This page contains Frequently asked Questions (FAQs) relating to the Financial Claims Scheme for general insurers.
1. Are some insurance policies not covered under the FCS?
Yes. The FCS only covers policies issued by general insurance companies. It does not cover life insurance policies or private health insurance policies.
In addition, there are some insurance products that are excluded from the FCS. These include:
- policies that are required to be held under State or Territory law and are protected separately by arrangements administered by the State or Territory,
- certain policies that relate to liabilities that arose before 1 July 2002,
- reinsurance and retrocession arrangements, and
- a policy that indemnifies (insures) another insurance policy.
If you are unsure whether your insurance policy is covered under the Financial Claims Scheme, you should content your general insurer.
2. How are the amounts payable for each claim determined?
In the unlikely event that a general insurer fails, if the Australian Government activates the FCS, APRA will pay policyholders and certain other claimants the amount they would have been able to claim from the failed insurer for a valid insurance claim that is under $5,000.
If the insurance claim is valid and $5,000 or over, APRA will need to determine whether the policyholder or claimant is eligible under the FCS. If they are eligible, APRA will determine through a claims assessment process the validity of each claim and the amount payable to eligible policyholders and claimants. The amount paid will be the full amount that the policyholder or claimant would have been entitled to under the insurance policy, assuming the claim is valid and the amount claimed is justified.
3. What happens with unexpired insurance premiums?
The FCS does not apply to any unexpired insurance premiums paid to the general insurer before its failure. Policyholders may be entitled to claim some or all of their unexpired premiums in the winding up of the insurer. For example, if an insurer failed part way through a year in which you had already paid your premium, you may be able to claim for the unexpired portion of the premium in the winding up of the insurer, but not through the FCS.
4. How are alternative insurance cover arrangements covered under the FCS?
It is recognised that policyholders whose policies are in force at the time the FCS is activated will need some time to find alternative insurance cover. The FCS will continue to cover policyholders, and certain other claimants, for valid claims for 28 days following the activation of the Scheme for a general insurer. After this time, policyholders will be expected to set up alternative insurance cover.