FAQ – Insurance

1. Help my insurance claim is taking forever, what are my options?

Under the General Insurance Code of Practice, insurers have timeframes they must meet when handling your claim. These timeframes include:

• Within 10 business days of receiving your claim, they must tell you what information they need to make a decision, appoint a Loss Assessor or Loss Adjuster where necessary, and give you an estimate of when a decision will be made.
• Keep you informed about the progress of your claim every 20 business days.
• Respond to your enquiries about your claim within 10 business days.
• Once all relevant information has been obtained, they must accept or deny claim within 10 business days
• A decision must be made on your claim within 4 months of receiving your claim, under ordinary circumstances.

If your insurer does not meet these timeframes in handling and making a decision on your claim, you should first lodge an internal dispute with your insurer. They must make a decision about your complaint within 45 days of it being lodged.

Should your complaint not be resolved through your insurer’s internal dispute resolution process, you may lodge a complaint with the Australian Financial Complaints Authority.

 

2. Does my insurance company have to cash settle, repair, or replace?

Under most policies, your insurer has the right to decide whether to cash settle, repair or replace. The decision will depend upon the nature and extent of the damage.

 

3. Insurance investigations – What information can my insurance company request for me?

If your insurer is conducting an investigation into your claim, they must only investigate matters that are relevant and necessary to the claim, and must do so in an appropriate and respectful manner. Investigators must only collect information that is reasonably relevant to the investigation. Some information that is commonly requested includes bank statements, telephone records, driving records. If you have concerns about the nature of the information being requested from you, you should ask your insurer to explain why the information is relevant

 

4. If I pay my premiums by instalments am I still covered?

Yes, you will still be covered if you are paying your instalments on time. Your insurer cannot cancel your insurance policy for non-payment without providing you with written notice at least 14 days before cancellation.

 

5. What special services do I need to consider as a broker?

• An insurance broker is required to act in the best interests of its clients. All brokers must comply with a code of conduct as members of the National Insurance Brokers Association of Australia (“NIBA”). As part of the NIBA, Insurance Brokers are expected to review its clients’ policy of insurance, advise on changes that may have an affect on its clients and must do what is necessary to ensure that its clients are in compliance with their insurance, whether it be fulfilling disclosure requirements or ensuring that an insured’s premiums are paid on time.
• As there is a requirement for insurance brokers to act in the best interests of their clients, those interests must comply with all relevant laws, there must be transparency to manage conflicts of interest that may rise. There are various other service standards to must be complied with and this can be found under the NIBA Code of Practice.
• An insurance broker is required to assist its clients in identifying risks and explain terms or conditions, benefits, costs associated with insurance policies or discuss exclusions that may affect an insured’s compliance with its policy of insurance.

 

If you have any questions or concerns please contact Chamberlains and talk to one of our insurance law experts today.