Australia Life Insurance Code of Practice (CALI Life Code)
Section 5: claims handling, investigations and decisions – Australia Life Insurance Code of Practice (CALI Life Code)

Australia Life Insurance Code of Practice (CALI Life Code) 5.12-5.17: Claims information: fresh consent per claim, proportionate requests, limited verification of unrelated history, online information and income claim rules

Each new claim (other than a death claim) starts with the claimant's consent to collect information on finances, work or health, and each use of the consent is notified unless the claimant opts out; a disputed request is reviewed. Requests are made as early as possible and multiple requests minimised. Privacy is respected by asking only what is reasonably needed; the history of the claimed condition may be fully investigated, but application disclosures about unrelated conditions are verified only on explained reasonable grounds that the claimant may ask to have reviewed. Publicly available online information is used only lawfully. For income claims the insurer may need regular medical and financial information but does not seek doctor statements more often than reasonably necessary or solely to release a routine payment, requests financial information only to assess entitlement or amount, and may ask the doctor every six months even for stable conditions.

Maintained by Gerard Blokdyk

Other controls in Section 5: claims handling, investigations and decisions – Australia Life Insurance Code of Practice (CALI Life Code)

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The graph holds this control, the 0 it maps to, and the evidence behind each claim, over MCP and REST.