Australian General Insurance Claims Practice

By and large general insurers are required to:

• Meet agreed timeframes for handling claims or responding to complaints.
• Fast track claims or make advance payments when consumers show that they are in financial hardship because of the damage or loss which led to their claim.
• Enable claims arising from a natural disaster to be reviewed after they have been settled.
• In the event they are unable to provide cover, give reasons for the decision and they will refer consumers to another insurer, the insurance ombudsman service or the brokers association for further information about insurance options.
• Provide better and clearer information to consumers regarding what is covered in their policies.
• Handle disputes and rectify mistakes in a transparent and efficient manner within a specified time period.

Specifically timeframes apply in most cases:

• Once all relevant information for a claim is received a decision is to be made by the insurer and the claimant notified within ten working days of it.
• Where further information is required the insurer must write to the claimant within the ten day period detailing the information required and provide an initial time estimate for reaching a decision.
• The insurer must inform the claimant of the claim progress every twenty days.

Lawyers and Loss Adjusters retained by insurers are required to meet these standards.

The requirements cover all Insurance Council of Australia member general insurers excluding those providing CTP, Workers Compensation, Medical Indemnity, Marine, Life & Health Insurance.

We advise that insurers for their part and persons seeking insurance/policy holders for their part have a mutual duty to act with the utmost good faith towards each other.