{"id":72388,"date":"2024-07-12T13:44:19","date_gmt":"2024-07-12T03:44:19","guid":{"rendered":"https:\/\/riskinfo.com.au\/news\/?p=72388"},"modified":"2024-07-23T11:12:58","modified_gmt":"2024-07-23T01:12:58","slug":"life-code-breached-by-failure-to-provide-claim-updates","status":"publish","type":"post","link":"https:\/\/riskinfo.com.au\/news\/2024\/07\/12\/life-code-breached-by-failure-to-provide-claim-updates\/","title":{"rendered":"Life Code Breached by Failure to Provide Claim Updates"},"content":{"rendered":"<p>A life insurer breached the Life Insurance Code of Practice when it failed to provide updates about the progress of a customer\u2019s claim within the required timeframe on five occasions, a Notice of Determination by the <a href=\"https:\/\/lifeccc.org.au\" target=\"_blank\" rel=\"noopener\">Life Code Compliance Committee<\/a> has found.<\/p>\n<p>The LCCC says that following an assessment and investigation, it found the life insurer:<\/p>\n<ul>\n<li>Failed to provide updates about the progress of a customer\u2019s claim within the required timeframe on five occasions, representing a significant breach<\/li>\n<li>Failed to request claim information within the required timeframe, representing a serious breach<\/li>\n<li>Communicated the claim decision 15 months after the required two-month timeframe had expired and failed to communicate the decision to the customer within 10 business days of having all the required information, representing serious breaches<\/li>\n<\/ul>\n<p>The committee says the life insurer attributed the breaches to a staff member who did not follow established processes.<\/p>\n<p>It notes that as remediation, the life insurer:<\/p>\n<ul>\n<li>Paid the customer interest for the claim delays and $2,500 as goodwill<\/li>\n<li>Reviewed the staff member\u2019s portfolio for similar issues and engaged in performance management<\/li>\n<li>Reviewed and improved internal processes for breach identification, breach reporting, aged claim reviews and complaints<\/li>\n<\/ul>\n<p>The LCCC says this case highlights that \u201c\u2026failures to meet communication timeframes can cause unnecessary frustration for customers and increase the likelihood of complaints, leading to increased costs for insurers.\u201d<\/p>\n<p>Life insurers should continually review the effectiveness of key controls to ensure issues are identified early and remediated, it states.<\/p>\n<p><a href=\"https:\/\/lifeccc.org.au\/app\/uploads\/2024\/07\/Determination-CX14597-1.pdf\" target=\"_blank\" rel=\"noopener\">Click here<\/a> to read the full determination.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A life insurer breached the Life Insurance Code of Practice when it failed to provide updates about the progress of a customer\u2019s claim within the required timeframe on five occasions, a Notice of Determination by the Life Code Compliance Committee has found. The LCCC says that following an assessment and investigation, it found the life [&hellip;]<\/p>\n","protected":false},"author":24,"featured_media":72391,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8,3],"tags":[],"class_list":["post-72388","post","type-post","status-publish","format-standard","has-post-thumbnail","category-compliance-regulation","category-general"],"_links":{"self":[{"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/posts\/72388","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\/24"}],"replies":[{"embeddable":true,"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/comments?post=72388"}],"version-history":[{"count":0,"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/posts\/72388\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/media\/72391"}],"wp:attachment":[{"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/media?parent=72388"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/categories?post=72388"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/tags?post=72388"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}