CTP Insurer Claims Experience and Customer Feedback Comparison - December 2022
Chapters
Chapters
- Insurer comparison
- Why does SIRA publish insurer data
- How many claims did insurers accept?
- Why were claims declined?
- How long did it take to receive treatment and care benefits?
- How quickly have insurers paid income support to customers after motor accidents?
- What happened when customers disagreed with the insurer’s decision?
- Outcomes of determined internal reviews
- Internal review timeframes
- Internal review timeframes by dispute type
- Recovery through work measures
- Complaints
- Enforcement and Prosecutions (E&P)
- Glossary
7. What happened when customers disagreed with the insurer’s decision?
Customers who disagree with the insurer’s decision can ask for a review. The decision will be reconsidered by the insurer’s internal review team, who did not take part in making the original decision. Insurers accepted most applications for internal reviews. However, some applications were declined because:
- the request was submitted late, and the customer did not respond to requests for reasons why it was submitted late, or
- the insurer determined it did not have the jurisdiction to conduct an internal review of that decision.
Customers sometimes also withdraw their application for an internal review.
Internal reviews by insurers and status (%)
Totals 2022 vs 2021
The number of internal review requests received by insurers depends on how many claims they are managing. Insurers with more claims are more likely to receive a greater number of internal reviews.
By measuring internal reviews per 100 claims, SIRA can compare insurers’ performance regardless of their market share. The base for calculating this ratio is the number of open claims at the start of the reporting period, plus all claims lodged during the reporting period.