Talking to your insurer part 5: Making a complaint

Making a complaint

You have a right to complain about the actions and behaviour of the insurer or anyone involved in their workers compensation matter.

All Insurers have a complaints handling system with 4 escalation steps and levels of review.

Both the State Insurance Regulatory Authority and WIRO expect an injured worker to make an effort to raise their concerns first with their insurer before raising the same complaint with them.

The complaints escalation and handling procedures of the insurers differs between the insurance companies.

Each insurer has a complaints form and phone line:

Allianz: 1300 130 664

customer_experience_feedback@allianz.com.au

GIO: 1800 689 762

www.gio.com.au/contact-us/general-enquiries

Employers Mutual: 02 8251 9000

www.employersmutual.com.au/contact-us/feedback/

QBE: 02 9375 4444

NSWWCcomplaints@qbe.com

CGU: 1800 801 241

customer.feedback@cgu.com.au

Step 1:

Frontline Complaints Resolution (inside the claims team)

General time frame: 2 days for contact 5 days for resolution

Step 1Who handles your complaint?
Level 1Your case manager
Level 2A senior team member
Level 3A technical member

Step 2:

Internal Complaints Resolution (external to the claims team)

General time frame: 2 days for contact 5 days for resolution
Step 2Who handles your complaint?
Level 1A team member
Level 2A service manager
Level 3A specialist

Step 3:

SIRA Complaints Resolution (external to the insurer)

General time frame: 2 days for contact 5 days for resolution

Step 3Who handles your complaint?
Level 1A business manager
Level 2State Insurance Regulatory Authority
Level 3WIRO/Ombudsman/WCC/Other Relevant External Body.

Step 4:

External Complaints Resolution

The response time will be as directed by the external body.

Step4Who handles your complaint?
Level 1WIRO/Ombudsman/WCC/Other Relevant External Body.
Level 2State Insurance Regulatory Authority
Level 3Team Leader/Claims Manager/ Customer Service Specialist/Technical Manager/Compliance Manager