During a review of our claims handling processes, we have discovered some calculation errors affecting a small number of Life and Disability insurance claims.
These errors have meant some Members have been underpaid, while others have been overpaid. In some cases, Members have been charged incorrect premiums during their claim period, where the waiver of premium benefit was incorrectly applied.
We are currently improving our claims calculation processes to ensure this does not happen again in the future.
What are you doing to fix the mistake?
We are conducting a review of closed and open claims to identify where errors have occurred. If we find an error and a Member is owed a refund, we will contact them to explain what has happened and how we will correct it.
If we have underpaid a Member, or a Member has paid too much in premium, we will be refunding these Members and paying them compensation for this mistake.
If a Member is still on claim, we may need to amend their weekly benefit amount going forward to ensure it is correct.
Why did it happen and how do I know it won’t happen again?
Due to the complex nature of some of these policies and the benefits that can be claimed, these claims benefits have previously been calculated manually, leading to the risk of human error.
Occasionally, numbers have been mistyped during calculations, payments have been duplicated, or waiver of premium not applied correctly.
To prevent these errors happening in the future, we have created automated claims calculators to remove the risk of human error. We have also increased our oversight of these processes to ensure that if an error is made in the future, it will be picked up and corrected promptly.
What do I need to do?
You do not need to do anything unless we contact you regarding a refund, in which case we may ask you to confirm or provide your bank account details.
If you are not contacted, it means we have reviewed your claim and have not found any errors.
I’m not happy with what you’re proposing. What are my options?
If you have questions about the review process, please contact firstname.lastname@example.org
If you wish to make a complaint about the review, you can find details about how to do this at https://www.mas.co.nz/contact/make-a-complaint/.
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