Improving consumer experiences, choice, and outcomes in Australia’s retirement system

However, if the AFCA decision-maker is not satisfied and considers there is some unfairness or unreasonableness then they can take one of the following remedial actions: • Vary the decision • Set aside the decision and substitute their own decision; or • Set aside the decision and send the matter back to the superannuation provider (and insurer) to make a new decision in accordance with AFCA’s dir. [...] The data presented below sets out: • superannuation related complaints volumes across the past three years • detailed breakdown of the complaints within the superannuation product category and the smaller group of complaints from complainants who are in the retirement phase. [...] In reviewing the complaint, AFCA will review whether the insurer's decision and the trustee's decision are fair and reasonable in their operation in relation to the complainant. [...] • comply with the timeframes set out in the Life Insurance Code of Practice, the Insurance in Superannuation Claims Handling Guidance Note from 1 July 2021 and (where applicable and for the period in which it was in effect) the Insurance in Superannuation Voluntary Code of Practice. [...] AFCA determined the insurer’s decision (or failure to make a decision) was unreasonable and set it aside, remitting the claim to the insurer with a direction to approve the TPD claim and pay interest (calculated with reference to s57 of the Improving consumer experiences, choice, and outcomes in Australia’s retirement system Page 21 of 22 Insurance Contracts Act).