A: Yes, if an investigator or employee is appointed to investigate your claim, then within 5 business days, your insurer will tell you that they have been appointed and what their role is.
FAQs
Q: What is a significant breach of the code?
A: A 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 an insurers ability to provide their services; c. the extent to which the breach, or likely breach, indicates that an insurers 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.
Q: Is the Code independently monitored to ensure insurers compliance with it?
A: Yes, the Code is monitored and enforced by the Code Governance Committee. Anyone can report alleged breaches of the Code to the CGC.
Q: Can I report alleged breaches of the Code?
A: Anyone can report alleged breaches of the Code to the Code Governance Committee
Q: Can I access information that the insurer relied on to make certain decisions?
A: Yes. You may access, free of charge, documents and information relied on in assessing your application for insurance cover, handling your claim, or in responding to your complaint. The information that you can access includes: documents and information relied on to deny your claim; copies of the product disclosure statement and insurance certificate; reports relied on from Service Suppliers or External Experts; and copies of any recordings or transcripts of any interactions we had with you that they relied on.
Q: Can an insurer refuse me access to information?
A: Yes, there are circumstances where this could happen however this cannot be done unreasonably and the insurer will tell you the reasons. For example in situations: where the Privacy Act says that the insurer doesn’t have to; when a claim is being investigated and the privacy of others would be impacted.
