CommInsure has appointed consulting firm, Deloitte, as the independent expert that will supervise the review of past life insurance declined claims.
It follows media reports earlier this year around CommInsure’s claims handling process, including allegations that claimants had been denied compensation based on outdated health definitions and claims assessment processes.
CommInsure was working with the Australian Securities and Investments Commission (ASIC) to find an independent expert.
Deloitte’s role would include independently selecting and reviewing a representative sample of declined claims over the last five years to 30 April, 2016, assessing whether CommInsure was right to decline past claims, keeping customer advocacy in mind, and give recommendations to the CommInsure board on any improvements that could be made to the firm’s claims policies and procedures.
This process would be completed independent of CommInsure, the board, and the Commonwealth Bank, the bank said in a statement.
CommInsure has also appointed law firm, DLA Piper, to investigate ethical issues, as well as issues raised in the media during March and April, and examine policy definitions and wording, claims handling, CommInsure’s dealings with medical practitioners, medical file and record keeping, treatment of staff and governance.
CommInsure has also added general practitioner, Dr Robyn Napier, to its Claims Review Panel, after it appointed Financial Ombudsman Service board member, Chris McRae, consumer representative on the investment, life insurance and superannuation panel of FOS, Professor Justin Malbon, and former Bupa head of clinical advisory, Dr Stan Goldstein.
Napier is the chair of the case committee for medical indemnity insurer, MDA National, Australian Medical Association (AMA) (NSW) medical secretary, and medical director and past AMA Federal Councillor.
