Insurance Council of Australia

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New CoP

Part 16: Definitions

May 4, 2021 by TheoTheoICA

Business Days are Monday to Friday, excluding public holidays.

Calendar Day means any day, including weekends and public holidays.

Catastrophe means an event declared by the Insurance Council of Australia to be a Catastrophe – for example fire, flood, earthquake, cyclone, severe storm, or hail, resulting in a large number of insurance claims and involving multiple insurers.

Code means the General Insurance Code of Practice 2020.

Collection Agent means a person, company or entity who is not our Employee that we contract to recover money owing to us.

Complaint means an expression of dissatisfaction made to us, related to our products or services, our staff, or the handling of a Complaint where a response or resolution

is explicitly or implicitly expected or legally required. A Complaint also includes such expressions of dissatisfaction made about us on a social media channel or account owned or controlled by us, where the person making the Complaint is both identifiable and contactable.

Consumer Credit Insurance means insurance as defined in regulation 7.1.15 under the Corporations Regulations 2001, but it excludes:

  • a. Consumer Credit Insurance sold through motor dealer intermediaries; and
  • b. Consumer Credit Insurance sold alongside a refinanced loan where Consumer Credit Insurance has been purchased with the original loan.

Distributor means a person, company or entity when acting on our behalf, that is not an Employee, and;

  • a. is authorised to provide financial services, other than a claims handling and settling service, under our Australian Financial Services Licence, in accordance with the Corporations Act 2001; or
  • b. has authority to issue, vary or dispose of, a general insurance product covered by this Code under a binder with us (excluding an interim contract).

Domestic Builders Insurance and Domestic Builders Warranty/Indemnity Insurance means insurance as defined by the relevant State or Territory legislation.

Employee means a person employed either:

  • a. by us; or
  • b. by a related entity that provides services to which this Code applies.

External Expert means:

  • a. a company, entity, or a person who is not our Employee or a Service Supplier; and
  • b. that we contract solely to provide an expert opinion about the likely cause of your loss or damage.

Extraordinary Catastrophe means a Catastrophe that is so significant in size or magnitude or one that coincides with multiple other

Catastrophes that the Board of the Insurance Council of Australia declares it to be extraordinary.

Financial Hardship means you have difficulty meeting your financial obligations to us.

in writing means a communication conveyed by any one or more of mail, email, facsimile, text message, or a document sent or given to the relevant person.

Instalment Policy means a Retail Insurance policy for which the premium is payable by 7 or more instalments in a year, as defined in the Insurance Contracts Act 1984.

Insured means a person, company or entity holding, or seeking to hold, a general insurance product covered by this Code. It excludes a Third Party Beneficiary.

Investigator means:

  • a. a company, entity, or a person who is not our Employee; and
  • b. that we contract to verify the circumstances relating to your claim.

Loss Assessor or Loss Adjuster means:

  • a. a company, entity, or a person who is not our Employee; and
  • b. that we contract to:
  •    i. examine the circumstances of your claim;
  •    ii. assess the damage or loss;
  •    iii. determine whether your claim is covered under your policy;
  •    iv. assist in obtaining a repair quote, or a replacement quote; and
  •    v. help settle the claim.

Marine Insurance means insurance to which the Marine Insurance Act 1909 applies. The Code applies to pleasure craft covered by the Insurance Contracts Act 1984.

Medical Indemnity Insurance means medical indemnity cover for health care professionals under a contract of insurance covered by the Medical Indemnity (Prudential Supervision and Product Standards) Act 2003.

Motor Vehicle Injury Insurance means insurance that covers personal injury or death arising out of the use of a motor vehicle, including cover for the injury or death of a driver of a motor vehicle which is caused by the fault of that person when driving.

No Claims Bonus, No Claims Discount or No Claims Entitlement means a discount on your premium that we offer you in which the discount increases (up to a maximum level) for each consecutive insurance period during which you do not make:

  • a. a claim about something involving your fault; or
  • b. a claim that we do not pay.

