Insurance
Rejected TPD claims deemed fair

An independent review of 141 rejected TPD claims has cleared BT Financial Group of any wrongdoing.

The review, conducted by an independent law firm with oversight from EY, confirmed that none of the 141 Total and Permanent Disability claims made over a three year period had been incorrectly denied.

The review stated that outcomes were based on evidence, transparent and with no material or systemic issues identified. It also said that BTFG "adopted reasonable positions having regard to all of the available evidence open to it and the declines were appropriate."

However, the review did suggest that BTFG could have exercised greater discretion in regards to one particular case due to medical complexity and case background, resulting in a reassessment by BTFG and the claim being paid in full with interest.

BTFG general manager insurance, Sue Houghton, said: "We are committed to ensuring our claims practices are fair and we are pleased that two independent organisations have confirmed the right claims decisions are being made."

BTFG has implemented additional processes when reviewing TPD claims, including a third layer of internal review for all denials prior to claimants being notified.

EY said the findings of the review were consistent with an earlier review undertaken by the consultancy firm in August 2016 which found BTFG's assessment of claims to be of a very high standard, demonstrating "a broad minded, objective and good faith approach."

Houghton said BTFG believes the review highlights the need for standardised reporting and greater transparency to enable customers to make meaningful comparisons.

"We have been open about our claims data, this review and the outcome. We strongly believe the same level of transparency is needed across the industry so consumers are not misled by confusing and misleading headlines," Houghton said.

"All insurers need to report claims outcomes using common definitions and data to help restore consumer confidence in an essential financial product for many Australians."

BTFG was under the microscope in October last year for its denial of 37% of all TPD claims received in 2015. At the time chief executive Brad Cooper defended the rejection rate, saying it was "not comparable" with other insurers.

BTFG has notified ASIC of the review findings.

Read more: BTFGBT Financial Group ofAustraliansBrad CooperSue Houghton
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