🇦🇺Australia

Poor Claim Outcome Decisions

2 verified sources

Definition

Manual processes lead to errors in loss quantum assessment, reducing payouts and agency reputation.

Key Findings

  • Financial Impact: 10-20% reduced claim value per case (AUD 10,000+ on avg. mid-sized claim)
  • Frequency: 15-25% of escalated claims
  • Root Cause: Insufficient data/tools for precedent-based decisions

Why This Matters

The Pitch: Insurance Agencies forfeit AUD 10-20% of claim values due to weak advocacy. Automated tools ensure maximum recoveries.

Affected Stakeholders

Senior Brokers, Claims Directors

Deep Analysis (Premium)

Financial Impact

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Current Workarounds

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Methodology & Sources

Data collected via OSINT from regulatory filings, industry audits, and verified case studies.

Evidence Sources:

Related Business Risks

Delayed Claim Settlements

5-10% annual client churn (AUD 50,000-200,000 per mid-sized agency based on avg. client value)

Claims Processing Delays

20-40 hours per claim (AUD 1,000-2,000 at AUD 50/hr staff cost)

APRA Licensing Application Fees

AUD 110,000 per application for general/life insurance[3]

Application Delays from Incomplete Submissions

4-5 days delay per application, leading to 2-5% lost deals (industry avg revenue impact)[1][2]

Misrepresentation Claim Denials

Full premium refunds + 1-3% revenue from invalidated policies (LOGIC: typical misrepresentation rates)[1][6]

Self-Insurer Licence Application Costs

AUD 40,000 minimum annual contribution + application expenses[5]

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