{"id":36313,"date":"2017-03-05T13:00:36","date_gmt":"2017-03-05T02:00:36","guid":{"rendered":"https:\/\/riskinfo.com.au\/news\/?p=36313"},"modified":"2025-09-02T11:34:01","modified_gmt":"2025-09-02T01:34:01","slug":"comminsure-defends-claims-review-outcome","status":"publish","type":"post","link":"https:\/\/riskinfo.com.au\/news\/2017\/03\/05\/comminsure-defends-claims-review-outcome\/","title":{"rendered":"CommInsure Defends Claims Review Outcome"},"content":{"rendered":"

CommInsure has used its appearance before the Parliamentary Joint Committee (PJC) Inquiry into Life Insurance to defend a review of its claims handling processes, following criticisms of an expert report which stated they contained no systemic problems.<\/p>\n

\"Commonwealth<\/a>
Commonwealth Bank Group Executive Wealth Management, Annabel Spring<\/figcaption><\/figure>\n

CommInsure released the report, prepared by Deloitte, on 28 February which stated that Deloitte \u201c\u2026did not identify any systemic issues relating to historically declined claims\u201d\u00a0and it\u00a0\u201cdid not identify any evidence that the current and planned improvements to the claims handling processes are designed in a way that could systemically deliver poor customer outcomes\u201d.<\/p>\n

The report, which was the final in a series of reviews and investigations first begun in mid-2016 also stated, \u201cGiven the level of coverage obtained by our sample we believe that the work performed is sufficient to have reasonably identified any matters that may systemically affect the declined claims population.\u201d<\/p>\n

Legal firm Maurice Blackburn criticised the report stating that it appeared to be highly selective in the types of claims chosen for review and had not gathered any input from people holding CommInsure policies.<\/p>\n

\u201cThe terms of reference for this report appear to have been very carefully limited to ensure an outcome that does not fully account for what was clearly a dark period within CBA,\u201d Maurice Blackburn\u00a0Superannuation\u00a0and\u00a0Insurance\u00a0Principal\u00a0Josh Mennen\u00a0said.<\/p>\n

“…there was nothing in the mistakes to suggest any wilful misconduct or anything malicious…”<\/h6>\n

\u201cWe also have concerns at how comprehensive this review has been, as the report confirms that no customers have been interviewed as part of the investigation. Nor does it say that any claims staff were interviewed,” Mennen said.<\/p>\n

In addressing the PJC, Commonwealth Bank Group Executive Wealth Management, Annabel Spring<\/strong> said \u201c\u2026the reviews and investigations showed a picture of the business which is vastly at odds with some of the commentary.\u201d<\/p>\n

Spring added the review also found that CommInsure did not have a culture of deliberately avoiding paying customers, nor was there evidence that medical opinions were tampered with to deny claims or that doctors were selectively chosen to provide medical opinions to deny claims.<\/p>\n

\u201cWe made nine mistakes which impacted customers and we take them seriously\u2026and there are 11 claims we are still looking into,\u201d Spring said, adding that CommInsure reviewed more than 800 claims since mid-2016.<\/p>\n

\u201cThe nature of the mistakes \u2013 there was no pattern to those mistakes. This was a review of our systems and processes and outcomes and Deloitte was looking for systematic issues. There was no pattern to the mistakes at all, and there was nothing in the mistakes to suggest any wilful misconduct or anything malicious in the nature of claims staff.\u201d<\/p>\n

Spring said the mistakes were the result of \u2018people dealing with people\u2019 during complex and emotional situations and \u201c\u2026at the end of the day, these were human mistakes.\u201d<\/p>\n

Spring also defended the fact that Deloitte did not contact any CommInsure customers during its review stating Deloitte was provided with all data related to the claim, including initial claim forms, file notes, correspondence and medical reports.<\/p>\n

\u201cIf they (Deloitte) felt they did not have the information required to make a claim, whether from a customer or from CommInsure, they asked us to request of the customer and provide it to Deloitte,\u201d Spring said.<\/p>\n

\u201cI cannot imagine a scenario in which it would be appropriate for Deloitte to call our customers and state \u2018we would like more information from you\u2019. At the end of the day they are CommInsure\u2019s customers and their relationship is with CommInsure and Deloitte had full access to all that information.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

CommInsure has used its appearance before the Parliamentary Joint Committee (PJC) Inquiry into Life Insurance to defend a review of its claims handling processes, following criticisms of an expert report which stated they contained no systemic problems.<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8294],"tags":[],"class_list":["post-36313","post","type-post","status-publish","format-standard","category-claims"],"_links":{"self":[{"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/posts\/36313","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/comments?post=36313"}],"version-history":[{"count":0,"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/posts\/36313\/revisions"}],"wp:attachment":[{"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/media?parent=36313"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/categories?post=36313"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/tags?post=36313"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}