Pressure Selling means unethical, misleading, or extended sales techniques that place customers under pressure, or that limit their ability to make an informed purchase decision. This includes the use of techniques to coerce a customer into taking out a policy they do not wish to buy.

Retail Insurance means a general insurance product that is provided to, or to be provided to, an individual or for use in connection with a Small Business, and is one of the following types:

  • a. a motor vehicle insurance product (Regulation 7.1.11);
  • b. a home building insurance product (Regulation 7.1.12);
  • c. a home contents insurance product (Regulation 7.1.13);
  • d. a sickness and accident insurance product (Regulation 7.1.14);
  • e. a Consumer Credit Insurance product (Regulation 7.1.15);
  • f. a travel insurance product (Regulation 7.1.16);
  • g. a personal and domestic property insurance product (Regulation 7.1.17) as defined in the Corporations Act 2001 and the relevant Regulations.

Retail Insurance Product Information means any one of the product disclosure statement, certificate of insurance, covering letter, covering email or other documents which are provided to you in connection with the issue of a Retail Insurance product.

Service Supplier means an Investigator, Loss Assessor or Loss Adjuster, Collection Agent, or a person, company or entity who is not our employee but is contracted by us to manage your claim on our behalf (including a broker who manages claims for us) and any of their sub-contractors who we have approved and who are also acting on our behalf.

Significant Breach means a breach that is determined to be significant by reference to:

  • a. the number and frequency of similar previous breaches;
  • b. the impact of the breach, or likely breach, on our ability to provide our services;
  • c. the extent to which the breach, or likely breach, indicates that our arrangements to ensure compliance with the Code are inadequate;
  • d. the actual, or potential, financial loss caused by the breach; and
  • e. the duration of the breach.

Small Business means a business that employs:

  • a. less than 100 people, if the business is or includes the manufacture of goods; or
  • b. otherwise, less than 20 people.

Third Party Beneficiary means a person, company or entity who is not an Insured but who is seeking to be, is specified to be, or is referred to as, a person to whom the benefit of the insurance cover extends. The relevant product must be covered by this Code. The person, company or entity may be specified by, or referred to by, name or otherwise.

we, us or our means the organisation that has adopted this Code.

Wholesale Insurance means a general insurance product covered by the Code which is not Retail Insurance.

Workers Compensation Insurance means insurance that covers an employer’s liability to pay compensation for an employment-related personal injury.

you or your means an Insured or Third Party Beneficiary, or as otherwise stated in relation to particular paragraphs of this Code.

Part 15: Claims investigation standards

May 4, 2021 by TheoTheoICA

Paragraph 73 of the Code states: If we appoint an Investigator or Employee to investigate your claim, then within 5 Business Days we will tell you that we have appointed them and what their role is. When we appoint an Investigator or Employee to investigate your claim then the investigation process will comply with these claims investigation standards.

