LMI - Experts in general insurance. That's our claim! LMI ClaimsComparison
have relied upon a range of data to rate the claims service of each of
the listed Australian Insurers by policy class. On this site we rate
the claims services of Insurers by product class. These products are
grouped into two broad categories, Category 1 and Category 2.
Different methodology is used to determine the published claims star rating for Category 1 and Category 2 Products.
We set out the criteria used to rate products in each class below.
How We Rate - Category 1 Products
The following classes of general insurance are included in this category: Domestic Building & Contents, Private Motor, Personal Travel, Residential Strata, Caravan, Pet and Pleasure Craft Insurance. We rate the claims service by product class separately as different claims teams are often responsible for different classes of insurance, but this is not necessarily the case for all insurance companies. Our comparisons may not include every Insurer that underwrites a particular policy in the class.
The rating is based on both quantitative and subjective data, as well as policy features that are
deemed by we at LMI ClaimsComparison as important to a positive claims experience with the weighting
of each criteria we have used set out in Table 1 below.
The product features we have used are the ability of the customer to choose their own repairer and a repair guarantee. Both of these features only apply to private motor insurance. The only other claims feature that applies to all claims is the contact hours for the relevant claims department. LMI ClaimsComparison is otherwise not a comparison of the features and benefits of a general insurance policy, but rather of the claims service provided in support of the policy. The following Table provides an overview of the factors influencing the rating of the claims service for each class of insurance.
Table 1: Weighting Per Category
|Ranked - Chances of Dispute Coming to FOS (Disputes per 100,000)
|Ranked Average Length in Resolution (Months)
|Ranked Resolution by Agreement & Other
|Ranked Resolution In Favour of Applicant
|Claim Contact Hours
|Choice of Repairer
Notes to Table 1:
The source of the data is the Financial Ombudsmen Service.
The Financial Ombudsmen Service (“FOS”) gather data each year and publish their results for each financial year in an Annual Report. The Annual Report follows the reporting requirements for external
dispute resolution schemes set out in ASIC Regulatory Guide 139. The review is available in hard copy and on the FOS
website at www.fos.org.au/annualreview.
Claims Comparison endeavour to update their tables using the newly published data shortly after publication. The date that an LMI ClaimsComparison was last updated is shown at the foot of each comparison.
The data taken from FOS is not necessarily collected with LMI ClaimsComparison in mind. It is nonetheless considered a reasonable foundation as it is based on the number of disputes per 100,000 policies and standardizes the probability across Insurers, regardless of their size. LMI ClaimsComparison stress that there is room for a possible distortion where an Insurer(s) may have a disproportionate number of claims as a result of a natural disaster in an area where they have a large market share compared to another Insurer that has few or no customers in that geographical area. The frequency of this situation is considered low and short term by LMI ClaimsComparison.
Where an Insurer has multiple brands, but report disputes to the Financial Ombudsmen Service under the one Australian Financial Licence entity, LMI ClaimsComparison applies the same rating across all brands for that proportion of the overall Star Rating allocated to the FOS data.
This is number of disputes per 100,000 policies and standardizes the probability across Insurers, regardless of their size.
Average length of time to resolve a dispute in months. This criteria accounts for a maximum of 5% of the overall rating.
It is appreciated that the length of time for a dispute to be resolved is not necessarily in the hands of the Insurer alone.
However, as the issue is universal to all Insurers it is still considered a criteria that should be taken into account but is treated
as having a low influencing factor.
Ranked Resolution by Agreement & Other. It is considered good customer practice to attempt to resolve disputes amicably through mediation rather than requiring a judgment. It is expected and accepted that commercial considerations will be taken into account by an Insurer. Examples may include but are limited to the length of time a customer has been with the Insurer and the amount of insurance placed with the Insurer.
Ranked Resolution In Favour of Applicant. These are claims that have failed at mediation, and negative weighting is allocated where an Insurer has been found to have not paid a claim in accordance with their policy terms and conditions. Any award, including a part payment award made by the Ombudsmen is regarded by FOS as having been found in favour of the Applicant.
Claim Contact Hours. Loss or damage is potentially a stressful time for a policyholder. The ability to contact an Insurer and report a loss and where appropriate seek advice to mitigate the loss is considered important by LMI ClaimsComparison and therefore included in the rating. The contact hours are recorded from two sources: the policy document for the particular class of insurance and the Insurers website. The numbers and times are checked for accuracy quarterly. Typically there are three levels of contact i.e. Business hours only, extended business hours to cover Australian time zones and 24/7.
While LMI ClaimsComparison display the telephone number for convenience, you should also cross check the Insurers’ website, your insurance broker/adviser and/or your policy.
Choice of Repairer/Repairer Guarantee: These criteria are only applicable to private motor and are considered important enough to be included in the LMI ClaimsComparison rating.
Survey. A quarterly survey of: insurance brokers; service providers to the insurance industry such as builders, household items and jewellers, investigators, loss adjusters; and the like; and individuals who have sought to take part and/or selected the “Have Your Say” button on this site, is carried out. The methodology for the survey is detailed in the Section below.
The factors for rating for all classes of insurance will be a) speed of service, b) accuracy of service and c) fairness in settlement. Please note that general insurance brokers, repairers and others included in the survey may receive benefits or have a financial relationship with the Insurers that they are rating.
How We Rate - Category 2 Products
All other classes of general insurance not listed as Category 1 and where the survey is the only source of data for the Product’s star rating.
The star rating has been calculated following a regular survey commencing from the 3rd quarter of 2014, along with responses left on the site under the heading “Have Your Say” with equal weighting given to four (4) categories that respondents are asked to consider when completing the survey/questionnaire.
Respondents were asked to consider the following:
Speed relates to the response of the Insurer in respect of:
- Initial acknowledgement
- Acceptance or denial of the claim
- Action on receipt of assessment
- Progress payments (if applicable)
- Final payment
- of loss adjuster (if appointed), did they check on you/the client or
- of the claims department, was it necessary for you/someone to keep chasing them?
Were the circumstances giving rise to the claim correctly identified by the loss adjuster, investigator, Insurer, engineer and/or other consultants appointed by the Insurer?
Were the policy's Terms & Conditions correctly interpreted in your view?
Was their entitlement explained to the respondent?
Was the respondent refused assistance that they felt the policy provided or the Insurer ought to have supplied?
Was the original settlement offer fair and reasonable?
There are five Measurements to grade each of the four (4) criteria:
Please note: To avoid any potential conflict of interest or allegation of bias, LMI directors and employees are not permitted to participate in any survey which could affect the star rating of any Insurer listed on this site.
How Often We Rate
As can be seen a large proportion of the criteria used to develop the LMI ClaimsComparison Ratings are derived from the FOS Annual Report. It is our experience however that claims service can change quickly either for the better or worse. To track changes as they occur, a regular survey of insurance brokers, repairers, consultants to the claims function and LMI Claims Division staff will be undertaken and the results will be used to update the Star ratings. As previously mentioned the date of the current rating will be shown on the results page for the particular class of insurance.