New CoP

Individuals entitled to support

105. We will have information about applying for Financial Hardship support on our website. The information will set out the types of support options that may be available, and how you can access Financial Hardship support.
106. You have a right to ask us to fast-track a claim if you have an urgent financial need. See paragraph 64.
107. You may be entitled to support because you are suffering Financial Hardship if you are:
     a. an individual Insured or a Third Party Beneficiary who owes us money — including an excess — under an insurance policy we have issued; or
     b. an individual and we are seeking to recover money from you because we believe you caused damage or loss to either an Insured, or a Third Party Beneficiary who we cover under an insurance
108. The support that we provide does not include support with paying the premiums under an insurance policy we have issued.

Identifying people experiencing Financial Hardship

109. We will have internal policies and training appropriate to our Employees’ roles to help them to identify if you are experiencing Financial Hardship and decide how they may be able to provide support to you.
110. We encourage you or your representative to tell us about your Financial Hardship so that we can work with you to discuss your situation and the options available to support you — otherwise there is a risk that we may not find out about it.
111. If you tell us, or we identify, that you are experiencing Financial Hardship, we will give you:
     a. details about how to apply for Financial Hardship support; and
     b. if appropriate, contact details for the National Debt Helpline: 1800 007 007.

Keeping you informed

112. We will communicate with you about your application and where possible, we will use your preferred method of communication.
113. If we know that you have nominated a representative, then we will keep that person updated about your request for Financial Hardship support, unless you tell us not to.

Assessing your request for Financial Hardship support

114. When we are assessing your request for Financial Hardship support, we will consider all reasonable evidence — for example:
     1. evidence of serious illness that prevents you from earning income;
     2. evidence of a disability, including a disability caused by mental illness;
     3. if you are a Centrelink client, your Centrelink statements; and
     4. evidence of your unemployment.
115. We will request information from you only if it is reasonably necessary for us to assess your application for Financial Hardship support.
116. If, after we receive your application for Financial Hardship support, we need more information from you before we can make our decision, then we will:
     1. tell you the information we need as early as possible; and
     2. be specific about the information we need.
117. You have 21 Calendar Days from the date of our request under paragraph 116 to provide that information to us, unless we have agreed to a different timeframe.

Putting recovery on hold

118. If we are taking action to recover an amount from you, we will put that action on hold if we identify that you are experiencing Financial Hardship, or if you ask us for Financial Hardship support in relation to that amount.
119. When we put the action on hold, we will contact any Collection Agent or solicitor that we have appointed and tell them the action is on hold.
120. The action will stay on hold until we have assessed your application for Financial Hardship and notified you of our decision about it.

Making our decision

121. We will tell you in writing of our decision about whether to give you Financial Hardship support within 21 Calendar Days after we receive your application, unless we have asked you to provide us with more information.
122. If we do ask you for more information under paragraph 116 and:
     1. you provide all information we requested, then within 21 Calendar Days of receiving it we will tell you in writing, our decision about whether to give you Financial Hardship support; or
     2. you do not provide all information we requested within 21 Calendar Days (or by a later date we agree to), then within 7 Calendar Days of that deadline passing, we will tell you in writing, our decision about whether to give you Financial Hardship support.

If you are entitled to Financial Hardship support

123. If we decide you are entitled to Financial Hardship support, then we will work with you to implement an arrangement that could include any one or more of the following:
     1. delaying the date on which the payment must be made;
     2. paying us in instalments — we will not refuse a reasonable request from you to pay the amount you owe in instalments;
     3. paying a reduced lump sum amount;
     4. delaying one or more instalment payments for an agreed period;
     5. deducting the excess from the claim amount we pay you;
     6. waiving cancellation fees.

124. We will confirm the agreed arrangement with you. Where possible this will be in your preferred method of communication.
125. If we agree you are entitled to Financial Hardship support, but we are unable to agree about how you can be supported, then we will tell you in writing, about our Complaints process.

Releasing your debt

126. If we decide you are entitled to Financial Hardship support, then you may ask us to release, discharge, or waive a debt or obligation. However, you are not automatically entitled to this.
127. If we agree to release, discharge or waive a debt or obligation, then we will confirm this with you in writing.
128. You can ask us to notify any financial institution with an interest in your insurance policy that you are entitled to Financial Hardship support and, if applicable, that we have released, discharged or waived a debt or obligation. If you ask us to do this, then we will tell them about this in writing.

