Recent media reports have revealed allegations of unethical claims handling against one of Australia’s largest insurers, CommInsure, the insurance branch of the Commonwealth Bank.
Unethical handling of claims
The allegations include deliberately altering or removing medical records and using outdated fine print in an attempt to delay or reject paying claims on valid insurance policies. CommInsure has over 4 million policy holders and collects over $2.5 billion in premiums each year.
Inquiry include life insurance industry
The Senate has responded quickly to these reports, announcing that the scope of the current financial services inquiry into scrutiny of financial advice will be extended to include the life insurance industry.
The report alleges that CommInsure has deliberately engaged in deceitful practices, designed to deny claimants their rightful entitlements, presumably in an attempt to enhance profits. Whistleblower and former chief medical officer of CommInsure Dr Benjamin Koh has revealed a toxic culture where he and his staff were instructed to alter medical assessments to delay or deny claims. He further alleges they used an outdated definition for heart attack claims which allowed for more than 50% of legitimate claims to be rejected. One particularly shocking case highlights that the sufferer of a serious heart attack was given only $25,000 despite being insured for $1 million, because he had suffered “the wrong type” of heart attack.
Other practices which are common place include, alleged delay of claims through excessive paperwork, in the hopes that people simply give up on their entitlements, as well as sending a claimant to numerous doctors to try and find an opinion which is favourable to delaying or denying the case.
Total and Permanent Disability claims rejected
Incidents have also emerged showing the insurer rejecting the claims of terminal illness sufferers on the alleged basis that if they received a transplant they may live longer than their original diagnosis. Other complaints include Commonwealth Bank employees being denied total and permanent disability claims on the basis that they are fit to work, despite being forced to retire from the bank.
Unfortunately, such incidents are becoming increasingly common with insurers. The practices used by insurers can victimise some of the most vulnerable in society, those who have little time to live or are unable to work any longer. This can cause significant financial and personal hardship which often pushes people, who are already usually stressed and not working, to their limits. By delaying claims, insurers can simply wear people down until they no longer have the ability to fight for their legal rights. At this point, people will often accept a low settlement offer to simply get some money from their insurer.
Turner Freeman specialise in TPD, superannuation and insurance claims
In situations such as these it is beneficial to have a strong legal team behind you. At Turner Freeman Lawyers we specialise in all types of superannuation, disability and insurance claims. We have assisted many hard-working people to gain access to their lawful entitlements and pride ourselves on our ability to achieve justice for our clients.
We can assist you from the initial lodging of a claim and will fight for your rights until the claim is completed, taking the matter to court if necessary, and we will do so on a ‘No Win, No Fee‘ basis. Our expert knowledge means that we have the skill and ability to navigate through any potential obstacles to the approval of your claim. This will ensure you are able to access your benefits as quickly as possible.
If you believe that you are entitled to any form of superannuation, insurance or disability payment call 13 43 63 to speak with one of our experts or accredited specialists in New South Wales. Our offices are located in Sydney, Parramatta, Campbelltown, Newcastle, Penrith, Wollongong and Gloucester.