Our World-Class Claims Managment Process
Our claims management process provides our clients with a world-class system to ensure that they can monitor the progress of claims 24 hours a day. This is all achieved through our online system and our 1300 toll free number, allowing you to use the system in a friendly and secure environment.
We have invested heavily in our claims management system, ensuring it exceeds industry best standards. The system provides faster processing of claims and is capable of generating customised reports to suit our client’s needs.
The claims management system has been specifically designed in conjunction with our leading software provider which has over 20 years experience in claim management design and support.
Benefit payments are normally paid on a fortnightly basis; however, payments can be made to suit the individual needs of our members.
Australian Income Protection also offers stand-alone claims management services.
Claims Handling Procedure
On the day the claim is received we will contact the member by phone advising their Case Manager and our claims procedures, we will also post a letter notifying them of this, the letter will also give the member login 24/7 access to our online claims management system and view the current live status of their claims.
Within 5 working days from the receipt of claim, the Case Manager will make one of the following 3 decisions:
- Accept the claim and payment will commence, in accordance with the waiting period and our payment dates.
- Reject the claim and notify the member of our decision and outlining the reason why, we will also give the member their rights to appeal.
- Requiring further information, such as further medical or employer information etc. Requested information we be followed up weekly and the member will be contacted by their Case Manager on a weekly basis, notifying them of their claim status.
Complaints
AIP regards customer satisfaction of the upmost importance. If you are experiencing any problems or difficulties with our products or services we would like you to tell us straight away so we can resolve any issues you are experiencing, which we will respond within 5 working days from the complaint.
If the issue cannot be resolved within 5 days the complaint will be referred to our Internal Disputes Resolution Process. Our Internal Disputes Resolution Process will take the following procedure:
- Confirm your complaint has been received by phone and letter within 24 hours and advise your point of contact.
- we will review your complaint within 15 working days. In the event where we need extra time to assess your complaint we will advise you of the new time frame.
- we will provide you with the reasons for our decision in writing adequately address the issues that were raised in the initial complaint.
If you are not satisfied with our internal disputes resolution we will provide you with access to our External Disputes Resolution Process. This will include providing you with access to Lloyd’s Limited’s Disputes Resolution Process ENTERLINK BROCHURE and the Financial Ombudsman Services ENTER LINK BROCHURE.
Please forward your complaint for us to review and resolved by mail, email, phone or fax. Please include your name and contact details, and nature of the complaint.
AIP Complaints Resolution Services
Attention: Complaints Officer
Mail: PO Box R1196Royal Exchange NSW 1225
Telephone: 02 8252 7900
Fax: 02 9252 6643
Email: complaints@aipi.com.au
Declined Claims Review Process
In the event of AIP declining a claim and you are dissatisfied with our decision, or believe our decision is incorrect, you have the following options.
- Review
You can make a request in writing with attached supporting documentation which will be reviewed by our claims manager; if our decision is unchanged we will refer your claim to the Disputes Claims Group. This group consists of two representatives on your behalf and two from the Australian Income Protection. The group’s role is to review any claim which has been rejected if a member is not satisfied with our decision. (The entire review process will respond within a total of 15 business days in conjunction with General Insurance Code of Practice guidelines) - Lloyd’s Review
Should the internal and group review not satisfactorily resolve your issue, you may request your claim be reviewed by the Lloyd’s General Representative in Australia at Lloyd’s Australia Ltd, Suite 2, Level 21 Angel Place, 123 Pitt Street, Sydney NSW 2000, Australia, phone (02) 9223 1433, fax (02) 9223 1466. The process is described in the attached Lloyd’s IDR brochure ENTER LINK. - Additional Review
Through your Super Fund/Employer/Union/ or other relevant party also have alternative rights of appeal which are not overridden by any other review outlined above.
