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.