62ZZFEntitlement to payment of claimant under protected policy

62ZZF Entitlement to payment of claimant under protected policy

Who this section covers (1) This section applies to a person if: (a) the person is entitled to claim under insurance cover provided under a protected policy: (i) that a general insurer issued before becoming a declared general insurer; or (ii) in respect of which liability was accepted by a general insurer before becoming a declared general insurer; whether the entitlement to claim arises because the cover is provided to the person under the policy or because the person is otherwise entitled to claim under the cover; and (b) the person makes a claim under that cover, in the approved form (if any), within the period: (i) starting on the day prescribed by the regulations for the purposes of this subparagraph; and (ii) ending on a day prescribed by the regulations for the purposes of this subparagraph or, if APRA specifies a later day, that later day; and (c) APRA determines under section 62ZZI that the insurer is liable to the person in respect of the claim; and (d) the person is not covered by a determination under section 62ZZ. Claims worth less than $5,000 (2) The person is entitled to be paid by APRA an amount equal to the insurer’s liability to the person in respect of the claim if APRA determines that the amount of the liability is less than $5,000.

Note: Section 62ZZI requires APRA to determine not only whether the insurer has a liability in respect of the claim but also the amount of the liability.

Claims worth $5,000 or more (3) The person is entitled to be paid by APRA an amount equal to the insurer’s liability to the person in respect of the claim if APRA determines that: (a) the amount of the liability is $5,000 or more; and (b) the person meets the conditions prescribed by the regulations for the purposes of this paragraph.

Note 1: Section 62ZZI requires APRA to determine not only whether the insurer has a liability in respect of the claim but also the amount of the liability.

Note 2: Section 62ZZJ requires APRA to determine whether the person meets the prescribed conditions, if the person applies for the determination.

Different claim periods for different claims (4) To avoid doubt, regulations for the purposes of subparagraph (1)(b)(i) or (ii) may prescribe different days for the purposes of that subparagraph applying in relation to different claims or claims under different cover.