AFCA Criticizes Insurance Industry Over Delayed Dispute Resolution

The delayed resolution of complaints has resulted in significant frustration among policyholders, brokers, and other stakeholders. Insurance brokers have reported extensive delays, with one residential claim taking as long as nine months to be resolved. The issue has been ongoing for a while, with AFCA issuing an apology last year for the protracted delays. However, the problem has persisted.

AFCA is worried that the continuous rise in volumes of complaints – most notably delays in claim handling – will hamper its ability to resolve disputes promptly and efficiently. Thus, Mr. Locke advocates that firms focus on exploring ways to resolve complaints in the early stages of their process, or before they reach AFCA. 

He notes that fewer complaints are being resolved after referral back to the financial firm, while more members are asking for extensions or not responding to complaints within the timeframes outlined. The Internal Dispute Resolution (IDR) is the first step, while External Dispute Resolution (EDR) was not designed to be "the only avenue for redress." Nevertheless, Mr. Locke insists that deep concern exists with firms not meeting their IDR and EDR obligations.

AFCA is undertaking several steps to tackle delayed dispute resolution, such as using technology solutions to expedite processing, reassigning staff to high-impact product areas, batching complaints and standardizing responses, and regularly updating complainants on the status of their complaint. However, these efforts will come at a cost to members.

AFCA's annual review for the year to June 30, 2022, noted that it takes an average of 72 days to close a complaint, but this statistic includes all complaints, not just those that go to determination. Around 3% of complaints take more than a year to resolve. The Insurance Council of Australia has acknowledged that the record flood event last year, which resulted in almost 240,000 claims, was an already stretched system of claims.

Finally, a lot more disputes have been resolved through internal dispute resolution processes, and the industry will pay close attention to the issues brought out through the external AFCA process. Therefore, the financial services industry needs to tackle the issue of delayed dispute resolution to ensure that complainants' expectations are met, customer satisfaction is guaranteed, and the industry's reputation remains solid.

Published:Monday, 20th Mar 2023
Source: Paige Estritori

Share this news item:

Insurance News

Antique Car Claim Hits the Brakes: Home Insurance Does Not Cover Vehicle Damage 24 Apr 2024: .Paige Estritori In an intriguing turn of events, a dedicated car enthusiast's claim for damages to his vintage vehicle under home insurance has been denied after a careful review by the Australian Financial Complaints Authority (AFCA). The individual's relic, a 1970 Mercedes-Benz 280e sedan, which was being lovingly restored and was far from operational, rolled into an adjacent van following the snap of a winch cable. - read more

Communities Laud Insurance Improvements Post-Flood Events 23 Apr 2024: .Paige Estritori Residents and officials from regions affected by flooding have observed a discernable shift in insurers' handling of claims following natural catastrophes, with recent proceedings reflecting a more positive trajectory. This outlook emerged during a federal inquiry session that gave a voice to flood-impacted communities in Heathcote, Victoria. - read more

Traveler's Appeal on Wildfire Claim Denied by Adjudicator 22 Apr 2024: .Paige Estritori An individual's anticipation of a serene vacation in Hawaii was met with a grievous twist when wildfires ravaged Maui, leading to an urgent evacuation and unplanned expenses. A customer of Mitsui Sumitomo ventured to the Pacific paradise only to have plans upended by nature's wrath. The ensuing insurance claim denial sparked a dispute which has now been resolved by the authoritative voice of the industry’s dispute resolver, leaving a glaring reminder of the importance of scrutinizing insurance options. - read more

Life Insurance Participation Drops By Nearly One-Fifth in Five Years 19 Apr 2024: .Paige Estritori Last year, research from a major insurance provider signaled a significant shift in the life insurance landscape within Australia, showing a marked decrease in the percentage of insured non-dependent adults of working age. Only 77% now carry some form of life insurance, a stark contrast to the 94% coverage rate recorded in 2017. Industries evolve, yet the dip in these figures marks a noteworthy trend within the life insurance sector. - read more

London's CFC Gears Up for Australian Expansion With Local Acquisition 18 Apr 2024: .Paige Estritori In a strategic move to fortify its Australian footprint, the prominent London-based cyber insurance firm CFC has announced the procurement of Melbourne's Solution Underwriting. Already an experienced player in the Australian insurance sector, CFC’s recent acquisition marks a significant augmentation of its local operations. - read more