I helped expose insurers for denying medical claims. 15 years on, a court has found what they did is illegal

Fri, 16 Jun 2023 22:44:18 +1000

Andrew Pam <xanni [at] glasswings.com.au>

Andrew Pam

"A court judgement handed down last Friday has delivered what years of promises
from Australia’s life insurance industry have not – insurance that pays out on
what it says it will.

I first raised the issue of outdated medical conditions within the insurance
industry almost 15 years ago. Then in 2016, after stepping down as chief
medical officer for CommInsure, then owned by the Commonwealth Bank, I spoke on
Four Corners about the practice of using outdated definitions of conditions
such as heart attacks to refuse payouts.

A random audit conducted of 40 heart attack claims found CommInsure had knocked
back more than half by using a threshold for diagnosing substances in the blood
that was by then out of date.

This then led to two parliamentary inquiries and an investigation by the
Australian Securities and Investments Commission that found that while selling
policies with outdated medical definitions was not against the law, it was “out
of step with community expectations”."

       *** Xanni ***
mailto:xanni@xanadu.net               Andrew Pam
http://xanadu.com.au/                 Chief Scientist, Xanadu
https://glasswings.com.au/            Partner, Glass Wings
https://sericyb.com.au/               Manager, Serious Cybernetics

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