The Australian Securities & Investments Commission (ASIC) issued two infringement notices totalling AUD 37,560 to Zurich Australia Limited for allegedly making false or misleading statements to two policyholders about their entitlement to trauma insurance benefit payments. In May 2024, Zurich declined the two claims on the basis that the relevant medical conditions were excluded and no benefit was payable. ASIC alleges the statements were false or misleading because the applicable trauma cover terms did not exclude the conditions and the policyholders were entitled to benefits. Zurich identified the errors through a quality assurance review, remediated the customers by paying the benefit entitlements with interest, reported the issue to ASIC, and paid the infringement notices on 8 May 2025; payment is not an admission of liability. ASIC noted insurance claims handling as a 2024 enforcement priority and signalled a 2025 focus on insurers dealing fairly and in good faith with customers, including ensuring claims staff can readily access the correct policy terms for legacy products and policy enhancements.
Australian Securities & Investments Commission 2025-05-16
Australian Securities & Investments Commission issues Zurich AUD 37,560 in infringement notices over misleading trauma claims statements
The Australian Securities & Investments Commission (ASIC) issued two infringement notices totaling AUD 37,560 to Zurich Australia Limited for allegedly making false or misleading statements about trauma insurance benefits. Zurich initially declined claims based on incorrect exclusions, later identified through a quality assurance review. The company remediated affected customers and paid the notices, which is not an admission of liability. ASIC emphasized insurance claims handling as a 2024 enforcement priority and highlighted a 2025 focus on fair dealings by insurers, ensuring claims staff access correct policy terms.