2020–21 Annual Review

Superannuation complaints

Between 1 July 2020 and 30 June 2021

Complaints received

5,249 complaints received

33% resolved at Registration and Referral stage

Top five superannuation complaints received by product 1
Product Total
Superannuation account 2,717
Total and Permanent Disability 978
Income protection 833
Death benefit 453
Pension 52
Top five superannuation complaints received by issue 2
Issue Total
Delay in claim handling 856
Denial of claim 517
Service quality 517
Account administration error 487
Incorrect fees/costs 419
Complaints closed

6,214 complaints closed 3

Average time to close a complaint 116 days

Stage at which superannuation complaints closed
Stage Total
At Registration 2,052
At Case Management 2,466
At Rules Review 168
Preliminary Assessment 909
Decision 619
Average time taken to close superannuation complaints 4
Time Total
Closed 0–30 days 12%
Closed 31–60 days 22%
Closed 61–180 days 49%
Closed 181–365 days 12%
Closed greater than 365 days 4%

 

AFCA can consider complaints about the following superannuation products:

  • superannuation pensions and annuities
  • corporate, industry and retail super funds
  • some public sector schemes
  • self-managed super funds (handled under our investments and advice jurisdiction)
  • approved deposit funds
  • retirement savings accounts
  • small APRA funds.

The types of issues and problems AFCA resolves include:

  • advice given about a superannuation product
  • fees or costs that were incorrectly charged or calculated
  • misleading or incorrect information – for example, if benefit statements are incorrect
  • information not being provided about a product, including fees or costs
  • decisions a superannuation provider has made, including about an application for insurance held through superannuation
  • decisions about a disability claim, including where the claim involves insurance cover held through the superannuation fund
  • payment of a death benefit
  • an unreasonable delay in paying a benefit
  • if a complainant gave instructions and they weren’t followed
  • transactions that were incorrect or unauthorised.

AFCA received 5,249 superannuation complaints during the 2020–21 financial year, which was around 7% of the total complaints received by AFCA for the year.

This is a 31% decrease in the number of superannuation complaints received during 2019–20, when AFCA received 7,556 super complaints.

Of the super complaints received, 2,717 were about superannuation accounts. These complaints include disputes about the cancellations of insurance policies where a complainant was unaware their policy had been cancelled. There is a range of reasons for this, including the impact of the Protecting Your Super legislation and the Putting Members’ Interests First legislation, and there being insufficient funds in the member’s account to pay premiums.

The second most common super product complained about in 2020–21 was Total and Permanent Disability, with 978 complaints. These complaints are often complex and involve detailed medical records and other sensitive information. In determining these disputes, AFCA often convenes a panel composed of an ombudsman, an industry representative and a consumer representative. AFCA may also seek the expertise of a specialist medical professional to assist in the assessment of competing medical reports.

The most common issues for super complaints in 2020–21 were delays in claim handling (856 complaints). These complaints frequently relate to a lack of communication from the fund. To assist all parties in their understanding of how AFCA resolves these types of disputes, we recently issued an approach document outlining how AFCA will assess complaints that raise delays in claim handling.

AFCA also received 419 superannuation complaints about incorrect fees and costs. AFCA is unable to consider complaints about fees and costs being too high, but we do consider complaints about fees being applied incorrectly, or disclosure about fees and costs being inadequate or misleading.

This year, 6,214 superannuation complaints were closed, including 2,403 received before 1 July 2020.

Of the superannuation complaints closed, 2,052 were closed at Registration and Referral, 2,466 were closed at Case Management, and 619 progressed through to a final Decision.

Superannuation complaints often take longer to resolve than other complaints because of their complexity, and funds and trustees have up to 90 days to resolve the complaint at the Registration and Referral stage, compared to 45 days for most other types of complaints.

Case study

The complainant held total and permanent disability (TPD) cover through their superannuation account. In October 2014, the complainant’s account had insufficient funds to pay the insurance premiums. The relevant insurance policy said that a member’s TPD cover would cease the day after premiums were unpaid for 60 days. The premiums remained unpaid for that period and cover duly ceased.

The complainant sought to make a claim for a TPD benefit, which was declined as the trustee said they did not have cover. The complainant said the trustee did not notify them about the cancellation of their cover. The trustee provided copies of two letters sent to the complainant, one warning that cover would cease if specified steps were not taken to maintain cover, and one saying that cover had ceased. The trustee also provided a member statement sent to the complainant for the year ended 30 June 2016, indicating that there was no insurance on the account. The ombudsman accepted that the trustee had notified the complainant appropriately.

Findings and outcome

The determination affirmed the decisions of the trustee and the insurer not to compensate the complainant. This was because the complainant had not ceased working until after the cessation of her TPD cover, and the trustee had adequately notified the complainant about the cessation of her cover.

Case studies are used to demonstrate AFCA’s approach to an issue and have been simplified for length and clarity.

Case study

The complainant had TPD insurance through their superannuation account. They lodged a TPD claim in November 2015. The insurer declined the claim in September 2016, saying the medical evidence supported the complainant would be able to return to work after back surgery. In July 2017, the complainant had the surgery, but their condition deteriorated. The complainant resubmitted their claim in May 2018, and it was accepted in June 2018.

The complainant sought interest on the insured benefit, saying the claim should have been accepted in February 2016, as sufficient medical evidence had been provided. They also sought payment of legal costs.

Findings and outcome

The determination affirmed the decision of the trustee and the insurer not to pay interest and legal costs. The ombudsman found the medical evidence was not conclusive in 2016, that the complainant met the TPD definition in the policy. Once further medical information was provided in 2018, as well as a full work history for the complainant, the claim was promptly accepted and paid. Further, it was not reasonable for the trustee to pay the complainant’s legal costs given that he was not successful in demonstrating an entitlement to interest.

Case studies are used to demonstrate AFCA’s approach to an issue and have been simplified for length and clarity.

 

One complaint can have multiple products.

One complaint can have multiple issues.

This includes 2,403 complaints received before 1 July 2020, and 3,811 received from 1 July 2020 to 30 June 2021.

Percentages have been rounded and, as a result, do not total to 100%.

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