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Life Insurance Code of Practice

The Life Insurance Code of Practice is a voluntary industry code that sets higher standards than legal minimums for how life insurers should treat customers, handle claims, and conduct business.

Detailed Explanation

The Life Insurance Code of Practice is a self-regulatory code developed by the Financial Services Council that member life insurers commit to follow. The Code, which underwent major revision in 2024, sets standards exceeding legal minimums across key areas: clear communication and product design; fair claims handling with maximum timeframes; support for vulnerable customers including those with mental health conditions or family violence situations; improved dispute resolution; and transparency in policy terms and changes. Key provisions include: insurers must complete initial claim assessments within 12 months (with limited exceptions); they must explain claim decisions in plain language; they cannot discriminate based on genetic testing; they must have specialist support for mental health claims; and they commit to ongoing policy reviews to ensure fairness. The Code is monitored by an independent Code Governance Committee which investigates breaches, issues sanctions, and publishes compliance reports. Breaches can result in requirements to remediate affected customers, public naming, and referral to regulators. Consumers can reference the Code when making complaints, and AFCA considers Code requirements when assessing disputes. While voluntary, all major life insurers are Code subscribers, covering the vast majority of the market.

Common Misconceptions

  • The Code is not law - it's voluntary, but subscribers must comply and breaches can be enforced by the Code Governance Committee and considered by AFCA
  • Not all life insurers subscribe to the Code - check whether your insurer is a subscriber (though most major insurers are)
  • The Code doesn't guarantee claim approval - it sets standards for how claims are handled, not the outcome of assessments

Real-World Examples

  • An insurer took 18 months to assess a TPD claim; the Code Governance Committee found a breach of the 12-month timeframe and required remediation for the delay

  • A mental health-related income protection claim received specialist assessment as required by the Code, resulting in approval after the insurer's initial standard assessment had denied it

  • An insurer was found to have breached the Code by using unclear language in a claim denial letter; they were required to rewrite the decision in plain English and review similar letters

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