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Life Insurance Sector to Develop New Mental Health Claims Framework

A significant update is on the horizon for mental health claims within the Australian life insurance sector.

The Council of Australian Life Insurers (CALI) has announced the creation of a new assessment framework.

This move will be developed in collaboration with consumer advocates, medical specialists, and other key stakeholders.

The forthcoming plan aims to establish minimum standards for evaluating claims, ensuring that they are based on consistent and evidence-based criteria.

Furthermore, the framework will aim to clarify the purpose of disability insurance, aligning it with contemporary medical evidence and promoting positive return to work outcomes.

CALI CEO Christine Cupitt emphasized the need for transparency and simplicity in the claims process, responding to feedback from customers and consumer advocates. She highlighted Australia's current mental health crisis, stressing the importance of providing clear guidance on the role of life insurers in supporting affected Australians.

The Council has noted that mental health conditions represent the fastest-growing cause of life insurance claims. While insurers remain committed to aiding Australians with severe conditions that impede their ability to work, Cupitt clarified that life insurers, similar to the National Disability Insurance Scheme and workers' compensation programs, cannot be the solution for every case.

An expert panel will be set up to advise on developing the framework. This panel will comprise medical practitioners, legal specialists, rehabilitation and return-to-work experts, life insurance professionals, and individuals with lived experience of mental health issues. This diversified team aims to ensure the framework is comprehensive and adequately addresses varied perspectives and expertise.

Early next year, a three-month targeted consultation will take place, incorporating input from various stakeholders, including consumer representatives, mental health advocates, superannuation trustees, financial advisors, and medical professionals. This phase of consultation is key to refining the framework to be as inclusive and practical as possible.

In parallel, CALI’s initiative will run alongside the independent review of the Life Insurance Code of Practice, spearheaded by Peter Kell. A consultation paper concerning this review is anticipated shortly. The findings from this review will inform the new framework's development, and CALI will maintain engagement with Kell throughout the process.

Published:Tuesday, 21st Oct 2025
Source: Paige Estritori

The information on this website is general in nature and does not take into account your objectives, financial situation, or needs. Consider seeking personal advice from a licensed adviser before acting on any information.

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