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Why investigating insurance claims is a fine balance

Claims HandlingInsights & AnalysisTechnical Knowledge

Australia’s Life Insurance Code of Practice 2023 has sought to balance the rights of claimants to privacy and the rights of the insurer to fully investigate and make sure claims are legitimate. Introduced in 2017, the Code has generally been...

calendar icon22 May 2023

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Why investigating insurance claims is a fine balance

Australia’s Life Insurance Code of Practice 2023 has sought to balance the rights of claimants to privacy and the rights of the insurer to fully investigate and make sure claims are legitimate.

Introduced in 2017, the Code has generally been considered a success story for industry self-regulation, but that does not mean the right balance has been struck in every case and insurers can learn from these rare missteps.

Corporate watchdog ASIC called out some insurers last year over their methods in investigating people who had made mental-health claims.

The issue for ASIC was overly zealous surveillance of some claimants, which they said may not have been warranted.

Surveillance now comes in many forms. Insurers don’t necessarily need to have claimants physically observed: they have access to more data than ever before, in addition to historical social media posts.

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