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Insurers told to increase scrutiny on claims investigations

Insurers should more closely oversee external claims investigators following complaints about their behaviour towards customers, the industry’s independent monitor has found.

The General Insurance Code Governance Committee says external investigators are not always given enough guidance when interviewing consumers, including children, and some contracts with services suppliers do not align with the code of practice.

Chairman Lynelle Briggs says the committee hopes the findings will prompt “renewed efforts on the part of code subscribers to ensure good industry practice extends to every customer interaction”.

The Insurance Council of Australia (ICA) earlier this year instigated a review of the latest version of the General Insurance Code of Practice, introduced in 2014.

“ICA has recently discussed the use of claims investigators and outsourced service providers with consumer advocacy groups, and will consider how consumer protections could best be incorporated into the next iteration of the code,” ICA spokesman Campbell Fuller said.

The committee’s “own motion” inquiry makes 30 recommendations after a review involving 27 companies.

The Financial Rights Legal Centre, which last year produced a report on insurance investigations titled Guilty Until Proven Innocent, says the findings vindicate its concerns.

“Enough is enough,” Principal Solicitor Alexandra Kelly said in a statement. “The general insurance industry needs to introduce a comprehensive set of best-practice standards for insurance investigations in the code of practice, to restore trust and confidence in the insurance industry.”

Ms Kelly says the centre regularly hears from consumers who were threatened, bullied and harassed by investigators, subjected to incredibly long interviews, and treated like criminals.

The committee says insurers should ensure external investigators receive training on the code and do not exceed the scope of the investigation without prior consent.

It also calls for better monitoring of interviews and development of best-practice standards that incorporate the report’s recommendations.

“The code itself also contains some gaps,” Ms Briggs said. “We will therefore make further recommendations about gaps in current standards in our submission to ICA’s review.”