General investigation obligations

  1. If we appoint an Investigator, or Employee, to investigate your claim, then we will make sure that they investigate:
    1. only those matters they need to investigate; and
    2. in an appropriate and respectful manner.
  2. We have a quality assurance program to regularly monitor and review our investigations. That program might include reviews of:
    1. recordings, statements, affidavits or transcripts of interviews
    2. Investigators’ records of investigation activities; and
    3. Complaints about investigations, including disputes referred to the Australian Financial Complaints Authority.
  3. Our quality assurance program will include reviews of our non-genuine claims indicators to make sure they remain relevant, appropriate and do not discriminate — we review these at least once a year.
  4. If an investigation has gone on for 4 months, then we will have your claim independently reviewed by an Employee with appropriate authority, knowledge or experience. We will inform you if this happens.
  5. During the review, the Employee will determine if there is sufficient cause for the investigation into your claim to continue. If it is determined that the investigation should stop, then your claim will be referred for a decision as set out in part 8.
  6. The review process will not exceed 30 Calendar Days. If we do not complete the review and notify you of the outcome within that time, we will tell you in writing about our Complaints process.
  7. After the review, we will tell you in writing, why we have not been able to make a decision on your claim and any information we still need that we do not have.
  8. To ensure our investigations are appropriately focused:
    1. we will ensure that any requests to you for more information, or documents, are reasonable and relevant to the claim under investigation. We will:
      1. use our best endeavours to do that in one request;
      2. tell you why we need the information that we are requesting.
    2. when we give our Investigators and Employees authority and instructions in relation to your claim, we will:
      1. clearly limit the purpose of the investigation to the claim in question;
      2. carefully define their scope about the type of information we are requesting and the period covering the request.
  9. Before we first start the investigation of your claim, we will discuss with you why your claim is being investigated. We will train our Employees about how to have these conversations and the information they need to discuss with you.
  10. Before we first start the investigation of your claim, we will tell you, verbally and in writing:
    1. about our claims investigations process;
    2. who is your primary contact for the investigation and their details;
    3. the role and responsibility of the Investigator or any Employee that has been appointed to investigate your claim;
    4. when to expect to hear from the Investigator or Employee — and what to do if you do not hear from them within that timeframe;
    5. that within 10 Business Days after we have received all relevant information and completed all of our enquiries, we will tell you if we are going to pay your claim, unless an exception in the Code applies;
    6. your rights and responsibilities under the policy during the investigation;
    7. about our Complaints process.
  11. If we need your authority to access information from someone else, then we will explain to you why we think you should give us that authority.
  12. At least every 20 Business Days, we will update you about the investigation’s process.

Before any formal interview

  1. If we need to formally interview you as part of the investigation, then before the interview starts, we will tell you in writing:
    1. the purpose of the interview;
    2. your rights and responsibilities during the interview;
    3. your right to have an interpreter — free of charge — to translate any information given to you and any answers you provide;
    4. who will conduct the interview — and their contact details;
    5. if an Investigator is appointed, that they are acting on our behalf;
    6. how long the Investigator expects the interview to take;
    7. our contact details, so you can contact us with any questions about the interview, the Investigator or the Employee appointed to investigate your claim;
    8. your right to have a legal representative or a support person, who may be a family member, friend or other person, to support you through the interview but may not answer questions on your behalf; and
    9. how the interview is to be recorded.
  2. If you have asked us to communicate through a representative, then we will tell the Investigator, or Employee appointed to investigate your claim, to contact the representative first. If they cannot make contact with the representative within a reasonable time, then they will contact you.
  3. If an independent interpreter is needed either for you, or for us, we will arrange for this at our cost.
  4. If you tell us, or we identify, that you need additional support or have other particular needs, then we will arrange for the Investigator or Employee to be someone who we are satisfied has appropriate training or experience to conduct the interview in light of those needs.
  5. If you request for the Investigator, or Employee appointed to investigate your claim, to be the same gender as you we will tell you if we can arrange for this. We may not be able to do this if it is not reasonably practical for us to do so.
  6. When we are arranging the interview, we will tell you:
    1. several possible convenient locations, including your home, where the interview can occur, and that you can suggest another location, provided it is a reasonable place for both you and the Investigator or Employee;
    2. that you can schedule the interview for a time and date that suits you.
  7. If we intend to interview (or our Investigators or Employees inform us that they wish to interview) someone who is under 18, then we will:
    1. assess whether the interview is necessary and whether the interviewee is capable of distinguishing truth from fiction. We will use trained professionals to assess this and they will record how they made that assessment;
    2. require any Investigator or Employee to clearly set out the scope of the interview;
    3. require any Investigator or Employee conducting the interview to obtain our written approval to the interview and the scope of the interview before
    4. require any Investigator or Employee conducting the interview to obtain our written approval before expanding the scope of the interview beyond what we consented to — that approval may be given only by one of our Employees with appropriate experience and training;
    5. use an Investigator or Employee who we are satisfied has appropriate training or experience to conduct the interview;
    6. make sure that any interview takes place only in the presence of the interviewee’s parent, guardian or responsible adult; and
    7. make sure that the Investigator pauses the interview:
      1. i. if they are aware that the interviewee is distressed by the interview process; or
      2. at the request of the interviewee, parent, guardian or responsible adult.

