CommInsure notes the Report on ASIC’s Investigation into The Colonial Mutual Life Assurance Society Limited released yesterday by the Australian Securities and Investments Commission (ASIC).
The report established that various improvements have been made in the CommInsure business over the past year.
We will be examining the findings closely as we always know we can do more to enhance the customer experience. We recognise the industry is evolving and we expect, and will advocate for, further industry reform to make life insurance simpler and better for customers.
ASIC’s report found:
- No evidence to support allegations that CommInsure claims managers applied undue pressure on doctors to change or alter their medical opinions
- No evidence of ‘cherry picking’ doctors to give preferred opinions
- No breaches of the law in relation to claims handling
- No significant increase in surveillance by CommInsure in the relevant period and that the figures quoted to support the allegations raised were inaccurate. The report found the trigger for, and use of, surveillance to be reasonable in each instance
- No evidence to suggest that medical opinions stored on the database were deleted or altered by staff outside the Medical Risk Team, other than for appropriate administrative functions. Furthermore the database was not the main record keeping tool for customer claims and there was no evidence that medical opinions had been removed from hardcopy claims files.
In May 2014, CommInsure’s heart attack definitions were consistent with a number of competitors, but the majority had changed their definitions. In March 2016, we accelerated a planned update to our heart attack definition and backdated to May 2014. As a result we have paid $2.5 million to 17 eligible customers based on the changed definition.
We take our responsibilities seriously and having carefully considered ASIC’s commentary we will extend our updated heart attack definitions back further to include customer claims from October 2012. We believe this is the right decision for our customers in the absence of consistent definitions across the industry.
We will continue to advocate for:
- Industry initiatives to achieve a better balance between retirement outcomes and life insurance
- The use of plain English and regulatory assistance to implement standardised definitions
- Changes to make it easier to rationalise legacy products and reduce the costs to customers.
Our focus continues to be on supporting customers in their time of need. In 2016, CommInsure paid over $1 billion in life and income protection payments to around 20,000 customers – that’s $2.7 million every day.
CommInsure customers who have any questions or concerns about their CommInsure policy are encouraged to contact us directly on 13 10 56.