The General Insurance Code Governance Committee (CGC) has highlighted improvements in how insurers oversee and engage external experts, with better measures to strengthen accountability and quality assurance.
A report released today reveals how the CGC’s recommendations from its August 2024 inquiry into oversight of external experts have led to changes in the way insurers use experts in assessing claims.
The CGC expects the changes to improve transparency and consistency, setting higher standards for fairness in how customer claims are assessed.
Chair of the CGC, Veronique Ingram, was pleased to see action in response to the Committee’s inquiries into industry use of external experts.
“It is encouraging to see insurers strengthen their controls and set clearer expectations for external experts,” Ms Ingram said.
“These improvements will support more consistent decisions and timely and fair outcomes for customers. They show a positive commitment to lifting practices.”
The report shows that all eight insurers reviewed now prohibit external experts from recommending whether a claim should be accepted or denied. Insurers have also introduced new templates and training programs to ensure experts only provide factual evidence within their area of expertise.
Industry-wide improvements in training and oversight
The CGC’s findings show that insurers have made important changes to their training, evaluation, and quality assurance frameworks.
Seven insurers have refreshed onboarding programs for external experts, five have introduced formal knowledge checks, and all have strengthened quality assurance processes and monitoring systems.
Ms Ingram said these reforms will help improve confidence in the industry’s use of external experts in claims assessment.
“The improvements reflect a recognition that there needed to be a shift in the way the industry worked with its experts,” she said.
“We now expect to see better quality decisions and better outcomes for customers.”
Continued momentum and monitoring
The CGC will continue to monitor insurers’ implementation of improvements over the next 12 months to ensure progress remains on track and they deliver lasting benefits.
“Our role is about identifying problems as well as ensuring lasting change,” Ms Ingram said.
“The progress we’re seeing shows the Code in action. It is working to lift standards across the industry and drive a fairer outcomes for customers.”
Read Oversight of external experts: follow-up.
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The General Insurance Code Governance Committee is an independent body that monitors and enforces insurers’ compliance with the Code of Practice.
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