In response to media allegations of unethical behaviour, CommInsure said it has made a raft of changes to its trauma product and claims processes, while also denying it was unresponsive to concerns that were raised within the company.
In a statement issued today, Commonwealth Bank (CBA) has announced that the Board of The Colonial Mutual Life Assurance Society Limited (CommInsure Board) has approved a range of measures to upgrade its product offering.
CBA chief executive Ian Narev said he remains concerned about the customers who were the subject of recent media reports, and welcomed the actions being taken by CommInsure in response to the issues raised.
A Four Corners and Fairfax Media investigation aired allegations by former CommInsure chief medical officer Dr Benjamin Koh, as well as four case studies of policyholders who claim they have been poorly treated by the insurer, with Mr Narev subsequently apologising for the incidents.
Despite this, CBA said that “assertions made in the media that CommInsure was not responsive to internal concerns raised are incorrect”.
“The CommInsure Board commissioned an independent review and other enquiries were made. CommInsure has taken a range of actions, including benchmarking of product features, targeted review of customer claims, governance changes to enhance structural independence and additional training for claims staff, including customer empathy and professional protocols,” the statement said.
As part of a raft of changes, CommInsure says it will accelerate the planned upgrade of its 'heart attack' and 'severe rheumatoid arthritis' definitions in its trauma product.
“This upgrade will be released in a product disclosure statement by the end of March but coverage will be backdated and apply for all claim events from May 2014 onwards. May 2014 was the date of the last relevant product disclosure statement for the Trauma product. CommInsure has also committed to a more regular review of the life insurance offering to ensure definitions reflect evolving medical standards and practices,” the statement said.
CommInsure has also committed to instituting a layer of independence to improve its claim process.
“Where CommInsure’s claims committee recommends a complex claim be declined, it will be referred to an Independent Review Panel. The Panel will consist of the managing director of CommInsure and at least two independent industry experts, who will be announced within the next month. A sub-committee of the CommInsure Board will monitor the outcomes of the Panel,” the statement said.
It will also be reviewing ongoing claims and concerns and will appoint an independent expert to oversee a claim review program focused on declined claims, with particular emphasis on customer advocacy.
CBA's insurance arm said ethical concerns that have been aired in recent media reports will be “independently investigated”.
The chairman of the CommInsure Board, Geoff Austin, said he apologised on behalf of CommInsure to the affected customers. He said the CommInsure Board has met and reviewed current initiatives and agreed to immediately take additional steps to reassure customers of CommInsure's values and the insurer's commitment to them.
“We remain absolutely focused on our customers," Mr Austin said. "The concerns raised in the recent cases reported are not a reflection of the values of our people or our business.
“We expect the highest ethical standards of all our employees and will continue to ensure that the policies and processes within the business support these standards.”
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