Legislation that started in March 2019 would have ceased the woman's default cover, unless she responded to a notice saying she wanted it to continue. The trustee said it complied with legislation by emailing the notice, but the complainant said she never received it.
The life insurance policy ceased on July 1 2019. On March 5 2020, the member asked for a replacement of the policy and was covered again. The member died on February 12 2021, and the complainant made a claim for the death benefit.
But AIA declined to pay, after determining that she had died from a preexisting medical condition. The complainant argued that he should be paid the death benefit but the trustee rejected the claim.
The complainant stated that it was never their intention to cancel the death benefit and in fact were relying on the benefit payout as part of her final estate for the family.
He went on to say that the trustee had failed to appropriately notify them that the death benefit would be cancelled.
He said that they had not been initially made aware that the death benefit had ceased. "When we did become aware, via online account, that the death benefit had ceased, we contacted [the trustee] to have it reinstated immediately.” he said.
He said the trustee also did not mention that the new cover excludes pre-existing conditions.
However, the Australian Financial Complaints Authority said it was satisfied and that new cover was explained in the Product Disclosure Statement. The decision to decline the claim is fair and reasonable, it added.
Published:Tuesday, 17th May 2022
|Ensuring Insurance Availability and Affordability in the Face of Natural Disasters|
03 Feb 2023: .financialservicesonline.com.au
The Australian government is taking action to tackle the rising cost of insurance in areas prone to natural disasters. The insurance industry is working in partnership with the Albanese government to provide solutions that make insurance more accessible and affordable for households. - read more
|Life Insurers Under Scrutiny: The Consequences of Failing to Meet Obligations|
02 Feb 2023: .financialservicesonline.com.au
The regulation of insurance claims handling and settling as a financial service under the Corporations Act 2001 in Australia has far-reaching implications for both consumers and life insurers. As per the Australian Securities and Investments Commission (ASIC), the handling of claims must be done efficiently, honestly, and fairly, and any breaches in these obligations can result in severe consequences for life insurers. - read more
|Flood victims receive $6 million in compensation from insurance companies following complaints|
27 Jan 2023: .financialservicesonline.com.au
The recent flood disasters in Victoria and New South Wales have resulted in nearly $6 million in compensation to policyholders affected by the floods, according to the Australian Financial Complaints Authority (AFCA). Data from the AFCA revealed that 1,064 flood-related complaints were recorded as of December 31, with the majority of complaints related to home building insurance (74%) and home contents insurance (9%). - read more
|Suncorp's AAMI and GIO fined for breaches of internal review timeframes|
27 Jan 2023: .financialservicesonline.com.au
The New South Wales State Insurance Regulatory Authority (SIRA) has recently imposed a fine of $100,000 on Suncorp's compulsory third party (CTP) brands AAMI and GIO for failing to meet their internal review timeline obligations. This marks the first time that a civil penalty has been imposed on CTP insurers under the Motor Accident Injuries Act. - read more
|Undisclosed debt agreement results in rejected insurance claim|
25 May 2022: .
A motorist lost her insurance claim dispute after failing to disclose a debt agreement while renewing her insurance policy. - read more
|Who Needs Disability Insurance?|
If you are like most people on this planet, you are not financially free. You would not be able to stop working and still support yourself and your family from your financial resources. Your continued ability to work to earn an income would therefore be one of your greatest assets. - read more
|Why life insurance is a necessity in tough times|
With household budgets under pressure ... and consumer confidence weak, many families are wondering whether life insurance is worth the expense. Or maybe it is something they can do without? - read more
|Income protection insurance|
It's trite but true to say that, for most people, their most valuable asset is their ability to earn an income. But how relevant is income insurance to most Australians? - read more
|Loss of income insurance: Case Study |
Rebecca is a single, self-employed graphic designer who works from home. Aged in her mid-30s, she has monthly commitments of a mortgage and car payments and the usual living expenses. - read more
|DIY Review Checklist for your Income Protection Insurance|
If you have an income protection insurance plan already - or are thinking about buying one, then you need to be aware that these policies require regular maintenance and careful scrutiny to ensure that they adequately meet your needs. Unfortunately, many people purchase income protection insurance policies only to find out about their shortcomings at claim time. - read more