Document ID: chunk:federal_register_of_legislation:F2018L01496:body:0:p23
Version: federal_register_of_legislation:F2018L01496
Segment Type: other
Provision Reference: 
Character Range: 59874–62953

allocating the number of claims into the following 'claims duration categories':
(a)          0 to 2 weeks
(b)          >2 weeks to 2 months
(c)          >2 months to 6 months
(d)          >6 months to 12 months
(e)          >12 months to 24 months
(f)           >24 months to 36 months
(g)          >36 months
70.         The Claims Processing Duration detail set out in paragraphs 68 and 69 should also be provided in respect of the Claim Sum Insured, as defined in paragraph 50.
71.         The Claims Processing Duration detail set out in 68 to 70 should be provided for each combination of the following data dimensions:
(a)          Insurance Type;
(b)          Advice Type; and
(c)          Cover/Product Type.
72.         Premium refunds in paragraph 59 should be treated in the following ways:
(a)          Where premiums collected after a Claim Event are refunded due to a purely administrative process, it should be excluded from this reporting form.
(b)          Where a premium refund is made following the cancellation of a contract or Policy Benefit (for example, in the event of innocent non-disclosure), it should be reported in the 'All other ex-gratia payments, settlements or premium refunds' category.
(c)          Where a premium refund is a contractual benefit or made on an ex-gratia basis (for example when death occurs as a result of sickness, but cover is for Accidental Death only), it should be reported in the 'All other ex-gratia payments, settlements or premium refunds' category.
    Premium waiver benefits should be treated like any other Ancillary Benefit.
73.         Claims that are re-opened after previously being finalised are excluded from the main collection. Where such claims are re-opened and subsequently finalised in the Reporting Period, the relevant detail should be included in the SUPPLEMENT_REOPENED sheet. Claims should be split across the following dimensions:
(a)          Insurance Type;
(b)          Cover Type;
(c)          Original claims decision (in accordance with the categories set out in paragraph 59);
(d)          Updated claims decision (in accordance with the categories set out in paragraph 59); and
(e)          Reasons for re-opened claims that are subsequently finalised:
(i)            'Additional information received'. These are instances where the claim has been re-opened after receiving additional information that could potentially overturn the original decision.
(ii)         'Review requested / dispute lodged'. These are instances where the claim has been re-opened because the policyholder, their authorised representative or the superannuation fund trustee has requested a review of the original claims decision, or has lodged a dispute.
(iii)       'Other'. Any claim re-open reasons not covered by one of the preceding categories, including administrative errors.
74.         Additional CCI claims detail should be recorded in the SUPPLEMENT_CCI sheet of the reporting form. The detail provided should be consistent with what has been reported in the main collection, but providing a further