ASFA publishes new service standards on claims handling

ASFA has released a new ASFA Service Standard - Claims Handling in Superannuation: Insurance and Health Related Claims, which it said is a significant step forward in improving member outcomes.

ASFA said the new standard was made to guide superannuation funds dealing with superannuation insurance claims, helping to ensure improved service delivery, transparency and security for fund members.

"Superannuation fund members rightly expect that their insurance cover will be there for them when they need it, and this Service Standard will ensure that insurance claims are processed in a timely manner and members are provided with helpful and timely service throughout the claims process," ASFA chief executive Mary Delahunty said.

"It sets out clear commitments by superannuation funds to deliver a considerate and consistent claims experience for the members of the more than nine million superannuation accounts that hold insurance, and makes clear what members can expect from the industry."

The Service Standard is the latest step in lifting outcomes for fund members when making claims, and follows the release of ASFA's Service Standard, Death Benefits Payments in September last year.

This comes after ASIC has called out the superannuation industry on numerous occasions this year around poor claims handling times.

The new ASFA standard applies to insurance claims and certain claims for early release of superannuation benefits due to ill health.

The new standard includes timely and clear communication with members at each stage of a claim, including early engagement and regular updates, and stipulating timeframes for engaging with members throughout the process.

In addition, it points to creating a supportive claims experience that considers the member's full entitlements and manages expectations early in the process; trustee accountability even when third-party providers are involved, ensuring strong governance and consistent member experiences; and strong oversight and reviews where claims are declined, including clear explanation and an efficient path for review.

It also sets out the interoperability and efficiency where both insurer and trustee decisions are required for members to receive a benefit payment.

The service standard takes effect immediately and ASFA encouraged all trustees to adopt the standard as soon as possible, and no later than 1 July 2026.

ASFA said it led detailed collaboration and consultation with the superannuation sector on the new standard, involving funds, insurers, administrators and other industry associations the Super Members Council, the Council of Australian Life Insurers and the Financial Services Council.

Former chair of the Superannuation Complaints Tribunal Jocelyn Furlan chaired the broad working group.

"This Service Standard will improve members' experiences in moments that matter. With strong collaboration across the sector, I'm confident this will make a positive difference to outcomes for members," Furlan said.

Delahunty added: "We know this work is ongoing, and ASFA remains committed to leading the sector's efforts to continually improve claims outcomes for members."

"This is an example of how productive collaboration across the sector leads to good outcomes on behalf all 18 million Australians with superannuation."