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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 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 98% of claims and, if they deny any claims, must explain why.

Table 1a: Percentage of claims insurers accepted

  Accepted
AAMI 98.7%
Allianz 98.6%
GIO 98.9%
NRMA 96.7%
QBE 99.2%
Total 98.2%

Table 1b: Main reason why insurer denied claims

  Main reason
AAMI Insufficient information
Allianz Not a car accident
GIO Insufficient information
NRMA Late claim >90 days
QBE Late claim >90 days
Total 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 makes a formal claim.

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

  Pre-claim support
AAMI 61%
Allianz 79%
GIO 61%
NRMA 77%
QBE 72%
Total 72%

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

  0-4 weeks  5-26
weeks
Over 26 weeks
AAMI 29% 8% 2%
Allianz 16% 4% 1%
GIO 29% 8% 2%
NRMA 17% 5% 1%
QBE 21% 6% 1%
Total 21% 6% 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.

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

  0-4 weeks
AAMI 39%
Allianz 49%
GIO 41%
NRMA 39%
QBE 35%
Total 41%

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

  5-13 weeks  14-26 weeks Over 26 weeks
AAMI 46% 12% 3%
Allianz 40% 7% 4%
GIO 47% 9% 3%
NRMA 46% 11% 4%
QBE 47% 13% 5%
Total 45% 10% 4%

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

  30 Sept 2019
  Per 100,000 green slips
AAMI 57
Allianz 47
GIO 55
NRMA 37
QBE 29
Total 41

 Customers who request an insurer review may find the outcome is better, the same or lower than before. While 74% stay the same, it depends on the subject under review.

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

  Better Lower Same
Amount of weekly payments 55% 8% 37%
Is injured person mostly at fault? 21% 0 79%
Treatment and care 36% 1% 63%
Minor injury 14% 0 86%
Other 34% 0 66%
Total 25% 1% 74%

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

  30 Sept 2019
  Per 100,000 green slips
AAMI 26
Allianz 28
GIO 27
NRMA 20
QBE 14
Total 22

Customers who lodge a DRS dispute may find the outcome is better, the same or lower than the insurer review decision. While 64% stay the same, it depends on the subject under review.

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

  Better Lower Same
Amount of weekly payments 43% 0 57%
Is injured person mostly at fault? 71% 1% 28%
Treatment and care 43% 2% 55%
Minor injury 29% 0 71%
Other 35% 2% 57%
Total 34% 1% 64%

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

  30 Sept 2019
  Per 100,000 green slips
AAMI 11
Allianz 5
GIO 11
NRMA 14
QBE 9
Total 11

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

  30 Sept 2019
  Per 100,000 green slips
AAMI 2
Allianz 2
GIO 2
NRMA 3
QBE 1
Total 2

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

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

  1st 2nd 3rd
AAMI Decision/service Delays Policy buying
Allianz Decision Service/delays Claims managing
GIO Decision Delays Service
NRMA Delays Decision Service
QBE Delays Service Decision
Total Decision Delays Service

 
Sources: State Insurance Regulatory Authority (SIRA) CTP Insurer Claims Experience and Customer Feedback Comparison, 1 Dec 2017 to 30 Sept 2019. Compliments and complaints data are collected by SIRA and do not include those directed to insurers.

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