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AIA admits to fair dealing breaches - could face $700k fine

Life insurer AIA has admitted to making false and/or misleading representations to customers and could face a fine of up to $700,000 after court proceedings were brought against the company by the Financial Markets Authority (FMA).

Thursday, July 29th 2021, 12:29PM 1 Comment

by Matthew Martin

The case was filed in the High Court in Auckland and alleges three causes of action under the Fair Dealing provisions (Part 2) of the Financial Markets Conduct Act 2013 (the FMC Act).

AIA essentially dobbed itself in to the FMA after being asked to provide information as part of the joint FMA/Reserve Bank of New Zealand conduct and culture review of life insurers in 2018.

AIA has told the FMA that remediation for affected customers has been completed and the FMA will be seeking confirmation of this as part of the process.

AIA has agreed to admit all causes of action and will file a Notice of Admission of the breaches in the High Court.

The matter will now proceed to a penalty hearing before the High Court where the FMA will seek declarations of contravention and that AIA should be ordered to pay a penalty of $700,000.

In a statement, the FMA's head of enforcement Karen Chang says the FMA case is based on three core breaches regarding incorrect and misleading communication to customers holding various life insurance and associated policies - the purported enhancement of policy benefits, charging premiums after the termination of a policy and treating policies as terminated when they should have remained in force, and incorrect inflation adjustments (see below).

In deciding to bring this action, the FMA took into account a number of factors, including AIA’s self-reporting, its remediation efforts, the nature of the alleged misconduct, and the number of affected customers.

The FMA considered the seriousness of the breaches and the length of time it has taken to deal with impacted customers, warranted enforcement action.

The FMA says it is determined to hold such misconduct to account and send a strong message of deterrence to the market.

The FMA case only captures breaches that occurred from April 1, 2014 – when the FMC Act came into force – but some breaches occurred prior to this and continued after the Act came into effect.

“Consumers’ trust in the integrity of their life insurance provider is paramount for the industry to be effective," says Chang.

"This case demonstrates that firms providing critical insurance must ensure they have necessary systems and controls in place to perform their core business and manage their customers’ policies correctly.

“The customers affected by the passback benefits issue will have undergone a traumatic and life-changing event before making a claim.

"AIA’s behaviour exacerbated and prolonged the harm to customers who were already in vulnerable circumstances. They took out insurance to reduce stress and financial impact in a time of significant hardship and uncertainty, but when they needed the cover they had been told they had, it was denied.

"Moreover, AIA would not pay out until much later,” Chang says.

AIA NZ chief executive Nick Stanhope says an internal review found a small number of instances where AIA fell short of its standards and commitment to being as transparent as possible with its customers.

"Since self-disclosing these issues to the FMA, we have worked relentlessly to remediate these complex issues whilst engaging and cooperating with the FMA throughout.

"We have also worked swiftly with the FMA to come to a resolution,” Stanhope says.

“Our remediation process is complete and if a customer was impacted by one of the issues they have already heard from us directly and we have put the issue right.

"As part of this remediation, we have also reviewed our systems and processes to ensure this does not happen again. We always strive to do the right thing by our customers and community, and this situation is no different,” he says.

Charge details:

1. Passback benefits: AIA wrongly told certain customers they were entitled to passback benefits (cover enhancements to an existing policy), without clarifying that the benefits only applied to post-2003 policies.

The information customers received in anniversary letters misrepresented the benefits, and in some cases misled them about their policies.

2. Termination Date issues: (a) Premiums beyond termination: AIA continued to charge premiums when customers had no cover. Letters were sent to certain customers with policies approaching the end of their duration, specifying when cover would cease, but the letters contained the incorrect date.

(b) Cover Cessation: AIA wrongly ceased cover for certain customers while their policies remained in force, which resulted in some customers, whose claims had been accepted, being underpaid on those claims. Customers were informed by cover cessation letters.

3. Inflation Adjustments: AIA applied incorrect inflation adjustments to premiums.

Many AIA customers choose to have their sum-assured adjusted in line with inflation, with premiums increased accordingly. Policy anniversary letters were sent to customers where the inflation adjustment had been incorrectly applied, and, as a consequence, some customers were charged excess premiums.

Tags: AIA court Financial Markets Conduct Act FMA

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Comments from our readers

On 29 July 2021 at 3:00 pm Matron said:
Again the FMA has overstepped the mark by seeking to significantly penalise a life company that displayed integrity by dobbing itself in, and then proactively undergoing remediation of issues that are clearly systems related.

This happens to all insurers at some point or another so I don't know what the FMA is expecting to accomplish here other than throwing its weight around after the fact. They probably need the cash for more tea and muffins.

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