The Australian Prudential Regulation Authority (APRA) has released its Life Insurance Claims and Disputes Statistics publication, covering a rolling 12-month period from 1 January 2019 to 31 December 2019.
The data is the product of a between APRA and the Australian Securities and Investments Commission (ASIC), aimed at making it easier to compare life insurers’ performance in handling claims and disputes. This is the fourth publication using the full data set since it was launched in March 2019.
APRA’s Life Insurance Claims and Disputes Statistics publication presents the key industry and entity-level claims and disputes outcomes for 20 Australian life insurers writing direct business (i.e. excluding reinsurance).
ASIC’s MoneySmart has been updated with the latest data. The online tool compares insurers across cover types and distribution channels on four metrics – the percentage of claims accepted, the length of time taken to pay claims, the number of disputes and the policy cancellation rates.
The admittance rate by cover type and channel for the 12 months to December 2019:
Individual Advised | Individual Non-Advised | Group Super | Group Ordinary | |
|---|---|---|---|---|
Cover type | % admitted | % admitted | % admitted | % admitted |
Death | 97% | 89% | 98% | 99% |
TPD ^ | 81% | 67% | 91% | 86% |
Trauma | 86% | 86% | * | 75% |
DII ^ | 95% | 85% | 96% | 96% |
CCI ^ | n/a | 91% | n/a | * |
Funeral | n/a | 99% | n/a | n/a |
Accident | 36% | 88% | n/a | n/a |
^Total and Permanent Disability Insurance (TPD), Disability Income Insurance (DII), Consumer Credit Insurance (CCI)
* In this publication, Group Ordinary CCI is masked as there was only one provider of this product, which reported fewer than 50 finalised claims.
The claims paid ratio^ by cover type and channel for the 12 months to December 2019:
Cover type | Individual Advised | Individual Non‑Advised | Group Super | Group Ordinary |
|---|---|---|---|---|
Death | 43% | 41% | 80% | 54% |
TPD | 45% | 58% | 85% | 61% |
Trauma | 58% | 44% | * | 112% |
DII # | 70% | 106% | 82% | 91% |
CCI | n/a | 29% | n/a | * |
Funeral | n/a | 25% | n/a | n/a |
Accident | 4% | 24% | n/a | n/a |
^ The claims paid ratio is the dollar amount of claims paid out in the reporting period as a percentage of the annual premiums receivable in the same period.
# DII has recurring monthly payments. For the purposes of the reported claims ratio, total payments are approximated using an average 24-month payout period.
The PDF and spreadsheet version of the Life Insurance Claims and Disputes Statistics publication provide additional detail and analysis. They are available on APRA’s website at: .
