTFG’s claims process and claims decisions were transparent and based on evidence to hand.
The review also found that BTFG “…adopted reasonable positions having regard to all of the available evidence open to it and the declines were appropriate.”
BTFG engaged in the review after the 141 cases were provided to ASIC as part of its Life Claims Review, at which time BTFG outed itself as the life insurer with a 37% TPD denial rate in ASIC’s review (See: BTFG Argues Claims Data Not Representative)
At that time, BTFG Chief Executive, Brad Cooper stated the figure was not comparable with other insurers due to the way BTFG reported its denied claims and the lack of consistency in reporting across the life insurance sector.
The review…found there was no material or systemic issues within BTFG’s claims process…
EY stated the TPD claims review, the second review of BTFG’s claims process in 2016, was consistent with its previous review of BTFG’s Life claims management practices in August 2016 which found the assessment of claims was of a very high standard.
In related news, BTFG has rejected claims by ASIC that two subsidiaries of Westpac had provided personal financial product advice and had failed to meet the best interest duty required under the Future of Financial Advice reforms.
ASIC has alleged Westpac Securities Administration Limited and BT Funds Management Limited, during two telephone campaigns, provided personal financial product advice to customers regarding superannuation rollovers despite not being able to do so under their Australian financial services licences.
ASIC stated it had commenced civil penalty proceedings in the Federal Court and it case would set out 15 examples of alleged contraventions of the ‘best interests duty’ in which ASIC claims the two businesses did not undertake a proper comparison of the superannuation funds as required by law.
BTFG said it rejected ASIC’s interpretation of what was general or personal advice and had not failed any best interest obligations and would oppose the court action brought by ASIC.
Cooper said in each of the 15 cases cited by ASIC customers were given a ‘general advice warning’ as a standard and required part of its process.
“We reject ASIC’s legal interpretation that some customers may have thought they were receiving personal, rather than general advice,” Cooper said.
“We take our obligations to provide compliant general advice to customers very seriously. These customer interactions have all been conducted in accordance with the spirit and requirements of the law and have provided real benefits to our customers.”
