Further misconduct has been revealed by the Royal Commission into Misconduct in the Banking, Superannuation and Financial Services Industry.
Commonwealth Bank’s insurance arm has refused to pay out on insurance claims for heart attacks based on the out-dated criterion they use to define ‘severe’ heart attacks. The Royal Commission has heard the CBA’s CommInsure admit to publishing misleading advertising about their cover and to knowing at the time that their definition of heart attack ‘didn’t reflect the universal definition’.
Not limited to heart attacks, CommInsure also refused to pay out for a breast surgery, based on another out-dated definition of ‘radical’ breast surgery which only included mastectomy. Once again, the insurance company’s definition was not found in the publicly available policy documents. In this case, the operation involved a combination of breast-conserving surgery and radiotherapy, which is now commonly used instead of a complete mastectomy. CommInsure had not updated its definition to keep up with medical advancements until 2017, meaning treatments before this year were not covered.
Other companies that have been asked to appear before the Royal Commission in relation to insurance practices include AMP, TAL, REST, Allianz and Youi. What is clear from the findings of the Royal Commission is that misconduct is not limited to any one area in the financial services industry.
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