Claims Charter | MHIA Insurance
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Claims Charter

We are committed to handling your claim professionally, fairly, and as quickly as we can.

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Claims Charter

Claims Charter

We are committed to handling your claim professionally, fairly, and as quickly as we can. This charter explains what you can expect from us at every stage, and the timeframes we work to.

This document sets out our commitments to you. We review it regularly and update it when our practices or obligations change.

Our promise on every claim

Whatever the claim, we will:

  • Handle it in a fair, transparent, and timely way.
  • Only ask for, and only rely on, information that is relevant to deciding your claim.
  • Give you access to the information about you that we relied on, and a chance to correct any mistakes.
  • Act immediately to fix any error we identify in handling your claim.

In limited cases — for example, where a claim is being investigated — we may decline to release certain information or reports. We will not do this unreasonably, we will explain our reasons, and you can ask us to review that decision through our complaints process. We will provide our reasons in writing on request.

Supporting vulnerable customers

We recognise that some customers may experience vulnerability due to illness, disability, financial hardship, family violence, bereavement, language barriers, age-related needs or other personal circumstances. If you tell us about circumstances that make dealing with us more difficult, we will work with you to identify reasonable ways to support you throughout the claims process.

Claims handling timeframes

In brief, every claim follows the same journey: you lodge your claim, we confirm what information we need, we assess it (appointing an assessor, adjuster or investigator if required), we make a decision, and we pay the claim or explain our reasons. The timeframes we work to at each stage are set out below.

Straightforward claims

If we have everything we need when you lodge your claim and no further assessment or investigation is required, we will decide to accept or deny it, and tell you our decision, within 10 business days.

Where we need more information

If we need further information, assessment, or investigation, then within 10 business days of receiving your claim we will:

  • Tell you what information we need to make a decision.
  • Appoint a loss assessor or adjuster if one is needed.
  • Give you an initial estimate of how long a decision is likely to take.

From there:

  • If we appoint a loss assessor, adjuster, or investigator, we will tell you within 5 business days of doing so.
  • We will keep you updated on progress at least every 20 business days.
  • We will respond to your routine requests for information within 10 business days.
  • Once we have all the information we need and any required investigation is complete, we will decide to accept or deny your claim and tell you within 10 business days.
  • If these timeframes are not practical — for example, because your claim is complex — we will agree alternative timeframes with you. If we cannot agree, you can use our complaints process.

Home, contents, and motor claims

Unless exceptional circumstances apply, where further information, assessment, or investigation is required on a home building and contents or motor vehicle claim:

  • We will decide to accept or deny your claim within 4 months of receiving it.
  • If we have not made a decision in that time, we will tell you in writing about your right to use our internal complaints process, and to take a complaint about how we have handled your claim to an external dispute resolution scheme if you choose.
  • Where exceptional circumstances apply, we will make our decision within 12 months.
  • Where we engage an external expert whose report we need to assess your claim, we will ask them to provide their final report within 12 weeks. If they do not, we will tell you and keep you updated on progress.

Note: If you ask us whether your policy covers a loss, we will ask whether you would like to lodge a claim, explain that coverage will be fully assessed if you do, and never discourage you from claiming — even if we think the claim is unlikely to be accepted.

If we deny your claim

If we deny your claim, we will:

  • Give you written reasons for our decision.
  • Tell you that you can ask for copies of the information about you that we relied on, and request a review if we decline to release it.
  • Give you information about our complaints process.
  • On request, provide copies of the reports from our service providers and external experts that we relied on (except where the claim is being or has been investigated). We will send copies of external experts’ reports within 10 business days of your request.

Our people and service providers

Our employees and service providers will act honestly, efficiently, fairly, and transparently. They will:

  • Only perform work that matches their expertise, and hold any licence the law requires.
  • Maintain membership of a relevant professional body or sufficient expertise.
  • Tell you what services they have been asked to provide and which insurer they act for.
  • Get our approval before subcontracting their services, and tell us about any complaint they receive while acting for us.

Our employees are trained to handle claims competently and to deal with you professionally. Their training covers the principles of general insurance and relevant consumer protection law, what to do in the event of a claim, product knowledge, understanding your situation (particularly after a catastrophe or disaster), and the requirements of this charter. We keep training records for at least five years and will make them available to AFCA on request. We monitor performance and arrange additional or remedial training where needed.

Where we have selected and directly authorised a repairer, we accept responsibility for the quality of their workmanship and materials, and we handle any complaint about the quality, timeliness, or conduct of the repairer through our complaints process. Complaints relating to our service providers, while they act for us, are handled the same way.

Urgent financial need and hardship

If you show us that you are in urgent financial need of the benefits you are entitled to as a result of the event behind your claim, we will:

  • Fast-track the assessment and decision on your claim.
  • Make an advance payment to help relieve your immediate hardship within 5 business days of you demonstrating that urgent need.

If you are in urgent financial need or experiencing hardship, please contact us at the earliest opportunity so we can put support in place as quickly as possible.

We will tell any financial institution you have told us has an interest in your policy. We and our service providers follow the ACCC and ASIC debt collection guideline for collectors and creditors, which requires us to act fairly and considerately.

If you are having difficulty repaying a debt to us because of illness, unemployment, or another reasonable cause, and you work with us, we will consider:

  • Extending the repayment period and reducing each payment accordingly.
  • Postponing payments for an agreed period.
  • Both extending the period and postponing payments for an agreed period.

If we cannot reach agreement, we will give you information about our complaints process and about Financial Counselling Australia, which can refer you to a free, not-for-profit financial counselling service.

Catastrophes and disasters

When a catastrophe or disaster leads to a large number of claims, we will respond in a fast, professional, practical, and compassionate way. If you have a property claim from a catastrophe or disaster and we finalise it within one month of the event, you can ask us to review it if you think the assessment of your loss was not complete or accurate — even if you have signed a release. You have six months from finalisation to ask for that review, and we will tell you about this entitlement and our complaints process when we finalise your claim. We co-operate with the Insurance Council of Australia under its catastrophe coordination arrangements.

When this charter does not apply

Except when we are responding to disasters and catastrophes, the standards in this charter do not apply if you, or another person who may be entitled to benefits under your policy, have started proceedings about your claim in any court, tribunal, or other dispute handling process. Taking a complaint to AFCA does not affect your rights under this charter.

If you are unhappy

If you are unhappy with a decision or with how we have handled your claim, please tell us. We will explain our complaints process and work with you to resolve it. You can also take your complaint to the Australian Financial Complaints Authority (AFCA) at no cost to you.

We monitor and review all complaints so we can keep improving our claims service and identify emerging customer needs.

Our commitment

When you make a claim, you should feel supported, informed, and treated fairly. We will keep you updated, decide your claim as quickly as we can, explain our decisions clearly, and move fast when you are in urgent need. That is the standard we hold ourselves to on every claim.