For individuals and small businesses, Part 11 of the updated Code relects the changes made to the complaints process by ASIC RG271 (Internal Dispute Resolution) including:
- The policyholder is to be informed about the contact details of the person assigned to handle the complaint, and that person must have appropriate authority to handle the complaint.
- The policyholder must be informed every 10 Business Days about the progress of the complaint unless it is resolved earlier or they agree to a different timeframe.
- A decision must be made within 30 calendar days.
- The insurer must provide the policyholder with a written response where their Complaint is about Financial Hardship, a declined claim, the value of a claim or they have requested a written response.
- Otherwise, a written response may not be provided where, within 5 business days, the insurer has been able to resolve the Complaint to the policyholder’s satisfaction, or the insurer has given the policyholder an explanation and/or an apology and can take no further action to reasonably address the policyholder’s Complaint.
- The insurer must give the policyholder the information that the insurer relied on when making a decision about the Complaint within 10 Business Days of the policyholder asking the insurer for that information.
- The policyholder can take their Complaint to the Australian Financial Complaints Authority at any time and if the insurer does not resolve the Complaint within 30 Calendar Days after the insurer first received the Complaint.
The Code covers general insurance products with the exception of Workers Compensation Insurance; Marine Insurance; Medical Indemnity Insurance; Motor Vehicle Injury Insurance; and Domestic Builders Insurance or Domestic Builders Warranty/Indemnity Insurance.
The Code does not cover reinsurance, life insurance products issued by a life insurer, and health insurance products issued by a registered health insurer.
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Author: David Jacobson
Principal, Bright Corporate Law
About David Jacobson
The information contained in this article is not legal advice. It is not to be relied upon as a full statement of the law. You should seek professional advice for your specific needs and circumstances before acting or relying on any of the content.