PJC Rejects Proposal for Insurer Funded Rehabilitation

A proposal to allow life insurers to pay for treatments not covered by health insurance or Medicare has been rejected by a Parliamentary Joint Committee (PJC), which claimed it could create conflicts of interest and may disadvantage consumers.

FSC CEO, Sally Loane

The report of the PJC on Corporations and Financial Services inquiry into life insurer involvement in worker rehabilitation, released on 24 October, also asserted the life insurance sector still had not fully addressed a range of major cultural issues raised in a previous PJC report (see: PJC Recommends Compliance Audits For Risk Advisers).

The proposal, led by the FSC, maintained that allowing life insurers to fund rehabilitation treatments and services would benefit around 10,000 people each year and save the Federal Government more than $1 billion over 20 years (see: Life Insurer Funded Treatments Would Benefit Thousands).

In its report, the PJC recommended the Government should not proceed with the FSC’s proposal stating there were concerns “…on the appropriateness of allowing a single organisation to offer both continuous disability insurance and provide assistance for medical rehabilitation services”.

The PJC was also concerned that payments would be made at the discretion of the life insurers and the possible provision of payments would not be included in product disclosure statements nor insurance contracts. The report added the proposal “… has no equity of access and no accountability”, and questioned the absence of dispute resolution processes in regards to the proposal.

“…the FSC believes that the PJC has not given due consideration to early intervention on its own merit”

Commenting on the PJC’s report, the FSC stated it was ‘deeply disappointed’ the proposal had been rejected given that APRA indicated it did not raise any prudential concerns and, if designed to remove unintended consequences, could improve the sustainability of the industry.

The FSC added that the PJC “…has also acknowledged the sizable benefits of early intervention” with its Chief Executive, Sally Loane claiming the PJC had focused on cultural issues within the life insurance industry rather than considering the current needs of consumers when deciding to reject the proposal.

“We accept that there are a range of issues which the life insurance industry must address – and we are working to confront these problems – but the FSC believes that the PJC has not given due consideration to early intervention on its own merit,” Loane said.

“The industry is facing into community concerns, listening and acting on recommendations from the PJC’s previous inquiry into the life insurance industry. We are well underway with the second iteration of the Life Code of Practice, which addresses many of the issues raised by the PJC,” she added.

In making its recommendation, the PJC rejected the FSC’s view that many of the committee’s previous recommendations “…have nothing to do with assisting consumers return to wellness through early intervention payments”.

“The committee begs to differ,” the Committee stated in the report, adding, “While it may be argued that the FSC is technically correct in a narrow sense, such comments do not reassure the committee that the life insurance industry is committed to implementing the recommendations set out in the committee’s report on the life insurance industry”.