Following scandals published in the media this week, CommInsure has moved to upgrade its heart attack definitions and has made changes to its claim assessment, the Commonwealth Bank announced.
CommInsure said it had accelerated the planner upgrade of its heart attack and severe rheumatoid arthritis definitions in its trauma product, and added another layer of independence and assurance to its claim assessment and decision-making processes.
“This upgrade will be released in a product disclosure statement by the end of March but coverage will be backdated and apply for all claim events from May 2014 onwards,” the announcement said.
“Where CommInsure’s claims committee recommends a complex claim be declined, it will be referred to an independent review panel. The panel will consist of the managing director of CommInsure and at least two independent industry experts, who will be announced within the next month.
“A sub-committee of the CommInsure board will monitor the outcomes of the panel.”
The CommInsure board will also appoint an independent expert to oversee a claim review program focused on declined claims.
“The independent expert will also be specifically asked to form a view on whether the circumstances surrounding the review of any particular claim warrants future action from the CommInsure board,” it said.
The chairman of the CommInsure board, Geoff Austin, said the board had met and reviewed current initiatives and agreed to take additional steps to reassure customers of its values and commitment to them.
“We expect the highest ethical standards of all our employees and will continue to ensure that the policies and processes within the business support these standards,” Austin said.
