Insurers have improved their oversight of external experts after an inquiry last year highlighted shortcomings, the industry code governance committee says.

Participants reviewed now prohibit external experts from recommending whether a claim should be accepted or denied and all have made other changes, according to a follow-up report.

Insurers have introduced templates and training to ensure experts provide factual evidence within their specialty areas only; seven have refreshed onboarding programs for external experts; five have introduced formal knowledge checks; and all have strengthened quality assurance processes and monitoring systems.

Code committee chair Veronique Ingram says the changes will help improve confidence in the industry’s use of external experts in claims assessments.  

“The improvements reflect a recognition that there needed to be a shift in the way the industry worked with its experts,” she said. “We now expect to see better-quality decisions and better outcomes for customers.”  

The follow-up report – which included six participants from the original inquiry and two additional insurers – found areas for improvement remain. 

Most companies were still unable to demonstrate how they will evaluate the effectiveness of reforms or measure their success.

“Establishing measurable indicators and evaluation cycles is critical to ensuring that current change initiatives deliver sustained improvements in claims quality and customer outcomes,” the report says.

The committee will continue monitoring implementation over the next year to ensure progress remains on track and actions will deliver lasting benefits.  

“If we find insufficient progress, and continue to see poor consumer outcomes, we will consider action, including potential sanctions for serious and systemic non-compliance with the code,” the report says.