Insights from APRA and ASIC's 2025 Life Insurance Claims Report

According to the data, the total number of life insurance claims for regulated funds in 2025 was 117,219, marking a slight decrease of 1.2% from the previous year's figure of 118,605. This marginal decline suggests a relative stability in the volume of claims processed by insurers.

However, a notable concern highlighted in the report is the significant rise in disputed claims. In 2025, there were 11,207 disputed claims, representing a 13.7% increase from 9,851 disputes in 2024. This uptick underscores the need for insurers to address the underlying causes of disputes and enhance their claims management processes.

Disability Income Insurance (DII) and Total and Permanent Disablement (TPD) claims were particularly prominent, accounting for 88% of all disputes. These two categories also constituted 64% of the total claims made in 2025, indicating their substantial impact on the industry's dispute landscape.

The report further reveals that 56% of all claim disputes were related to group insurance within superannuation funds, while 33% involved individuals who had received financial advice. This distribution highlights the importance of clear communication and transparency in both group and individual insurance arrangements.

In response to these findings, APRA and ASIC have emphasized the necessity for life insurers to refine their product designs, improve disclosure practices, and ensure that premium increases are applied in accordance with policy terms and reasonable policyholder expectations. The regulators have acknowledged some progress in these areas but stress that further efforts are required to enhance consumer trust and satisfaction.

For policyholders, these statistics serve as a reminder to thoroughly understand their insurance policies, stay informed about any changes, and actively engage with their insurers to address concerns promptly. As the industry continues to evolve, ongoing collaboration between regulators, insurers, and consumers will be crucial in fostering a more transparent and responsive life insurance market.