CommInsure review finds no systemic claims denial
Independent reviews of various retail advice and group policies in life insurance claims at CommInsure did not find systemic inappropriate decline of claims, the Commonwealth Bank (CBA) said.
In a statement, the CBA said over 70 per cent of the past declined terminal illness, death, trauma, and total and permanent disablement (TPD) claims selected by Deloitte had been reviewed.
While it did not find systemic inappropriate decline of claims, it did find improvements were needed to CommInsure's processes to ensure improved outcomes for clients.
CommInsure's board, which commissioned an independent review, found no evidence that medical files were "maliciously deleted or tampered with", the bank said.
An independent review of CommInsure's claims handling processes was also underway and was set to be completed by the end of 2016.
CommInsure's update of heart attack and severe rheumatoid arthritis definitions commenced in 2015 and were set to launch in late 2016 but was brought forward in the wake of revelations and allegations contained in media reports.
"In March 2016, we accelerated a planned upgrade to some definitions, backdated to May 2014, which was the last time we introduced new features to the product," the bank said.
"We have written to around 630,000 current and former customers to inform them."
CommInsure reassessed cases based on updated definitions and paid 17 customers who were deemed eligible. It said it was reviewing a small number of additional cases where customers provided more information, while it was following up with other customers.
Recommended for you
Policy and advocacy specialist Benjamin Marshan has left the Council of Australian Life Insurers after less than a year, having joined in March from the Financial Planning Association of Australia.
The declining volume of risk advisers meant KPMG has found a rising lapse rate for insurance policies arranged by independent financial advisers, particularly in the TPD and death cover space.
The Life Insurance Code of Practice has transferred from the Financial Services Council to the Council of Australian Life Insurers.
The firm has announced it will no longer be writing new life insurance policies in the retail advised and corporate group insurance channels, citing a declining market and risk adviser numbers.