During the formal interview

  1. When the interview happens, the Investigator, or Employee appointed to investigate your claim, will ask you a series of questions about the information contained in the interview consent form. Those questions are designed to make sure we have your consent to the interview (or not).
  2. We require our Investigators or Employees appointed to investigate your claim, to conduct all interviews in an objective, honest, efficient, transparent and fair manner at all times.
  3. A single interview sitting may only last for up to 90 minutes.
  4. If another interview time is needed, it will not be organised without at least a 24 hour break, unless otherwise agreed.
  5. If the total interview time required is over 4 hours, the Investigator or the Employee appointed to investigate your claim must obtain written consent from us. In that written consent, we will provide the reasons why this time extension is needed.
  6. If during the interview it becomes apparent that an interpreter is needed either for you, or for us, (even though one had not previously been requested or arranged), then the Investigator or Employee will:
    1. pause the interview; and
    2. restart it at a later time, or date, once an independent interpreter has been arranged.
  7. If during the interview you need additional support (for example a lawyer, consumer representative or a friend), even though one had not previously been requested or arranged, then the Investigator or Employee will:
    1. pause the interview;
    2. advise you of the support person’s role in the interview process in accordance with paragraph 205(h); and
    3. restart the interview at a later time, or date, once the support person has been arranged.
  8. We will offer you a 5 minute break in the interview every 30 minutes. However, if you tell us — or we identify — that you are experiencing vulnerability, then there will be a 5 minute break every 30 minutes. Any break is a time-out and is not included in the 90 minute period referred to under paragraph 214.
  9. Also, you can request additional breaks and stop the interview early and reschedule if needed.
  10. The Investigator or Employee must record all offers of breaks, and the interviewee’s responses.

After the formal interview

  1. We will offer you a transcript of the formal interview (or a digital copy of the recorded interview), and it will be given to you for free. You can also request this at a later time and it will be provided for free.
  2. Also, if we need to interview you more than once, then before the second or any later interview, we will give you a copy of the record of your previous interview.

External Investigators only

  1. Our contracts with Investigators will set out standards about how they are to conduct themselves, and what they need to do, when investigating people who may be vulnerable.
  2. If we appoint an Investigator to help us with your claim, then we will:
    1. give them written instructions about each investigation;
    2. confirm any changes to our instructions; and
    3. require them to get our consent before they exceed their existing instructions.
  3. We require our Investigators to:
    1. record the requests they make to individuals for written authorisation to access the individual’s personal information that is held by other parties; and
    2. to provide those records to us at the end of their investigation.
  4. Before we authorise an Investigator to investigate or interview a person who may be vulnerable, they will have received training on how to work with vulnerable customers.
  5. We keep an up-to-date register of our Investigators’ licences, including their expiry dates. We do this to make sure the licences of any Investigators we engage are valid and current.
  6. Our Investigators must make or retain contemporaneous records in writing of all investigation activities, including but not limited to details of:
    1. conversations held in person;
    2. telephone conversations;
    3. unanswered telephone calls — including any messages left;
    4. all written communications sent — whether: letters, faxes, emails etc.;
    5. their travel;
    6. interviews and statements obtained; and
    7. any electronic checks — including government and social media sites, for example: internet, land titles, Facebook, or business affairs.
  7. We and/or the organisations that provide our Investigators, must keep these records for at least 7 years.
  8. We require all our Investigators:
    1. to collect information only if they reasonably believe it is relevant to their investigation;
    2. to comply with any relevant law;
    3. to not use illegal means or methods to carry out the investigation;
    4. to not induce someone to perform a task, or activity, that they would not have performed without the involvement of the Investigator;
    5. to not make any threat, promise or inducement to any person when conducting an investigation on our behalf;
    6. to comply with the standards in this document that are relevant to their activities performed on our behalf; and
    7. to obtain authority by the insurer before alleging fraud.