If you are not entitled to Financial Hardship support

129. If we decide that you are not entitled to Financial Hardship support, we will tell you the reasons for our decision and about our Complaints process. Where possible, we will tell you this in your preferred method of communication.
130. If your circumstances change, then you may re-apply for Financial Hardship support in relation to the amount you owe. However, for any further application you make, it will be at our discretion whether we again put any recovery action on hold.

Standards for collecting money

131. We, as well as any Collection Agent or solicitor collecting money for us, will comply with the Debt collection guideline: for collectors and creditors published by the Australian Competition and Consumer Commission and the Australian Securities and Investments Commission.
132. We, as well as any Collection Agent or solicitor collecting money for us, are required to:
     1. understand the Financial Hardship requirements in the Code; and
     2. receive training to help identify whether you might need Financial Hardship support.
133. When we, our Collection Agent or solicitor, first communicates with you about any money owed, then we will ensure that this communication will provide you with information to show that the amount we are seeking to recover from you is fair and reasonable. This may include:
1. information on the relevant loss and/or damage and the claim;
2. the actual cost of completed repairs; and
3. the evidence we relied on when we calculated the amount.
134. This communication will also include:
     1. information about our Financial Hardship process; and
     2. contact details to enable you to contact us to discuss Financial Hardship support or if you have any questions.
135. If our Collection Agent or solicitor communicates with you about money owed, then that communication will identify us as the insurer that they are acting on behalf of and will specify the nature of our claim against you.
136. If you tell our Collection Agent or solicitor that you are experiencing Financial Hardship, then they must notify us and give you information in writing about our Financial Hardship process.

Bankruptcy

137. If you tell us that you intend to declare bankruptcy, then we will work with you (or your representative) to agree on the amount owed. We will also give you written confirmation of that amount for the purposes of your declaration of bankruptcy.

138. If we cannot agree on an amount, then we will provide details of our Complaints process in writing.

This part applies to Retail Insurance products only.

91. We are committed to taking extra care with customers who experience vulnerability. We recognise that a person’s vulnerabilities can give rise to unique needs, and that their needs can change over time and in response to particular situations.
92. A person’s vulnerability may be due to a range of factors such as:
    1. age;
    2. disability;
    3. mental health conditions;
    4. physical health conditions;
    5. family violence;
    6. language barriers;
    7. literacy barriers;
    8. cultural background;
    9. Aboriginal or Torres Strait Islander status;
    10. remote location; or
    11. financial distress.
93. We encourage you to tell us about your vulnerability so that we can work with you to arrange support — otherwise, there is a risk that we may not find out about it.
94. If you are experiencing Financial Hardship, see part 10 of the Code about the support we can provide to you.

Internal policies and training

95. We will have a publicly available policy about how we will support you if you are affected by family violence. This policy will be published on our website.
96. We will have internal policies and training appropriate to our Employees’ roles to help them:
    1. understand if you may be vulnerable;
    2. decide about how best, and to what extent, we can support you;
    3. take account of your particular needs or vulnerability; and
    4. engage with you with sensitivity, dignity, respect and compassion — this may include arranging additional support, for example referring you to people, or services, with specialist training and experience.

Support measures

97. If you tell us, or we identify, that due to a vulnerability you need additional support or assistance, we will work with you and try to find a suitable, sensitive and compassionate way for us to proceed. We will do this as early as practicable and we will protect your right to privacy.
98. If you tell us, or we identify, that you need additional support from someone else (for example, a lawyer, consumer representative, interpreter or friend), then we will recognise this and allow for it in all reasonable ways. We will try to make sure our processes are flexible enough to recognise the authority of your support person.
99. Additional support may include making it easier for you to communicate with us, referring you to a financial counsellor or an appropriate community support service.

Identification

100. If you need support to meet identification requirements, then we will take reasonable measures to support you — particularly if you are from an Aboriginal or Torres Strait Islander community or a non-English speaking background. Our approach to supporting you with verification and identification will be flexible.

Using interpreters

101. Where practicable, we will provide access to an interpreter if you ask us to, or if we need an interpreter to communicate effectively with you. We will record if an interpreter is used or if there are reasons we are unable to arrange one.
102. We will arrange relevant training for our Employees who are likely to be involved in communications requiring an interpreter.
103. On our website there will be an easy-to- find link to:
     1. information on interpreting services;
     2. teletypewriter services (TTYs);
     3. any information on our products that we have translated into other languages; and
     4. any other relevant information for people with language barriers.

