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Questions about insurers (general, life, private health)

How do I make a complaint about my insurance company?

Disputes about claims on insurance policies should be in writing to the institution, unless they are of a prudential concern, should be directed to the institution in writing.

If you are unsatisfied with the response or unable to resolve a claim dispute directly with your insurer, you can refer the matter to the Financial Ombudsman Service (FOS). The FOS can be contacted by phone on 1800 367 287 or online at www.fos.org.au.

Complaints about private health insurers can be lodged with the Private Health Insurance Ombudsman (PHIO) by calling 1300 362 072 or email phio.info@ombudsman.gov.au or visit the website at www.privatehealth.gov.au.

How are insurance claims covered under the Financial Claims Scheme?

In the unlikely event that a general insurer fails and cannot meet its financial obligations, such as claim payouts, the Australian Government may activate the Financial Claims Scheme (FCS). Once activated, the Scheme is administered by APRA.

The FCS only applies to insurance policies issued by a general insurer authorised by APRA.

The FCS does not apply to policies issued by life insurance companies or private health insurance companies.

To find out more about the Financial Claims Scheme for general insurers, go to the FCS website: www.fcs.gov.au.

Does APRA regulate the whole insurance industry?

APRA regulates general insurance companies in Australia as well as life insurers, private health insurers and reinsurance companies. APRA also authorises the Australian activities of Lloyd’s syndicates.

The Australian Securities and Investments Commission (ASIC) is responsible for the licensing and regulating of insurance brokers and agents.

Does APRA have a register of Lloyds’ accredited brokers in Australia or the Australian service companies of Lloyd’s syndicates?

No, APRA does not maintain a register of Lloyds’ accredited brokers in Australia or the Australian service companies of Lloyd’s syndicates.

Information about Lloyd’s in Australia: www.lloyds.com/lloyds/offices/australasia/australia or on APRA’s website: www.apra.gov.au/GI/Pages/Lloyds-in-Australia.aspx