Australia General Insurance Code of Practice (2020 Code as updated)
The Insurance Council of Australia's General Insurance Code of Practice (2020 Code as updated): the subscriber's commitment to honest, efficient, fair, transparent and timely dealing, conduct and training standards for employees, distributors and service suppliers, plain language, target market and no-pressure selling, renewal reminders and premium comparisons, refunds and instalment cancellation notices, the claims process with its ten-business-day, twenty-business-day, four-month and twelve-month timeframes, fast-tracking for urgent financial need, expert and investigator appointments, written denial reasons and access to information, catastrophe response and review rights, support for customers experiencing vulnerability including family violence, interpreters and mental health, financial hardship with recovery on hold and twenty-one-day decisions, complaints handling within forty-five days with AFCA, Code Governance Committee monitoring, sanctions and significant breach reporting, and the claims investigation, interview and surveillance standards.
Australia General Insurance Code of Practice (2020 Code as updated) is a compliance framework from Australia with 7 domains and 29 controls. The largest domains are Part 8: making a claim (timeframes, experts, decisions, denials, catastrophes) – Australia General Insurance Code of Practice (2020 Code as updated) (8 controls), Parts 9 and 10: supporting customers experiencing vulnerability and financial hardship – Australia General Insurance Code of Practice (2020 Code as updated) (5 controls), Parts 3, 4 and 5: the overarching obligation, standards for employees and distributors, standards for service suppliers – Australia General Insurance Code of Practice (2020 Code as updated) (4 controls). Every control below carries what it requires and what an assessor expects to see.
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Framework Domains (7)
Part 15: claims investigation standards – Australia General Insurance Code of Practice (2020 Code as updated)
| Code | Title |
|---|---|
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p15-193-204-investigation-conduct-review | Investigate only what needs investigating, respectfully, under a quality assurance programme that reviews recordings, records and complaints and tests fraud indicators yearly; independently review any investigation at four months within thirty days; limit requests and investigator scope; explain the investigation and the customer's rights before it starts; and update every twenty business days |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p15-205-223-interviews | Before and during formal interviews, give the written pre-interview information, contact representatives first, provide interpreters and trained interviewers for additional needs, protect interviewees under eighteen, obtain consent, limit sittings to ninety minutes with breaks and twenty-four hours between sittings, obtain written consent beyond four hours, record all break offers, and give free transcripts and prior-interview records |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p15-224-235-external-investigators-surveillance | Contract external investigators to conduct standards including for vulnerable people, instruct them in writing and control scope changes, train them on vulnerability, keep a licence register, require seven-year contemporaneous records and lawful methods with no inducements or threats, require authority before alleging fraud, and authorise surveillance only after alternatives, a recorded belief of inconsistency and senior review, never in prohibited places |
Part 8: making a claim (timeframes, experts, decisions, denials, catastrophes) – Australia General Insurance Code of Practice (2020 Code as updated)
| Code | Title |
|---|---|
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p8-58-63-claim-start-information | Answer pre-claim coverage questions without discouraging a claim, explain the claims process, excesses, waiting periods and contact points, inform uninsured third parties, explain scopes of works, and correct claim-handling mistakes immediately |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p8-64-66-urgent-financial-need | Fast-track assessment and decision, or advance a payment within five business days, where the event causing the claim left the customer in urgent financial need |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p8-67-71-assessment-timeframes-updates | Ask only for relevant information and say why, within ten business days of the claim state the information needed, appoint any assessor and give the likely timeframe, update progress every twenty business days and answer routine enquiries within ten |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p8-72-75-experts-assessors-investigators | Tell the customer within five business days when an assessor, adjuster or investigator is appointed and what their role is, run investigations under Part 15, require external experts to report within twelve weeks, and engage only experts with appropriate expertise who comply with their professional rules |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p8-76-78-decision-timeframes | Decide the claim within ten business days of having all information and completed enquiries, within four months of receipt overall, or within twelve months where an extraordinary catastrophe, fraud, non-response, communication difficulty or a customer-requested delay applies, telling the customer about complaints