Surveillance

  1. Before we authorise any surveillance of you, we:
    1. make sure that alternative methods of verifying the relevant information the surveillance would relate to have been considered;
    2. must reasonably believe that your claim appears to be inconsistent with the information available to us — and we must record our reasons for this belief; and
    3. arrange for a suitably experienced Employee to review and approve the request for surveillance.
  2. We will not conduct surveillance of you:
    1. inside any court, or other judicial facility;
    2. in any medical, or related facility;
    3. in any bathroom, change room, or lactation room;
    4. inside your house;
    5. at a business premises — unless it is open to the public;
    6. where prohibited by relevant law.
  3. We will stop surveillance of you if we become aware that you have a pre- existing mental health condition.
  4. We will require our Investigators to not communicate with your neighbours, or your work colleagues, in a way that might — directly, or indirectly — reveal that surveillance will be, is being, or has been, conducted.

Part 14: Promoting, reviewing and improving the Code

May 4, 2021 by TheoTheoICA

 

Promoting the Code

  1. The Insurance Council of Australia is responsible for promoting the Code to customers and to industry participants that have not yet adopted the Code.
  2. The Insurance Council of Australia will work with the Code Governance Committee, the Australian Securities and Investments Commission, relevant regulators and other stakeholders to encourage all general insurers and other industry participants conducting business in Australia to adopt the Code.
  3. We will work with the Insurance Council of Australia to promote and champion the Code.
  4. We will:
    1. provide information about the Code and the Code Governance Committee on our websites, and in our Retail Insurance Product Information. We will also provide this information in other places where we consider it appropriate to do so;
    2. work with the Insurance Council of Australia to provide general information to help you access insurance products;
    3. work with the Insurance Council of Australia to initiate programs to promote insurance, financial literacy and the insurance industry; and
    4. support the Insurance Council of Australia’s initiatives aimed at education on general insurance.

Reviewing and improving the Code

  1. The Insurance Council of Australia will consult with the Code Governance Committee, the Australian Financial Complaints Authority, consumer and industry representatives, relevant regulators and other stakeholders to develop the Code on an ongoing basis.
  2. At least every 3 years the Insurance Council of Australia will commission a formal, independent review of the Code.
  3. If the Code Governance Committee believes the Code is not meeting the objectives outlined in part 1 of the Code, then the Code Governance Committee may recommend to the Board of the Insurance Council of Australia that the Code should be reviewed.
  4. The Code Governance Committee may, in its quarterly reports to the Board of the Insurance Council of Australia, make recommendations about any one or more of the following:
    1. Code improvements, Code related issues and matters of importance as a response to its monitoring and enforcement;
    2. promoting the Code;
    3. education and training relevant to the operation of the Code;
    4. the Insurance Council of Australia’s industry Catastrophe coordination arrangements; and
    5. the Complaints process.
  5. We must comply with any additional obligations and binding standards that the Insurance Council of Australia introduces to the Code.
  6. The Insurance Council of Australia may issue non-binding best practice guides to help us meet our obligations under the Code.

Part 13: Enforcement, sanctions and compliance

May 4, 2021 by TheoTheoICA

 

Reporting breaches

  1. Anyone can report alleged breaches of the Code to the Code Governance Committee at any time.

The Code Governance Committee

  1. The Code is monitored and enforced by the Code Governance Committee
    1. a consumer representative;
    2. an industry representative; and
    3. an independent chair.
  1. The Code Governance Committee’s constitution, functions and powers are set out in its Charter.
  2. The Code Governance Committee may outsource to an appropriate service provider any of the following responsibilities:
    1. monitoring and enforcing compliance with the Code;
    2. annual reporting;
    3. the responsibilities under paragraphs 168 and 169.

The responsibilities of the Code Governance Committee

  1. The Code Governance Committee is responsible for:
    1. providing stewardship of the Code by helping the general insurance industry understand and comply with the Code;
    2. identifying areas for improvement of insurance practices;
    3. liaising with the Insurance Council of Australia on relevant matters;
    4. providing quarterly reports to the Board of the Insurance Council of Australia;
    5. publishing an annual public report containing aggregate industry data and consolidated analysis on Code compliance.
  2. The Code Governance Committee is also responsible for monitoring and enforcing compliance with the Code through:
    1. investigations, analysis of data, analysis of evidence and stakeholder engagement;
    2. receiving, investigating and making decisions about alleged breaches and giving us the opportunity to respond to any allegations that we have breached the Code;
    3. considering whether it is more appropriate for the Australian Securities and Investments Commission or another enforcement agency to investigate an alleged breach of the Code;
    4. agreeing with us on any corrective measures to implement within an agreed timeframe;
    5. imposing sanctions; and
    6. publishing breach decisions on a de-identified basis.

