Annual fund-level superannuation statistics – insurance glossary
| Term | Meaning |
|---|---|
| Claim Finalised | Means when the insurer has made a final decision on the claim (e.g. whether to admit or decline the claim) and communicated this decision to the claimant and is not dependent on payment to the insured having been made. Communication by email, text message, facsimile or telephone is deemed to have occurred on the date it was sent. Communication by postal service is deemed to have occurred three business days after it was sent. Where income protection (IP) payments have commenced prior to a final claim decision being made (so-called goodwill payments), the claim should not be classified as finalised. Such a claim should only be classified as finalised once a final claim decision has been made. If that claim decision is to decline the claim, the claim should be recorded as such, regardless of payments already made. |
| Claims Admittance Rate (1 year) | The number of claims admitted as a proportion of claims finalised over a one-year period. |
| Claims Admittance Rate (5 year) | The number of claims admitted as a proportion of claims finalised over a five-year period. |
| Current Level Of Cover | Describes the level of cover the member has at the reporting date. The possible values are: No Cover; Less Cover Than Default; Default Level Of Cover; More Cover Than Default No Underwriting; and More Cover Than Default With Underwriting. |
| Insurance Average Claim Duration Number (Finalised claims) | Means a length of time, in calendar days, between when a claim was received and when the claim was finalised, inclusive of the day the claim was received and the day the claim was finalised. |
| Insurance Claim Paid Amount | The value of claims paid which where an insurance provider has made a payment with respect to a claim made by an RSE licensee. Includes: rehabilitation costs or benefits that minimise claims experience or potential prepayment of insured amounts. |
| Insurance Claim Paid Count | The number of claims paid which measures an insurance provider has made a payment with respect to a claim made by an RSE licensee. Includes: rehabilitation costs or benefits that minimise claims experience or potential prepayment of insured amounts. |
| Insurance Claims Admitted Amount | The value of claims where the insurer has made a final decision to admit the claim. |
| Insurance Claims Admitted Count | The number of claims where the insurer has made a final decision to admit the claim. |
| Insurance Claims Declined Count | Means where a claim is denied with no benefit paid. |
| Insurance Claims Finalised Other Count | Means the insurer has made a final decision on the claim, but it does not meet the definition of admitted or declined. |
| Insurance Claims Received Count | Means the point in time where the first piece of information (not necessarily all information) is received by the insurer to allow it to commence the assessment of a claim. At this stage, the insurer has confirmed there is a policy in force that could potentially cover the indicated claim event and has recorded the existence of a claim. |
| Insurance Claims Withdrawn Count | Means the instance where a received claim is withdrawn and closed before being assessed and finalised. |
| Insurance Cover Aggregate Amount | Means the total level of cover of a particular insurance cover type held by a group of members. In the case of Income Protection Insurance (IP) cover, this would be the annual insured benefit held by a group of members. |
| Insurance Cover Type | Indicates the type of insurance cover being described. Possible insurance cover types are: Life Insurance; Total And Permanent Disability Insurance; Income Protection Insurance; Other Insurance. |
| Insurance Premiums Collected Amount | Means the amount of insurance premium collected from member accounts. |
| Insurance Premiums Paid to Insurer Amount | Means insurance premium paid to the life insurance company for the provision of cover under an insurance policy. |
| Insurance Premiums Rebate Amount | Means the value of insurance premium rebate received from the life insurance company. |
| Insurance Premiums Rebate Paid to Members Amount | Means rebates received from the life insurance company in respect of members’ insurance premiums paid to that insurer. Includes: all rebates regardless of how or to whom the rebate is paid, such as directly to the RSE licensee or an employer sponsor of the RSE, defined benefit RSE or ERF. |
| Insurnace Claims Undetermined Count |
Means a received claim that has not been finalised or withdrawn. |
| Member Accounts Count - End Period | The count of a distinct entry recorded in the register of member accounts (or other equivalent mechanism) at the end of the reporting period. |
| Member Accounts Count - Start Period | The count of a distinct entry recorded in the register of member accounts (or other equivalent mechanism) at the beginning of the reporting period. |
| Members with Default Level Of Cover | Means the amount of cover of a specific insurance cover offered that an individual member would have under an insurance policy included in an insurance cluster as at the reporting date had they made no elections relating to their insurance. This amount may be affected by the member’s age, gender, occupation category or other factors as determined by the RSE licensee in conjunction with the insurer. |
| Members with Less Cover Than Default | Means where, the member has cover as at the reporting date, but they have elected to have less cover than the Default Level Of Cover. |
| Members with More Cover Than Default No Underwriting | Means that, as at the reporting date, the member has more than the Default Level Of Cover and did not require underwriting in order to obtain that cover. |
| Members with More Cover Than Default With Underwriting | Means that, as at the reporting date, the member has more than the Default Level Of Cover and required underwriting in order to obtain that cover. |
| Number of insured members | The sum of member accounts where the current level of cover has been reported as either: Less Cover Than Default Default Level of Cover More Cover Than Default No Underwriting; or More Cover Than Default With No Underwriting |
| Proportion of members with cover | The number of insured members expressed as a percentage of total member accounts. |