Mental health

104. When developing our internal processes and procedures we will take into account those who have a past or current mental health condition by doing the following:
     1. at a minimum, we will design and sell our products and apply their terms in compliance with the requirements of the Disability Discrimination Act 1992 and/or any relevant State or Territory anti-discrimination requirements;
     2. we will treat people with any past or current mental health condition fairly;
     3. we will only ask relevant questions when deciding whether to provide cover for a pre-existing mental health condition;
     4. if we cannot provide you with cover for that condition we will tell you about your right to ask us for the information relied on when assessing your application. If you ask for that information, then we will give it to you as set out in part 12 of the Code.

This part applies to Retail Insurance products only.

Before making a claim

58. You can ask us if your insurance policy covers a particular loss before you actually make a claim. When we answer your question, we will not discourage you from making a claim and we will tell you that if you make a claim, we will fully assess whether your loss is covered.

Making a claim

59. If you make a claim, then we will tell you:
    1. about our claims process;
    2. about any excess amounts you have to cover or pay in relation to your claim;
    3. about any waiting or no cover periods that need to finish before we start paying you under the policy; and
    4. how to contact us regarding your claim.

60. If we are contacted by an uninsured person who wishes to make a claim against one of our customers, then we will tell them about our claims process and what is required for us to start a claim. If we have accepted a claim under our insured’s motor vehicle policy, then we will tell them:
    1. about the next steps in the claims process;
    2. about our Complaints process; and
    3. who to contact to find out about any claim they make, and their contact details.

Scope of works for a home building claim

61. If a scope of works is needed for a home building claim, we will provide your with information to help you understand how it works, its purpose and the process involved.

Issues with your claim

62. If we identify, or you tell us about a mistake we make in handling your claim, then we will immediately take action to correct the mistake.
63. If you have a Complaint about anything to do with how we handle your claim, then you may make a Complaint to us through our Complaints process.

Fast-tracking urgent claims

64. Where the event (for example, a natural disaster) that caused you to make a claim under your policy also caused you to be in urgent financial need of the benefits you are entitled to under that policy, then we will do either or both of the following:
    1. fast-track both our assessment of your claim and the process we follow to make a decision about your claim;
    2. pay you an advance amount to help ease your urgent financial need — we will do this within 5 Business Days after you demonstrate your urgent financial need.
65. See part 10 of the Code to read more about applying for Financial Hardship support.
66. If you are not happy with our response to your request about urgent financial need, then we will tell you about our Complaints process.

Assessing your claim

67. When we are assessing your claim, we will only ask for and rely on information that is relevant to our decision. If we ask you for information, then we will tell you why we need it.
68. If you make a claim and we need further information or assessment, then within 10 Business Days of receiving your claim we will:
    1. tell you any information we need to make a decision on your claim. We will use our best endeavours to do that in one request;
    2. if necessary, appoint a Loss Assessor or Loss Adjuster to assess your claim; and
    3. provide our estimate of the likely timeframe and process for us to make a decision about your claim.
69. When we assess your claim, we will consider all relevant facts, the terms of your insurance policy and the law.
70. We will tell you about the progress of your claim at least every 20 Business Days.
71. We will respond to your routine enquiries about your claim’s progress within 10 Business Days.

Using an External Expert, Loss Assessor, Loss Adjuster or Investigator

72. If we appoint a Loss Assessor or Loss Adjuster, then within 5 Business Days we will tell you that we have appointed them and what their role is. An appointed loss assessor or loss adjustor may be an Employee.
73. 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 the Claims Investigation Standards (see part 15).
74. If we engage an External Expert to provide us with a report that we need to assess your claim, then we will ask them to report to us within 12 weeks of us engaging them. If the External Expert does not meet that timeframe, we will tell you and keep you informed of our progress in obtaining the report.
75. We will engage an External Expert only if we believe they have the appropriate expertise to provide the opinion we ask them for and that they comply with the rules and regulations relevant to their area of expertise.

