Masterclass in

Insurance Claims

 
Registration
Members
$960.00
Professional Subscribers
$1080.00
Starter Subscribers
$1140.00
Non-Members
$1200.00

CPD 2

This event is over multiple days and all sessions will be recorded and can be accessed via your AIST portal if you cannot attend a session live

 

Masterclass in Insurance Claims

This unique and comprehensive course is specifically designed to address the needs of superannuation insurance staff. From disability and TPD claims handling to trustee and insurer responsibilities to interpreting insurance policies and the Insurance Contracts Act, this masterclass covers all you need to know in your role.

 

PART 1 – Disability Claims and Trustee and Insurer Duties

Tuesday 17 May 2022 | 1pm to 3pm (AEST)

In this first session, attendees will become familiar with the broad range of duties that are applicable when responding to disability claims. Failure to be aware of these duties can lead to a breach of duty resulting in filing a report to APRA or ASIC or both, or may even lead to civil liability. In addition to a trustee’s duties, insurer’s duties are covered as these may impact whether the insurer is liable to pay the claim.

This Masterclass covers:

  • Trustee duties under the general law
  • Trustee covenants under the SIS Act
  • Doing 'everything that is reasonable to pursue an insurance claim … if the claim has a reasonable prospect of success'
  • Acting ‘efficiently, honestly and fairly’ under the Corporations Act
  • Potential consequences of a breach of trustee duty
  • Insurer duties, including the duty of utmost good faith
  • Key differences between the trustee and the insurer.

 

PART 2 – Interpreting Insurance Policies and the Insurance Contracts Act

Tuesday 7 June 2022 | 2pm to 4pm (AEST)

Focusing on insurance policies and the Insurance Contracts Act, attendees will become familiar with the principles of interpreting insurance policies and knowing when the Act may assist a member’s claim. As an insurer cannot be expected to interpret its own policy in a way that goes against its interests, being able to interpret policies and the Act is fundamental to acting in members’ best interests when processing claims.

This Masterclass covers:

  • What are we looking for in the policy?
  • Where do we start and where do we go?
  • The onus of proof
  • Key rules of construction
  • Do we need to think about anything else?
  • Sections 13 & 14: The duty of utmost good faith
  • Section 47: Pre-existing sickness or disability
  • Section 54: Insurer may not refuse to pay claim in certain circumstances
  • Section 57: Interest on claims.

 

PART 3 – Key Issues in TPD Claims

Tuesday 19 July 2022 | 1pm to 3pm (AEST)

The final session in this series covers the principles governing TPD claims - a particularly fraught area of insurance claims. As such principles are not conveniently found in one place but are drawn from an extensive and growing number of cases, this session will provide a comprehensive overview of what such principles are and how they should be applied.

This Masterclass covers:

  • Which versions of the trust deed & insurance policy apply?
  • When does the claim become statute-barred?
  • What if the member’s employment is terminated during the qualifying period?
  • What weight can be given to later medical and other material?
  • Procedural fairness
  • Insurer's decision outside the range
  • Insurer's decision process not fair & reasonable
  • Insufficient reasons