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CommInsure appoints independent experts

20 May 2016

CommInsure has today confirmed the appointment of Deloitte Touche Tohmatsu (Deloitte) as the independent expert to oversee the review of past life insurance declined claims.

The objectives of Deloitte are to:

  • Independently select and review a representative sample of declined claims over the last five years to 30 April 2016
  • Form an independent view on whether the declined claims reviewed warrant further action
  • Provide recommendations to the CommInsure Board in regards to any enhancements that could be made to CommInsure’s claims policies and procedures

CommInsure has also commissioned legal firm DLA Piper as an independent expert to investigate ethical concerns that have been aired in recent media reports.

Additional Claims Review Panel member appointed

Dr Robyn Napier has been appointed as a further external member to the Claims Review Panel. Dr Napier is a general practitioner, Chair of MDA National’s Cases (Eastern) Committee and Corporate Social Responsibility Committee, AMA (NSW) Medical Secretary and Medical Director and past AMA Federal Councillor.

Measures established so far to provide further assurances

Greater level of assurance for new claims

Claims Review Panel

The Claims Review Panel (CRP) is a permanent and additional layer of assurance for complex claim assessment and decision making processes moving forward.

Where CommInsure recommends a complex life insurance claim be declined, this will be referred to the Claims Review Panel for additional review and input into the decision making.

On 15 April 2016, CommInsure announced the appointment of three external members to the Claims Review Panel. Today, an additional external member to the Claims Review Panel, Dr Robyn Napier, is also confirmed.

Independent reviews

Independent expert

Deloitte

Deloitte, as an independent expert, will look back over the last five years to 30 April 2016 and gather a representative sample of declined claims to review.

They will assess whether CommInsure has appropriately declined past claims, with a particular emphasis on customer advocacy.

The selection of claims, the claims assessment, the recommendations and the reporting will all be carried out independent of CommInsure, the CommInsure Board and the Commonwealth Bank.

Independent expert

DLA Piper

DLA Piper, as an independent expert, will investigate issues raised in the media during March and April 2016, including policy wording and definitions, claims handling, interaction with medical practitioners, medical file and record keeping and treatment of staff and governance.

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