Claim decision

76. Once we have all relevant information and have completed all enquiries, we will decide whether to accept or deny your claim and tell you of our decision within 10 Business Days.
77. Our decision will be made within 4 months of receiving your claim, unless paragraph 78 applies. If we do not make a decision within that time, we will tell you in writing about our Complaints process.
78. In circumstances where:
    1. your claim arises from an Extraordinary Catastrophe;
    2. your claim is fraudulent, or we reasonably suspect it is fraudulent;
    3. you do not respond to our reasonable inquiries or to our requests for documents or information about your claim;
    4. we have difficulty communicating with you about your claim due to circumstances beyond our control; or
    5. you request a delay in the claims process;

then within 12 months of receiving your claim we will tell you our decision in writing. If we cannot make a decision within 12 months, we will tell you in writing about our Complaints process.

Cash settlements

79. If we offer a cash settlement under a home building policy, we will provide you with information to help you understand how they work and how decisions are made on cash settlements.

Claims for total loss

80. When you have suffered a total loss, we and our Service Suppliers will treat your claim with sensitivity. If we have accepted your claim for a total loss under your home building and home contents insurance policy and you are unable to provide proof of ownership for the relevant insured property because it was lost in or damaged by the insured event (and we believe your ownership is clear) we will not:
    1. require you to provide proof of ownership; or
    2. require a list of insured property that was lost or damaged.

Information we give you if we deny your claim or do not pay in full

81. If we deny your claim, or do not pay it in full, then we will tell you, in writing:
    1. the aspects of your claim that we do not accept;
    2. the reasons for our decision;
    3. that you have the right to ask us for the information about you that we relied on when assessing your claim;
    4. that you have the right to ask us for copies of any Service Suppliers’ or External Experts’ reports that we relied on; and
    5. about our Complaints process.
82. If you ask for information or for copies of any Service Suppliers’ or External Experts’ reports that we relied on, then we will give you that information or report within 10 Business Days, as set out in part 12 of the Code.

Changes to timeframes

83. If any of the timeframes in this part are not practical due, for example, to the complex nature of your claim, we will agree a reasonable alternative timetable with you. If we cannot reach an agreement on an alternative timetable, we will provide details of our Complaints process.
84. We must comply with the timeframes in this part of the Code, unless any of the following apply:
    1. we have complied with an alternative timetable to which you agreed;
    2. our conduct, and the actual timeframe, were reasonable in all the circumstances;
    3. the reason we did not comply with the timeframe was that a report from an External Expert was delayed, even though we used our best endeavours to obtain the report in time.
85. The standards in this part of the Code do not apply to your claim if you have commenced any proceedings against us about your claim in any court, tribunal or under any other dispute handling process, other than through the Australian Financial Complaints Authority.

Use of repairers

86. If we have selected and directly authorised a repairer to repair your damaged property, then we will accept responsibility for the quality of their work and the materials they use. Complaints about the repairer’s conduct, timeliness, quality of work or the materials they use will be handled under our Complaints process.
87. If we have selected and directly authorised a repairer and we are satisfied that the repair requires rectification and because of that you need a hire car or accommodation over and above what we would provide to you in your policy, then we will arrange these for you and cover the reasonable costs.

How we respond to Catastrophes

88. We will respond to Catastrophes efficiently, professionally, practically and compassionately.
89. We will co-operate and work with the Insurance Council of Australia on industry coordination and communications under the Insurance Council of Australia’s industry Catastrophe coordination arrangements.
90. If you have a property claim resulting from a Catastrophe and we have finalised your claim within 1 month after the Catastrophe event causing your loss, you can request a review of your claim if you think that assessment of your loss was not complete or accurate, even though you may have signed a release. We will give you 12 months from the date of finalisation of your claim to ask for a review of your claim. We will inform you in writing about this entitlement and our Complaints process when we finalise your claim.

This part applies to Retail Insurance products only.

55. Your insurance policy may allow you to cancel it and obtain a refund. If you are entitled to a refund and you cancel your policy, then we will return the amount within 15 Business Days. However, if you arranged your insurance through an insurance broker, then different arrangements will apply — you will need to ask your broker about those arrangements.
56. If you have an Instalment Policy and we have not received an instalment payment, then we will send you a notice in writing regarding your non-payment at least 14 Calendar Days before any cancellation by us for non-payment.
57. If after sending the notice under paragraph 56 we do not receive the instalment payment for the Instalment Policy, then we will send you a second notice in writing either:
    1. before cancellation, informing you that your Instalment Policy is being cancelled for non-payment; or
    2. within 14 Calendar Days after cancellation by us, confirming our cancellation of your Instalment Policy.

