Page 207 - Be Reasonable – Do It My Way , Peter E. Daly AM, My Story

CHAPTER 19 - CONSUMER INTERESTS - THE 1990’S A PERIOD OF MASSIVE CHANGE
We were often challenged as to whether the Code would make a difference.
One of the most encouraging experiences was when George Pooley the former Commissioner of the Insurance and Superannuation Commission was appointed to conduct the first review of the Code in 1998.
Figure 3 George Pooley
George Pooley Recommends changes so IEC can consider more small business disputes
George Pooley noted that: since the code began, the culture of most insurers’ claims department has changed from something close to “how to avoid paying claims” towards “how quickly can claims be paid”.
The requirement to give reasons for rejecting or reducing claims has made it clear to most insurers that claims should not be denied on a “hunch” and proper reasons have to be given. In respect of fraudulent claims, there has to be reasonable grounds for the insurer to have the view that claims may be fraudulent before a
claim can be denied . . .
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