if the time is missed |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p8-79-82-cash-settlements-total-loss-denials-information | Explain cash settlements under home building policies, treat total losses sensitively without demanding proof of ownership where it was lost in the event, give written reasons and rights on a denial or partial payment, and supply the information and expert reports relied on within ten business days of request |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p8-83-87-timeframes-alternatives-repairers | Agree alternative timetables where the Code's timeframes are impractical, comply with the timeframes otherwise, stand behind the quality of directly authorised repairers' work and materials, and cover rectification-related hire car or accommodation |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p8-88-90-catastrophes | Respond to catastrophes efficiently, professionally, practically and compassionately, cooperate with the Insurance Council of Australia's catastrophe coordination, and allow a review of property claims finalised within one month of a catastrophe for twelve months |
Parts 11 and 12: complaints and access to information – Australia General Insurance Code of Practice (2020 Code as updated)
| Code | Title |
|---|---|
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p11-139-152-complaints-handling | Publish complaint rights and the external dispute resolution provider, acknowledge complaints, assign an appropriately authorised person other than the decision-maker, rely only on relevant information, update every ten business days, decide within forty-five calendar days with written reasons and AFCA rights, and correct handling mistakes |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p11-153-159-afca-third-party-complaints | Belong to the AFCA scheme, accept its binding decisions, and where complaints handling is outsourced require the third party to notify and handle complaints under the Code with the insurer liable for breaches and monitoring the handling |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p12-160-163-access-to-information | Comply with the Privacy Act, give free access within thirty calendar days to the information relied on in assessing an application, handling a claim or responding to a complaint, including expert reports and recordings, and refuse only on the stated grounds with reasons and complaint rights |
Parts 13 and 14: enforcement, sanctions and compliance, and promoting and reviewing the Code – Australia General Insurance Code of Practice (2020 Code as updated)
| Code | Title |
|---|---|
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p13-164-178-cgc-sanctions | Submit to Code Governance Committee monitoring and enforcement: respond to allegations within ten business days, accept corrective measures, sanctions including compliance audits, corrective advertising, compensation, publication and community benefit payments up to one hundred thousand dollars, and reporting to ASIC |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p13-179-182-compliance-governance-reporting | Report to the board or executive on Code compliance, maintain systems that let the Committee monitor compliance, lodge an annual compliance report, report significant breaches within ten business days, and cooperate with Committee reviews and investigations |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p14-183-192-promote-review-additional-obligations | Promote the Code and the Committee on websites and product information, support ICA education and financial literacy initiatives, comply with additional obligations and binding standards the ICA introduces, and have regard to ICA best practice guides |
Parts 3, 4 and 5: the overarching obligation, standards for employees and distributors, standards for service suppliers – Australia General Insurance Code of Practice (2020 Code as updated)
| Code | Title |
|---|---|
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p3-21-honest-efficient-fair | Be honest, efficient, fair, transparent and timely in all dealings, through employees, distributors and service suppliers |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p4-23-29-employees-distributors-conduct-training | Require appropriate sales conduct, match services to expertise, have distributors disclose their authority, pass on complaints and breaches within two business days, and train and keep training records for seven years |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p4-30-34-monitor-investigate-remedy | Monitor employee and distributor performance, investigate concerns, discipline or retrain, and remedy material harm from poor conduct with a refund, interest, adjusted cover, corrected information or a paid claim |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p5-35-41-service-suppliers | Appoint only licensed and competent service suppliers, bind them to the Code's standards by contract, require them to disclose their role, pass on complaints and breaches within two business days, get approval before subcontracting, and act on poor performance |
Parts 6 and 7: buying insurance and cancelling a policy – Australia General Insurance Code of Practice (2020 Code as updated)
| Code | Title |
|---|---|
