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Abacus Values
Aug 14, 2016

Australia's heart attack insurance scandal forces rethink in New Zealand


New Zealand banks are reviewing their life insurance policies as a result of a heart attack claims scandal involving Commonwealth Bank of Australia.

Earlier this year Commonwealth Bank of Australia was shamed into changing its definition of what constitutes a serious heart attack after a man died, was resuscitated and still had his claim turned down.

CBA's insurance arm would not pay out because the level of a hormone called Troponin in the man's body had not reached a level required in the policy wording, which led to an apology from chief executive Ian Narev.

But insurance policies sold in New Zealand by ASB, which is owned by Commonwealth Bank of Australia, Westpac and ANZ all have definitions of heart attack including Troponin levels reaching the same level as CBA's policies used to have.

One insurance expert, who reviewed 17 New Zealand insurance policies after the CBA scandal, found seven would have been unlikely to pay out after a heart attack of equivalent severity to the Australian man's.

The kinds of insurance that pay out after heart attack are loan protection insurance, and critical illness cover, both of which people buy to ensure they can continue to pay their bills should they be struck by serious illness.

Naomi Ballantyne from non-bank insurer Partners Life blew the whistle on restrictive heart attack definitions in 2013.

Ballantyne said policies sold by insurance advisers typically contained less restrictive definitions of a major heart attack than those sold by banks, but predicted media coverage would prompt banks to change their heart attack definitions.

In a statement ASB said a review of its policies was underway.

"This review is likely to lead to some definitions for these products, including the heart attack definition, being updated and will be complete within the next two months," ASB said.

Any heart attack claims made until then would be judged against any new heart attack definition it introduced, the bank said.

Westpac said it had been reviewing its insurance definitions and expected to announce "some changes in the near future as a result".

ANZ said: "We're following the issue in Australia closely and will consider potential changes to our policy definitions if this is the best move for our customers."

Insurance expert Russell Hutchinson from Quality Product Research studied which New Zealand policies would have made full, partial or no payout in the Australian man's case.

He found Partners Life and eight other policies would be likely to have made a full payout. ASB, Sovereign and Onepath (owned by ANZ) would be likely to have made a partial payout, and policies including Westpac's would be likely to have made no payout at all.

Hutchinson said it could be hard for the public to understand and compare policies.

"The way other countries have dealt with this varies. In the UK, the Association of British Insurers determined a set of minimum wordings. Insurers are allowed to innovate above the minimum standards, but not go below," he said.

- Stuff

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