CBA finds itself innocent of all crimes

Bloody Do-nothing Malcolm and his self-regulation banking balderdash:

Commonwealth Bank of Australia’s under-pressure life insurance arm CommInsure said it has not yet found any evidence of wilful misconduct or wrongfully knocked back claims in any of its internal or independent reviews.

In a submission to a parliamentary inquiry into the $44 billion life insurance sector, CommInsure hit back at a number of claims which have besieged the company over the last year.

An independent review of declined claims over the last five years by Deloitte is currently around 90 per cent complete, and CommInsure said it had not revealed any “systemic issues” regarding inappropriate denials of claims. The company and independent reviewers have “electronically” reviewed more than five million emails and documents, manually reviewed around 200,000 documents and carried out around 80 interviews as part of the process.

Hmm, well, here’s what another “independent” source  (Adele Ferguson and Four Corners) said:

The life insurer has disputed the prognosis of three specialists. Pashalis has accused CommInsure of “tormenting” a dying man who wants the money to plan his daughter’s education and future. He has never met the CommInsure doctors who made this call.

“I was classified as terminal, still am. Yet they declined.”

His case – which CBA finally moved to settle with an offer to Pashalis on the eve of this investigation being published – is part of a pattern of unethical behaviour within CommInsure exposed in a joint investigation by Fairfax Media and Four Corners.

It is behaviour laid bare in explosive internal documents, in numerous case studies and in the powerful testimony of whistleblower Dr Benjamin Koh.

Koh is a highly credentialed physician and was CommInsure’s respected chief medical officer. Appointed with great fanfare in 2013, he departed in disgust just two years later.

Koh agreed to speak about CommInsure’s treatment of its customers’ claims after repeatedly and unsuccessfully trying to speak out as a whistleblower inside the company. “It goes to the fundamental core of ethics of me being a doctor, of me doing the right thing,” he says.

In addition, Fairfax Media and Four Corners have obtained explosive internal documents, which were presented to and verified by Koh, suggesting the repeated use of delay tactics to avoid paying out claims and CommInsure using questionable and outdated medical definitions to deny customers their due.

There are allegations of claims managers cherry-picking doctors to get the prognoses they seek, and doctors being asked to change their opinions. In some cases, the files of claimants have gone missing.

It is systemic conduct that sick and suffering CommInsure customers say has added to their trauma; conduct that has broken trust with those the company is required to deal with in “utmost good faith”.

CommInsure has more than 4 million policyholders Australia-wide, and it collects $2.5 billion in premiums from them each year. In the past six months, it made a profit of $191 million for its parent company, the Commonwealth Bank, Australia’s biggest bank.

Every year, millions of Australians are funnelled into CommInsure life insurance policies through their industry super funds, as was the case with Pashalis, or through retail or corporate funds administered by Commonwealth-owned Colonial First State.

Others buy CommInsure life insurance, trauma insurance or income protection insurance through financial advisers, often through CBA’s army of financial planners.

It was Koh who, in mid-2014, audited the company’s trauma policy and found that it was using an outdated and discredited method for defining heart attacks. He warned it was an indefensible practice that potentially disadvantaged many customers and had the potential to tarnish the brand.

Now, who to believe…

And they wonder why folks are electing system wreckers.

Comments

  1. So does whats his name from the project care only about faux racism or will he call out the corruption in our banking system and their govt lick spittle lap dogs to his national fan club.
    This is disgusting, more so becasue it was totally expected.
    What a spineless worm turdbot had turned out to be.

    • Jumping jack flash

      In true Thatcheristic style, the private sector, banks included, is set-and-forget self-regulating.
      Government doesn’t need to know or care any more, they just support them 100% to “get their job done”.

      One less essential service they need to provide, one less thing they need to worry about, and I’m sure they made a quick dollar or two when they originally sold it off.

      With one less thing to do each day, they can have a longer lunch, or leave work a bit earlier in the afternoons.

  2. Easily fixed. Elevate the occupational hazard of claim managers and their superiors to that of Alaskan crab fishermen and all the claims will be fairly assessed.

  3. Disgusting. Unfortunately probably normal practice for insurance – ‘loss adjustment’.

    But absolutely needs to be regulated. Where is the Ombudsman?

    Self-regulation is an oxymoron, especially when it comes to finance.

    • Some of those terminal patients are in a unique position to send a message that it is not ok to deprive someone of their dignity.

  4. I can personally list a few for them but it is too long ago to do anything about. I’m sure they’ve changed in the meantime!!!!!!

  5. reusachtigeMEMBER

    The right decision. Banks provide the most important service to our nation and that is loans for property investment. If anyone should be above the law it is them, full stop!

  6. FYI, don’t rely on group schemes for protection cover unless you have no choice (existing health issues or very high risk occupation). There are way too many loopholes, including the fact that the terms can change.

    Funding cover only through Super means you have the Super complaints tribunal as ombudsman. Self regulated…

    If you instead fund cover outside Super or have a split arrangement, you can go to FOS instead and not be subject to self regulation. Also having a direct policy between you and the insurer means you have much better leverage if persuing legal recourse.

    Making sure you have cover with good quality definitions if key. Any automatic or group policies tend to have very poor definitions that you won’t necessarily realise until time of claim (too late).

    One policy is not equal to another. It is fairly messy.

  7. I was involved in addressing enforceable undertaking on comminsure some few years back. 98m spent to address poor governance and systems. Culture …. Probably the most toxic culture I have ever had to endure. Every day was hell.