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FAQs

Q: What are the guidelines for declaring an Extraordinary Catastrophe?

September 6, 2021 by insuranceca

A: The Code of Practice has a 4 month time frame for claims decisions, unless certain circumstances apply, for example, if a claim arises from an Extraordinary Catastrophe (see paragraph 78 of the Code).

The Insurance Council has developed the following guidance for use by the Board in determining whether an Extraordinary Catastrophe or disaster should be declared.

Relevant circumstances may include:

a. The number and frequency of recent declarations;

b. the impact or likely impact of a declaration on consumers and insurers;

c. the actual or potential financial impact of a declaration on consumers and insurers;

d. the extent to which insurers can or have taken reasonable steps to minimise the impact of the catastrophe or disaster on business operations;

The ability of members to determine claims may be materially affected in the following circumstances:

a. where infrastructure necessary to determine the claim has been damaged or destroyed;

b. where insurers are unable to gain access to an affected area;

c. where a significant increase in the number of claims is being experienced or is anticipated;

d. where it is unsafe for staff required to process claims to attend work premises (i.e. damaged buildings or pandemic);

e. any other circumstances considered to significantly affect the insurers’ claims handling capability as determined by the Board.

The ICA Board may consider the cumulative effect of multiple catastrophes or disasters when determining whether to declare an extraordinary catastrophe or disaster.  A declaration may apply to all Code signatory insurers or a specified insurer(s).  When making a declaration, the Board of the Insurance Council of Australia will provide reasons for its decision in line with the criteria outlined above.

Where an Extraordinary Catastrophe or disaster is declared, an insurer must continue to undertake best endeavours to process claims in timely manner.

Q: What general insurance products are covered by the Code of Practice?

May 4, 2021 by TheoTheoICA

A: The Code covers retail and wholesale insurance products bought by customers and small businesses.

Examples of retail insurance products:

Motor

  • Motor Vehicle Comprehensive
  • Motor Vehicle Third Party Fire and Theft (this does not include Compulsory Third Party – CTP)
  • Motor Vehicle Third Party Property Damage (this does not include Compulsory Third Party – CTP)
  • Motorbike and scooters insurance
  • Caravan & Trailer

Travel Insurance

  • Travel
  • Travel insurance – credit card

Home Insurance

  • Building and Contents (combined)
  • Building
  • Contents
  • Landlord
  • Residential strata
  • Body Corporate

Sickness and accident

  • Personal accident
  • Sickness and accident

Consumer Credit insurance

Personal and domestic property insurance

  • Accidental Damage
  • Caravan/Mobile Homes
  • Extended Warranty
  • Finance Gap
  • Jewellery and Valuables
  • Personal Legal Liability
  • Mobile Phones
  • Motor Equity
  • Moveables/Household Goods in Transit
  • Payment Protection
  • Personal Effects
  • Pet Health
  • Valuables

The Code covers a variety of wholesale products, the below are some common examples:

  • Business Insurance
  • Motor – Commercial and Fleet
  • Lenders Mortgage Insurance
  • Small business / Farm Insurance / Primary Industry
  • Travel – Commercial and Corporate

Q: Can surveillance of me be conducted anywhere?

May 4, 2021 by TheoTheoICA

A: No, surveillance cannot be conducted: inside any court or other judicial facility; in any medical facility; in any bathroom, change room, or lactation room; inside your house; at a business premises (unless it’s open to the public); or where prohibited by law. Before surveillance is authorised, there are obligations insurers must first meet, including considering alternative methods to verify the information.

Q: What’s the maximum length of time for a formal interview?

May 4, 2021 by TheoTheoICA

A: 90 minutes

Q: Will I be told what is involved in the investigation process?

May 4, 2021 by TheoTheoICA

A: Yes, before the investigation has started, you will be told relevant information about the process including; who your primary contact is, their details, role and responsibility; when to expect to hear from the Investigator — and what to do if you do not hear from them within that timeframe. 

Q: Will my investigation be reviewed after a period of time?

May 4, 2021 by TheoTheoICA

A: Yes, if an investigation has gone on for 4 months, the claim will be independently reviewed by an employee with appropriate authority, knowledge and experience. If it’s determined that the investigation should stop, then your claim will be referred for a decision, within 10 business days.

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