The insurance industry operates under a General Insurance Code of Practice directed at standards and consumer protection and other legislation covering the contents of insurance policies and standard cover for some domestic insurance policyholders. Insurance marketing and selling practices have been reformed by financial services legislation.

Contributor

Mark Attard

Partner, Clyde & Co.

Financial hardship

Last updated

1 July 2020

The Insurance Code deals with three situations of policyholder hardship:

  1. Policyholder is in urgent financial need;
  2. Policyholder owes an insurer;
  3. Policyholder is vulnerable

1. Policyholder is in urgent financial need

Where a policyholder has made a claim, is in ‘urgent financial need’, and can demonstrate the urgency of their situation, an insurer will fast-track the assessment and payment of the claim or make an advance payment or both (pt 8 Insurance Code).

2. Policyholder owes an insurer

Where a policyholder or other party is indebted to an insurer (but not in respect of the premium) – for example, a policyholder who is having difficulty paying an excess, or a third party from whom an insurer is seeking to recover money is suffering financial hardship – an insurer will consider providing assistance by modifying the terms of payment, or waiving or discharging the debt (pt 10 Insurance Code).

3. Policyholder is vulnerable

Insurers are committed to taking extra care of vulnerable policyholders. Part 9 of the Insurance Code sets out a range of factors that may give rise to vulnerability, including age, disability, language, family violence, and remote location. Insurers are required to have policies to support vulnerable policyholders.

Insurance CLAIMS AND COVID-19

As a result of the COVID-19 pandemic, there has been a significant increase in insurance claims for travel and business interruptions. Many policyholders have been disappointed by the rejection of their claims by insurers.

The law in relation to such policies is uncertain. In July 2020, the Insurance Council of Australia and the Australian Financial Complaints Authority filed a test case in a superior court in Australia to seek an authoritative decision on the operation of business-interruption policies and how these claims should be managed by insurers. Other test cases are likely to follow.

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