You might be surprised to know that insurance companies typically pay out on the overwhelming majority of claims made in Australia and New Zealand. However, if you are one of the very small percentage who has an insurance claim rejected each year, or if you are unhappy with the amount your insurer has deemed payable for a claim, it’s important that you know that there is a process in place through which you can make a complaint and seek an alternative resolution.
Here is everything you need to know about that process.
The law and the General Insurance Code of Practice
We recently discussed the various laws governing insurance in Australia (insert article here), as well as the Code of Practice by which all members of the Insurance Council of Australia must abide.
The laws and the Code are especially relevant where disputes and resolutions are concerned, as they lay out some steps and parameters of conduct. The Code is important here because it specifies that insurers must be fair and transparent with their customers — and this is especially pertinent where claims and complaints are concerned.
Meanwhile, the laws surrounding insurance in Australia make it compulsory for insurers to provide customers with an avenue to first make a complaint directly with the insurer (internal dispute resolution) and, then, if customers deem the outcome of the complaints process unsatisfactory, insurers are required to direct customers to an alternative outside avenue (external dispute resolution).
This may sound a bit convoluted, but it’s actually very straightforward when you break the two avenues down, which, as luck would have it, we are about to do