Imposing sanctions

  1. The Code Governance Committee may impose sanctions on us for a breach of the Code. When determining any sanctions to be imposed, the Code Governance Committee will consider:
    1. the appropriateness of the sanction;
    2. if we have not acted on — or have taken too long to act on — a request from the Code Governance Committee to remedy a breach;
    3. if we have breached an undertaking we gave to the Code Governance Committee;
    4. if we have not taken adequate steps to prevent a Significant Breach from reoccurring;
    5. if we have not acted with the utmost good faith.
  1. Before the Code Governance Committee imposes a sanction on us, it must give us the opportunity to provide a response. We will respond within 10 Business Days.
  1. The Code Governance Committee must give us written reasons for its final decision.

Types of sanctions

  1. As a sanction for our breach of the Code, the Code Governance Committee may require us to do any one, or more, of the following:
    1. take particular rectification steps within a set timeframe;
    2. audit our compliance with the Code at our own cost;
    3. advertise to correct something that the Code Governance Committee decides needs correcting.
  1. The Code Governance Committee may impose additional sanctions for Significant Breaches of the Code, including requiring us to do any one or more of the following:
    1. compensate an individual for any direct financial loss, or damage, we caused them arising from a Significant Breach;
    2. publish the fact that we have committed a Significant Breach of the Code;
    3. pay a community benefit payment for a Significant Breach up to a maximum of $100,000. The size of the community benefit payment must be in proportion to our gross written premium and number of customers.
  1. When requiring us to pay compensation or a community benefit payment, the Code Governance Committee must take into account any compensation awarded by the Australian Financial Complaints Authority or an enforcement agency. The Code Governance Committee must also take into account any impending or ongoing investigation by the Australian Securities and Investments Commission.
  1. The Code Governance Committee will report Significant Breaches or serious misconduct to the Australian Securities and Investments Commission.
  1. The Australian Financial Complaints Authority may report possible Code breaches to the Code Governance Committee.
  1. The Code Governance Committee’s decisions and sanctions are binding on us.

Our compliance with the Code

  1. We will have a governance process in place to report to our Board or our executive management, on our compliance with the Code.
  1. We will have appropriate systems and processes in place to enable the Code Governance Committee to monitor our compliance with the Code. We will prepare an annual compliance report to the Code Governance Committee on our compliance with the Code.
  1. If we identify a Significant Breach of the Code, then we will report it to the Code Governance Committee within 10 Business Days.
  1. We will cooperate with the Code Governance Committee in its review of our compliance with the Code and its investigations of any breaches of the Code.

Part 12: Your access to information

May 4, 2021 by TheoTheoICA

  1. We comply with the Principles of the Privacy Act 1988 and/or any relevant State or Territory requirements when we collect, store, use, disclose and destroy personal information about you.
  2. At your request, and subject to paragraph 163, we must give you — free of charge, access to any information that we relied on in assessing your application for insurance cover, or in handling your claim, or in responding to your Complaint. We must give you this information within 30 Calendar Days unless paragraph 82 or 151 applies.
  3. The information you may access includes:
    1. documents and information we relied on to deny your claim;
    2. copies of your product disclosure statement and insurance;
    3. copies of any reports from Service Suppliers or External Experts that we relied on; and
    4. copies of any recordings and/or transcripts of any interaction we had with you that we relied on.
  4. If we refuse to give you access to information, we will not do so unreasonably, and we will tell you our reasons for doing so and about our Complaints process. We may refuse to give you access to information in the following circumstances:
    1. where a law — for example, the Privacy Act 1988 — says we do not have to;
    2. in the case of a claim where the claim is being or has been investigated, and giving access would have an unreasonable impact on the privacy of other individuals or government agencies; or
    3. if doing so may be prejudicial to us in relation to a Complaint or a dispute about your insurance cover or your claim — however, even in this circumstance we must give you access to any External Experts’ reports we relied on.

