Last updated 30 November 2016
The General Insurance Code of Practice (Insurance Code) is an industry agreement adopted by most leading insurers. It is administered by the Financial Ombudsman Service Ltd (FOS), and a failure by the insurer to comply with the Insurance Code may be disclosed by the FOS in its annual report.
Some relevant claims procedure deadlines include:
- notify the insured of required information, appoint loss adjuster and/or provide initial time estimate of claims decision on initial claims receipt (10 business days)
- keep the insured informed of progress (at least every 20 business days)
- respond to the insured’s information requests (10 business days)
- accept or reject the claim once all relevant information in hand (10 business days)
- respond to a complaint (15 business days).
For claims rejections, it is required for the insurer to provide:
- written decision reasons
- information on complaints handling procedures
- copies of service provider reports upon which the rejection was made upon request.
A copy of the Insurance Code is available from the Insurance Council of Australia.
Financial Ombudsman Service Ltd
Most leading insurers are members of FOS, which is not a government ombudsman but an industry dispute resolution scheme controlled by its Operational Guidelines to the Terms of Reference. For more information visit the FOS website.