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Insurer Claims Performance

What to expect from insurers when making a claim

The greenslips.com.au calculator helps vehicle owners find the cheapest price for all five CTP insurers, AAMI, Allianz, GIO, NRMA Insurance and QBE. State Insurance Regulatory Authority (SIRA) now provides quarterly data on insurer performance to help people make more informed comparisons and know what to expect if they make a claim.

Each report answers these types of questions:

1. What are the chances of having my claim accepted? ›

2. How long will I wait for treatment and care benefits? ›

3. How long will it take to get income support if I take time off work? ›

4. What happens if I disagree with the insurer? ›

5. What happens if get into a dispute about this? ›

6. Can I complain about or compliment insurers? ›

1. What are the chances of having my claim accepted?

The new scheme since 1 December 2017 made benefits available to all injured parties in the first 6 months after a car accident. Benefits includes payments for loss of income, medical and rehabilitation costs.

Most insurers accept over 98% of claims and, if they deny any claims, must explain why. The main reason is currently late claims, by more than 90 days.

Table 1a: Percentage of claims insurers accepted

  2020 2019
  Accepted Accepted
AAMI 98.2% 99.8%
Allianz 98.2% 98.7%
GIO 98.1% 99.9%
NRMA 98.4% 96.1%
QBE 99.2% 99.7%
Total 98.5% 98.4%

Table 1b: Main reason why insurer denied claims

  2020 2019  
  Main reason Main reason  
AAMI Late claim >90 days Late/insufficient information  
Allianz Not a car accident Late claim >90 days  
GIO No injury or not in legislation No injury or not in legislation  
NRMA Late claim >90 days Late claim >90 days  
QBE Late claim >90 days No injury or not in law  
Total Late claim >90 days Late claim >90 days  

2. How long will I wait for treatment and care benefits?

How quickly insurers pay benefits is important for helping injured people make a full recovery after an accident. That is why insurers also pay pre-claim support before someone lodges a formal claim.

Table 2a: Percentage of claimants with pre-claim support

  2020 2019  
  Pre-claim support Pre-claim support  
AAMI 66% 59%  
Allianz 79% 77%  
GIO 67% 60%  
NRMA 78% 77%  
QBE 75% 70%  
Total 75% 71%  

Table 2b: Percentage with benefits in first 4 weeks and after

  2020 2019 2020 2019 2020 2019
  0-4 weeks 0-4 weeks  5-26 weeks 5-26 weeks Over 26 weeks Over 26 weeks
AAMI 28% 30% 5% 9% 1% 2%
Allianz 17% 18% 4% 5% 0 0
GIO 25% 30% 7% 8% 1% 2%
NRMA 16% 18% 5% 5% 1% 0
QBE 20% 23% 4% 6% 1% 1%
Total 20% 22% 4% 6% 1% 1%

3. How long will it take to get income support if I take time off work?

The sooner claimants send required information to the insurer, the faster they can receive income support. The rate of claims paid within the first month improved 11% from 2019 to 2020. 

Table 3a: Percentage of claimants with income support in first 4 weeks

  2020 2019
  0-4 weeks 0-4 weeks
AAMI 52% 39%
Allianz 69% 45%
GIO 48% 43%
NRMA 45% 40%
QBE 44% 35%
Total 51% 40%

Table 3b: Percentage of claimants with income support after first 4 weeks

  2020 2019   2020 2019 2020 2019
  5-13 weeks 5-13 weeks    14-26 weeks 14-26 weeks Over 26 weeks Over 26 weeks
AAMI 41% 47%   6% 13% 1% 1%
Allianz 25% 46%   5% 7% 1% 2%
GIO 43% 47%   7% 8% 2% 2%
NRMA 45% 47%   9% 11% 1% 2%
QBE 44% 49%   9% 13% 3% 2%
Total 40% 47%   7% 10% 3% 1%

4. What happens if I disagree with the insurer?

When customers disagree with the insurer’s decision, they can request a review by the insurer. Types of decisions include minor injury, treatment and care, weekly payments, or who was at fault in the accident. Insurers accept most requests for review, unless they are late, no reasons are given for being late, or the insurer lacked jurisdiction.

Table 4a: Number of insurer reviews per 100,000 green slips

  2020 2019
  Per 100,000 green slips Per 100,000 green slips
AAMI 48 35
Allianz 45 36
GIO 60 39
NRMA 28 28
QBE 30 22
Total 38 30

 Customers who request an insurer review may find the outcome is better, the same or lower than before. While around three quarters stay the same, it depends on the subject under review.

Table 4b: Type of outcome after each insurer review subject

  2020 2019 2020 2019 2020 2019
  Better Better Lower Lower Same Same
Amount of weekly payments 43% 60% 9% 7% 48% 33%
Is injured person mostly at fault? 32% 24% 0 0 68% 76%
Minor injury 12% 13% 0 0 88% 87%
Other 33% 30% 1% 0 66% 70%
Treatment and care 31% 32% 3% 1% 66% 67%
Total 24% 23% 2% 1% 74% 76%

5. What happens if get into a dispute about this?

If claimants are dissatisfied with the result of the insurer review, they can lodge a dispute with SIRA’s Dispute Resolution Services (DRS). The DRS helps clarify the issues in dispute between insurer and customer then arranges for an independent and binding decision.

Table 5a: Number of DRS disputes per 100,000 green slips

  1 Dec 2017 – 31 Mar 2020
  Per 100,000 green slips
AAMI 31
Allianz 34
GIO 36
NRMA 24
QBE 19
Total 27

Customers who lodge a DRS dispute may find the outcome is better, the same or lower than the insurer review decision. While 61% currently stay the same, it depends on the subject under review.

Table 5b: Type of outcome after each DRS dispute subject

  1 Dec 2017 – 31 Mar 2020
  Better Lower Same
Minor injury 31% 0 69%
Treatment and care 44% 0 56%
Is injured person mostly at fault? 71% 1% 28%
Amount of weekly payments 49% 0 51%
Other 46% 1% 49%
Total 38% 1% 61%

6. Can I complain about or compliment insurers?

Customers can complain about or give compliments to insurers. CTP Assist handles non-complex complaints within two working days. SIRA complaints handling experts deal with more complex complaints.

Table 6a: Number of complaints per 100,000 green slips

  Year end 31 March 2020
  Per 100,000 green slips
AAMI 15
Allianz 6
GIO 14
NRMA 14
QBE 12
Total 12

Table 6b: Number of compliments per 100,000 green slips

  Year end 31 March 2020
  Per 100,000 green slips
AAMI 3
Allianz 4
GIO 2
NRMA 3
QBE 2
Total 3

SIRA publishes only types of complaints, not types of compliments.

Table 6c: Top three types of complaint about each insurer

  1st 2nd 3rd
AAMI Decisions Delays Service/managing
Allianz Decisions Service Managing
GIO Decisions Delays Service
NRMA Delays Decisions Service
QBE Delays Service Decisions
Total Delays Decisions Service

 
Sources: State Insurance Regulatory Authority (SIRA) CTP Insurer Claims Experience and Customer Feedback Comparison, March 2020. In these tables, 2020 is 1 April to 31 March 2020 and 2019 is 1 April 2018 to 31 March 2019 unless stated otherwise.

Compliments and complaints data are collected by SIRA and do not include those directed to insurers.

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