Named. Sourced. Public.

The record

Nothing on this page is our opinion. Every number below was published by a regulator — AFCA, APRA or ASIC — about a named insurer, and links to the publication it came from. We just put it where you can see it.

complaints to AFCA in 2024–25 — "unacceptably high", AFCA's own CEO
+43%
rise in TPD complaints to AFCA, 2024–25 vs the year before
1 in 3
direct-sold TPD claims declined (31.2%), 12 months to Dec 2025
$23.5m
Federal Court penalty against Cbus for delayed death & TPD claims, Nov 2025

Sources: AFCA 2024–25 Annual Review · APRA Life Insurance Claims & Disputes Statistics, Dec 2025 (published 29 Apr 2026) · ASIC media release 25-286MR. All linked below.

Who declines TPD claims

Total and permanent disablement — the claim you make when you can never work again. Decline rates by insurer, from APRA's own workbook. Same regulator, same 12 months, same claim type.

Policies bought through an adviser

% of finalised TPD claims declined, 12 months to Dec 2025:

ClearView
42.3%
AIA Australia
24.0%
TAL
20.2%
Acenda (MLC)
15.1%
Zurich
14.2%
Resolution Life
12.5%
Industry
17.7%

Cover held through your super fund

% of finalised group-super TPD claims declined, 12 months to Dec 2025:

MetLife
14.2%
Zurich
14.1%
Resolution Life
13.8%
Acenda (MLC)
13.3%
AIA Australia
8.9%
TAL
8.5%
QInsure (ART)
6.4%
Industry
9.8%

Source: APRA Life Insurance Claims and Disputes Statistics, December 2025 (published 29 April 2026) — apra.gov.au. Bars scaled within each chart. Buying TPD direct (no adviser, no super fund) fared worst of all: 31.2% of those claims were declined across the industry.

How long they make you wait

InsurerAvg. months to decide a TPD claim (group super)Avg. months, income protection (group super)
Resolution Life6.9
QInsure (ART)5.71.4
Acenda (MLC)4.92.0
MetLife4.11.6
Zurich4.11.6
AIA Australia3.31.7
TAL3.01.1
Industry3.5

Same APRA publication, 12 months to Dec 2025. Advised individual TPD claims average 7.1 months industry-wide; 12.4% of all TPD claims take over 6 months, 4.4% take over a year.

What a premium dollar buys back

APRA also publishes how many cents in claims are paid per dollar of premium. It depends less on the insurer than on how the policy was sold to you.

TPD cover

99c per dollar through super.
53c per dollar bought direct.

Death cover

75c per dollar through super.
43–44c advised or direct.

The junk end

Accident insurance sold direct: 19c. Consumer credit insurance: 30c. Funeral insurance: 37c.

APRA Life Insurance Claims and Disputes Statistics, Dec 2025, industry-level results — claims paid ratio, 12 months to Dec 2025.

Complaints, by name

Life insurers — AFCA complaints, 2024–25

Insurer2024–252023–24
TAL625502
AIA Australia298300
Zurich188
Resolution Life183281
MLC (Acenda)168

General insurers — AFCA complaints, 2024–25

Insurer2024–252023–24
Suncorp5,3435,883
IAG3,4443,592
Auto & General3,0322,940
Allianz1,6251,736
QBE1,5881,619
RACQ1,075888

AFCA Datacube figures as reported by insuranceNEWS.com.au (10 Nov 2025 and 18 Nov 2024); raw firm-level data at data.afca.org.au. Life-sector complaints rose 5% to 1,518 in 2024–25; denial-of-claim complaints rose 40%. Complaint counts partly reflect size — read them beside the decline rates above.

And when you dispute a decision?

Across 12 months to Dec 2025 there were 2,913 TPD disputes and 3,194 income-protection disputes lodged over group-super cover. Of resolved disputes, insurers recorded the original decision as fully reversed in only 3–4% of cases. MetLife resolved 16 group-super death-benefit disputes in the period — and maintained its original decision in 15 of them. External review exists because internal review rarely changes the answer: take it to AFCA.