This part applies to Retail Insurance products only.

42. We will take reasonable steps to make sure that our communications are in plain language.
43. We will have a publicly available policy on our approach to the development and distribution of our products for appropriate target markets. This policy will be published on our website.

Pressure Selling

44. Pressure Selling of our products is prohibited. We will make this clear to our Employees and Distributors.

Applying for or renewing insurance policies

45. If we are assessing your application for insurance, then we will ask for and rely on information and documents only if they are relevant to our decision
46. Where we identify, or you tell us, about a mistake in your application or in the
    information or documents we have relied on in assessing your application, we will immediately take action to correct it.
47. If we cannot provide you with insurance, we will:
    1. give you our reasons for that decision;
    2. tell you about your right to ask us for the information we relied on when assessing your application — if you ask us for that information, then we will give it to you as set out in part 12 of the Code;
    3. refer you to either the Insurance Council of Australia or the National Insurance Brokers Association of Australia for information about your options for alternative insurance, or approaching another insurer or another broker; and
    4. give you information about our Complaints process if you tell us you are unhappy with our decision.

Sum insured calculators for home building policies

48. When you apply for or renew a home building insurance product, but not a strata insurance product, we will provide you with access to a calculator that is periodically reviewed and updated to enable you to estimate your sum insured.

Automatic renewal

49. If we are offering you an insurance product that can automatically renew, then, at the time of purchase and at each renewal we will:
    1. remind you about the automatic renewal process;
    2. remind you that you can opt-out of that process; and
    3. tell you to check the amount of your sum insured to see if your level of insurance cover is still appropriate for you.

Premium comparison

50. If we offer to renew any of the following products that you bought directly from us:
    1. home building;
    2. home contents;
    3. home building and home contents;
    4. motor vehicle — unless you have a fleet of vehicles or are a business or other organisation;

then, in our renewal notice, we will give you a comparison between this year and last year’s premium and explain to you how it is calculated.

No Claims Discount

51. If your insurance policy has a No Claims Discount, we must tell you how it works. A No Claims Discount is sometimes called a ‘No Claims Bonus’ or a ‘No Claims Entitlement’.

Consumer Credit Insurance

52. We will not sell you a Consumer Credit Insurance product during the deferred sales period.
53. If we, or any intermediary acting on our behalf, offer you Consumer Credit Insurance for credit cards, home loans or personal loans, then we will take reasonable steps to ensure that:
    1. you are given clear information, before the deferred sales period starts, about the cost of the Consumer Credit Insurance, the options for payment, how long it lasts and its key exclusions and limits;
    2. you are informed that purchasing the Consumer Credit Insurance has no bearing on whether your application for a credit card, personal or home loan will be approved; and
    3. c. no binding offer of Consumer Credit Insurance can be made to you until the end of the deferred sales period.
54. The deferred sales period is 4 days, starting on the day after you are informed that your credit card, home loan or personal loan is approved.

This part applies to Retail Insurance products only.

Conduct standards for our Service Suppliers

35. When our Service Suppliers are providing a service to you, they must tell you the service we have authorised them to provide and that they are acting on our behalf.
36. If you make a Complaint to one of our Service Suppliers about either us or their conduct, then the Service Supplier will tell us about the Complaint within 2 Business Days. Your Complaint will be handled under the Code’s Complaints process.
37. Our Service Suppliers must tell us within 2 Business Days about any breach of the Code that they are aware of when acting on our behalf.

Appointing and monitoring Service Suppliers

38. We will have measures in place to ensure that we appoint only suitable Service Suppliers. In particular, when we appoint a Service Supplier, they must:
    1. hold any licence the law requires; and
    2. reasonably satisfy us that they and their employees are qualified by education, training or experience (including but not limited to whether they hold membership with any relevant professional body) to provide the required service competently and to deal with you professionally.
39. All contracts entered into with Service Suppliers after we have adopted the Code, must reflect the relevant standards of the Code.
40. A Service Supplier must first get our approval before subcontracting any services they perform on our behalf.

Dealing with concerns about our Service Suppliers

41. If we are aware that our Service Suppliers’ performance does not meet the relevant standards of the Code, then we will address this — for example, by:
    1. cancelling our contract with the Service Supplier; or
    2. requiring them to go through further training.