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p6-42-47-plain-language-target-market-no-pressure-applications | Communicate in plain language, publish a product design and distribution policy, prohibit pressure selling, rely only on relevant information in applications, correct mistakes immediately, and give reasons and options when cover is refused |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p6-48-54-calculator-renewal-premium-comparison-ncd-cci | Provide a sum insured calculator for home building, remind customers about automatic renewal and opt-out, show last year's premium on direct renewals of home and motor policies, explain no claims discounts, and apply the four-day deferred sales period to consumer credit insurance |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p7-55-57-cancellation-refund-instalments | Refund within fifteen business days on cancellation where a refund is due, and give fourteen days' written notice before cancelling an instalment policy for non-payment, with a second notice before or within fourteen days after cancellation |
Parts 9 and 10: supporting customers experiencing vulnerability and financial hardship – Australia General Insurance Code of Practice (2020 Code as updated)
| Code | Title |
|---|---|
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p10-105-117-hardship-identify-apply | Give customers in financial hardship details of how to apply for support, train staff to identify hardship, request only necessary information, be specific and early about information needed, and allow twenty-one days for the customer to provide it |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p10-118-130-hardship-decisions-arrangements | Put recovery on hold once hardship is identified or support is requested, decide within twenty-one days (or seven days after an information deadline passes), implement arrangements such as deferral, instalments, reduced lump sums or excess deduction, confirm in writing, consider debt release, and give reasons and complaint rights on refusal |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p10-131-138-collection-standards-bankruptcy | Collect money, directly or through agents and solicitors, in line with the ACCC and ASIC debt collection guideline, with trained staff who understand the Code's hardship provisions, first communications that show the amount is fair and reasonable and explain hardship support, and cooperation on bankruptcy |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p9-100-104-identification-interpreters-mental-health | Support customers with identification requirements, provide interpreters where practicable and record their use, train staff and publish language access links, and design processes and products that treat past or current mental health conditions fairly and lawfully |
| australia-general-insurance-code-of-practice-2020-code-as-updated::gicop-p9-91-99-vulnerability-support | Take extra care with customers experiencing vulnerability: publish a family violence policy, train employees to recognise and support vulnerability, and once vulnerability is identified find a sensitive way to proceed, allow for support persons and refer to counsellors or community services |
What is Australia General Insurance Code of Practice (2020 Code as updated) and who does it apply to?
Australia General Insurance Code of Practice (2020 Code as updated) is a compliance framework from Australia with 7 domains and 29 controls. The Insurance Council of Australia's General Insurance Code of Practice (2020 Code as updated): the subscriber's commitment to honest, efficient, fair, transparent and timely dealing, conduct and training standards for employees, distributors and service suppliers, plain language, target market and no-pressure selling, renewal reminders and premium comparisons, refunds and instalment cancellation notices, the claims process with its ten-business-day, twenty-business-day, four-month and twelve-month timeframes, fast-tracking for urgent financial need, expert and investigator appointments, written denial reasons and access to information, catastrophe response and review rights, support for customers experiencing vulnerability including family violence, interpreters and mental health, financial hardship with recovery on hold and twenty-one-day decisions, complaints handling within forty-five days with AFCA, Code Governance Committee monitoring, sanctions and significant breach reporting, and the claims investigation, interview and surveillance standards. It is used by organisations to establish and maintain compliance with industry standards and regulatory requirements.
What does Australia General Insurance Code of Practice (2020 Code as updated) actually require?
Australia General Insurance Code of Practice (2020 Code as updated) has 29 controls organised across 7 domains. The largest domains are Part 8: making a claim (timeframes, experts, decisions, denials, catastrophes) – Australia General Insurance Code of Practice (2020 Code as updated) (8 controls), Parts 9 and 10: supporting customers experiencing vulnerability and financial hardship – Australia General Insurance Code of Practice (2020 Code as updated) (5 controls), Parts 3, 4 and 5: the overarching obligation, standards for employees and distributors, standards for service suppliers – Australia General Insurance Code of Practice (2020 Code as updated) (4 controls). Each control defines specific requirements that organisations must implement to achieve compliance.
If I already comply with another framework, how much of Australia General Insurance Code of Practice (2020 Code as updated) do I already cover?
Australia General Insurance Code of Practice (2020 Code as updated) does not currently have cross-framework mappings in our system. Check back as we continuously expand our mapping database.
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