APRA, Dec 2025 publication, dispute tables.

On the public record

Court outcomes and regulator actions over claims handling — each line links to the regulator's own media release.

Jun 2026

Super trustees — death benefit "stragglers"

ASIC report 831: trustees still failing to implement basic claims-handling improvements identified a year earlier. ASIC 26-116MR

Nov 2025

Cbus — $23.5m penalty

Federal Court penalty for serious failures processing death and TPD claims; at one point about half its open death claims had been open more than a year. Plus ~$32m remediation to ~7,402 members. ASIC 25-286MR

May 2025

Zurich — infringement notices paid

Paid $37,560 over trauma claims wrongly declined citing exclusions that did not exist in the policies. ASIC 25-077MR

Mar 2025

AustralianSuper — sued over death benefits

ASIC alleges at least 6,897 death benefit claims took between four months and four years to assess. Before the court. ASIC 25-034MR

2025

HCF Life — $750,000 penalty

Federal Court found a pre-existing-condition term liable to mislead; corrective disclosure ordered. ASIC 25-070MR

2024

Insurers "on notice" over complaint blind spots

ASIC review: insurers failed to identify 1 in 6 complaints as complaints, and self-identified only 85 systemic issues from over 1.4 million complaints. ASIC 24-268MR

2023

MLC Life — $10m penalty

Failed to pay rehabilitation benefits to 119 customers, used stale medical definitions, misled customers; ~$11.8m remediation. ASIC 23-128MR

2021

TAL — duty of utmost good faith breached

Federal Court found TAL breached its duty of utmost good faith on an income protection claim — a Royal Commission referral. ASIC 21-042MR

Policies people never asked for

"No health questions." "No medicals." Sold on the phone in minutes — and the paperwork appeared afterwards. This isn't anecdote; it's what the regulator and the Royal Commission found, in their own words.

The training said the quiet part

One direct life insurer's compliance test for new sales staff contemplated the customer being "under the impression they are only receiving paperwork and not setting up a policy".

ASIC REP 587 (2018), case study 29 — the report

"They won't send you the paperwork…"

"…until you start the process of payment" — a surveyed consumer. Four of eight firms refused to send policy documents until you committed and gave payment details; 22% felt they had to agree before seeing the terms.

ASIC REP 587, paras 24, 223–224

Sold in eight minutes

CommInsure telemarketing sales were completed in as little as eight minutes, with sales reps often selecting the level of cover for the customer. Refunds: over $12 million to about 30,000 people, plus 87 hawking convictions.

ASIC 19-314MR (2019)

300,000 admitted breaches

ClearView admitted at the Royal Commission to roughly 300,000 anti-hawking breaches over three years — with Counsel Assisting submitting it misrepresented "whether customers were agreeing to the purchase" at all.

RC closing submissions (2018)

$102 million to unwind it

Customers mis-sold Freedom-brand funeral and life policies by phone — including a man with Down syndrome whose bank details were taken before agreement was ever sought — were remediated over $102m across ~83,600 people.

ASIC 22-223MR (2022)

The channel got banned

ASIC banned cold-call sales of direct life insurance outright from 13 January 2020. Yet by 2025, dispute rates for directly sold life insurance had more than doubled since 2018 — "still notable deficiencies".

ASIC 19-335MR · 25-168MR

If an insurer produces a form you never filled in

It has happened before, and the complainant won: FOS ruled for a man whose mortgage-protection application was submitted electronically without him ever completing it or knowing the policy existed — full premium refund (AFCA's own 2019 submission to ASIC, case study 4). And AFCA's standard questions for these disputes begin: "Did the complainant complete and/or sign a form?" Dispute the document. Ask who created it, when, and from what source. Then take it to AFCA — and share your paperwork here.

Check the sources yourself

Method: figures are drawn from the linked regulator publications for the periods stated; masked or unverifiable figures are omitted rather than estimated. Complaint counts are raw (not adjusted for insurer size). Corrections with a source are welcome and will be published: hello@omxus.com.

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