FOS General Insurance Open Forum – Key Takeaways

Belinda_RandallThe Financial Ombudsman Service Australia (FOS) has made significant changes to its dispute resolution process, which FOS claims has resulted in improved performance and resolution of claims. The changes, introduced 1 July 2015, have received positive feedback from applicants and FOS members.

A General Insurance Open Forum was held by FOS on 16 March 2016. Michael Ridgway of FOS, Executive General Manager (Assessment & Resolution), outlined how the new changes were progressing.

There are three stages of the FOS dispute resolution process: Registration and Referral, Case Management, and Decision. Part of the new processes introduced last year included a re-organisation of the case management phase into Fast Track, Standard, or Complex disputes. Fast Track chiefly will cover all claims under $10,000, unless more difficult issues such as fraud or non-disclosure arise. These difficult claims will be dealt with in either the Standard or Complex stream, along with more valuable disputes allocated on a case-by-case basis.

FOS reported that the changes have resulted in a 35% decrease in open disputes between February 2015 and February 2016. The age profile of disputes has also decreased, dropping from 106 days in February 2015 to 75 days in February 2016. Feedback provided to FOS indicates that the industry and applicants have responded positively to the changes and FOS reports show speedier resolution of disputes, as well as better interactions with FOS staff.

Some challenges have arisen, including more claims progressing to the second case management phase, due (according to FOS) to insurers failing to notify FOS when claims are resolved early through internal dispute resolution, or when the shorter time frames cut off negotiations.

FOS is continuing to closely monitor the changes.

This blog was authored by DLA Piper graduate solicitor Grace Duncan.