Part 11: Complaints

May 4, 2021 by TheoTheoICA

This part applies to Retail Insurance products. In addition, it is available to an uninsured person making a claim against a customer who we insure under a Retail Insurance policy (see paragraph 60).

This part also applies to Wholesale Insurance products where you are entitled to Financial Hardship support under paragraph 107(b).

Making a Complaint

  1. You may complain to us about any aspect of your relationship with us.
  2. We will make readily available information about:
    1. your right to make a Complaint;
    2. our internal processes for dealing with Complaints; and
    3. our external dispute resolution provider.

This will be published on our website, other digital platforms and in our relevant written communications.

  1. Our Complaints process will comply with the Australian Securities and Investments Commission’s guidelines.

Handling your Complaint

  1. When we receive your Complaint, we will acknowledge that we have received it.
  2. We will tell you the name and relevant contact details of the person assigned to liaise with you about your Complaint.
  3. Your Complaint will be handled by a person with appropriate authority, knowledge or experience. This will not be the person whose decision or conduct is what your Complaint is about.
  4. When we are considering your Complaint, we will only ask for, and rely on, information that is relevant to our decision.
  5. We will keep you informed about the progress of your Complaint at least every 10 Business Days, unless it is resolved earlier or you agree to a different timeframe.

Decision about your Complaint

  1. We will make a decision about your Complaint within 30 Calendar Days. If we cannot make our decision within this time frame, then before this deadline passes we will tell you, in writing, the reasons for the delay and about your right to take your Complaint to the Australian Financial Complaints Authority, and its contact details.
  2. When we have made a final decision about your Complaint we will respond to you in writing, unless paragraph 150 applies.
  3. Our written response to you will include the reasons for our decision and inform you of your right to take your Complaint to the Australian Financial Complaints Authority if you are not satisfied with our decision. We will provide you with its contact details and the timeframe in which you are able to complain to it.
  4. We will provide you with a written response where your Complaint is about Financial Hardship, a declined claim, the value of a claim or you have requested a written response. Otherwise, a written response may not be provided where, within 5 business days, we have been able to resolve your Complaint to your satisfaction, or we have given you an explanation and/or an apology and can take no further action to reasonably address your Complaint.
  5. We must give you the information that we relied on when making a decision about your Complaint within 10 Business Days of you asking us for that information. We will give you the information as set out in part 12 of the Code.

Mistakes when handling your Complaint

  1. If it is identified that we have made a mistake when handling your Complaint, then we will take action to correct the mistake.

The Australian Financial Complaints Authority

  1. We are part of an independent external dispute resolution scheme administered by the Australian Financial Complaints Authority. The scheme is for customers and third parties as allowed under its Rules.
  2. You can take your Complaint to the Australian Financial Complaints Authority at any time and if we do not resolve your Complaint within 30 Calendar Days after we first received your Complaint.
  3. Under the Australian Financial Complaints Authority’s Rules, your Complaint may be referred back to us if it has not gone through our Complaints process.
  4. The Australian Financial Complaints Authority’s decisions are binding on us in the way set out in its Rules.
  5. If the Australian Financial Complaints Authority tells you that under its Rules it cannot assist you or consider your dispute, then you can seek independent legal advice. You can also access any other external dispute resolution or other options that may be available to you.

Complaint management by third parties

  1. We may authorise another person to act on our behalf to receive and handle Complaints about our products and services.
  2. Where we authorise another person to receive and handle Complaints under paragraph 158, then:
    1. that person must notify us of Complaints made to them;
    2. they must handle Complaints in accordance with the requirements as set out in this part of the Code;
    3. any breach of this part of the Code by them is a breach of the Code by us;
    4. we will have processes in place to monitor their handling of Complaints and take reasonable steps to ensure that they are meeting the requirements as specified in this part of the Code.
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