2025 Life Insurance Claims & Disputes Statistics
Each year, tens of thousands of claims are processed in the life insurance industry. APRA’s latest release of Life Insurance Claims and Disputes Statistics (June 2018 – June 2025) gives us a good indication of how insurers are performing across some of the major advised life insurance cover types. Examining this data typically gives you a clearer picture of which insurers accept claims, how quickly they are paid and which types of claims may be involved in disputes with insurers.
Understanding the Data
To compile these insights, we looked at data from several sources, including APRA and other life insurance claims comparison tools. These sources indicate that there are major differences in how claim admittance rates vary across different distribution channels and cover types.
Generally, APRA refers to “advised” policies as any case where the customer received guidance from a professional when choosing and applying for cover. While receiving advice may help you understand your options and complete applications accurately, claim outcomes are influenced by several factors. The 2025 data shows high acceptance rates across advised cover types: 97.2% for Death, 82.9% for TPD, 86.0% for Trauma, and 94.4% for Income Protection.
Advised Life Insurance Claims
Seeking professional advice for your life insurance requirements could help you find the type of cover that suits your requirements. However, its’ important to note that whether your claim is successful or not will typically depend on whether you’ve met the policy eligibility criteria. When it comes to advised life insurance policies, claims may have higher success rates than those for non-advised policies. The latest data, which covers the period from 1 July 2024 to 30 June 2025, provides a good insight into the differences.
Here are some key findings from the data:
- Industry Average: The industry average claims accepted rate for advised life insurance cover is 97.2%.
- Top Performers: MLC leads with a 98% claims accepted rate, followed closely by Resolution Life at 97.7%, and TAL at 97%.
Source: APRA (Data released 14 October 2025)
Advised TPD Insurance
Total and Permanent Disability (TPD) insurance is crucial for protecting your financial future if you can no longer work due to a severe disability. Claims are often more complex because of the different policy definitions, requirements for medical evidence and assessments. Professional advice may help customers understand their cover, definitions and obligations, though claims are decided based on policy terms and the evidence provided. Having a professional assist you may also help you tailor your cover to your specific requirements but generally doesn’t impact claim outcomes.
Here are the key insights from the latest data, covering 1 July 2024 to 30 June 2025:
- Industry Average: The industry average claims accepted rate for advised TPD insurance is 82.9%.
- Top Performers: Resolution Life comes in first with a 88.8% claims accepted rate. Next is MLC who have a claims acceptance rate of 86.7%, and Zurich with a 83.3% claims acceptance rate.
Source: APRA (Data released 14 October 2025)
Advised Trauma Insurance
If you’re diagnosed with a critical illness defined by your insurer, having a trauma insurance policy in place could help you care for your family while you focus on your recovery. Advisers may assist customers with understanding features at application stage, but claim admittance is determined by whether the medical event meets the policy definition.
Key insights from the most recent data (1 July 2024 to 30 June 2025) include:
- Industry Average: On average, 86.6% of trauma insurance claims are accepted when advised by a financial professional.
- Top Performers: NobleOak remains a stands out with a 97.6% acceptance rate, at 92.3% MetLife comes in at second places and in third top performing position is MLC at 90.7%.
Source: APRA (Data released 14 October 2025)
Advised Income Protection
Income protection insurance covers up to 70% of your income if you’re unable to work due to illness or injury. It is an important protection consideration if you rely on your personal exertion income to cover your families ongoing expenses.
Here are some key findings from the data:
- Industry Average: The average claims accepted rate for advised income protection insurance for 1 July 2024 to 30 June 2025 is 94.4%.
- Top Performers: NobleOak leads with a 97.4% claims accepted rate, followed by Resolution Life at 96.9% and then MLC at 96.9%.
Source: APRA (Data released 14 October 2025)
Claims Processing Times for Advised Policies
APRA keeps track of the average time it takes for claims to be processed. The time it takes typically varies depending on how complex the claim is.
| Cover Type | Average Time to Finalise | Fastest Insurer |
|---|---|---|
| Life Cover | 1.3 months | MLC – 0.8 months |
| TPD Cover | 7.5 months | MLC – 6.9 months |
| Trauma Insurance | 1.5 months | MLC – 1.1 months |
| Income Protection | 1.6 months | NobleOak – 1.3 months |
Source: APRA (Data released 14 October 2025)
Advised Policies Claim Disputes Statistics
APRA generally reports on how many policyholders have had to contest their insurers claim decision. Disputes often occur because of declines, delays, or if there’s disagreements about the benefit amount or definitions on the policy. Dispute volumes vary by insurer and cover type and can be influenced by product complexity, evidence requirements and policy wording.
Life Insurance
Zurich recorded the highest number of lodged disputes lodged against them at 79, followed by AIAA with 24 and TAL with 27. MLC lodged 15 disputes, while Resolution Life (RLA) lodged 12, and several smaller insurers reported minor volumes. When adjusted for the number of lives insured, dispute lodgement ratios ranged from 7 to 27 disputes per 100,000 lives, with Zurich again at the upper end of the range and MLC and TAL sitting closer to the industry average of 13.
Source: APRA (Data released 14 October 2025)
TPD Insurance
Zurich had 231 lodged disputes, resolving 191 with an average payout of $58,330. RLA follows with 251 lodged and 219 resolved disputes, averaging $29,625. TAL has 119 lodged against them and 86 resolved disputes, with an average payout of $21,547. The dispute lodgement ratio per 100,000 lives insured is highest for RLA at 183, followed by Zurich at 118 and TAL at 72.
Source: APRA (Data released 14 October 2025)
Trauma Cover
According to the 2025 APRA results, Zurich had the most Trauma disputes lodged against them at 132, followed by TAL with 115 and AIAA with 80. MLC recorded 36 disputes, RLA 28, and MetLife 5, while NobleOak reported 0 disputes for the period. When normalised for the number of lives insured, dispute lodgement ratios ranged from 0 (NobleOak) to 81 disputes per 100,000 lives insured (RLA), with Zurich at 76, AIAA at 72, and TAL at 59, compared to an industry average of 61.
Source: APRA (Data released 14 October 2025)
Income Protection
APRA’s 2025 data shows Zurich with the largest number of lodged disputes against them at 482, followed by AIAA with 367, TAL with 453, and MLC with 235. Resolution Life (RLA) also recorded 350 disputes, while NobleOak posted just 9, the lowest among major insurers. When adjusted for lives insured, RLA recorded the highest dispute lodgement ratio at 1,111 disputes per 100,000 lives insured, followed by Zurich at 331, AIAA at 407, and TAL at 204, compared to an industry average of 289. NobleOak remained the clear outlier with a ratio of 17, reflecting low escalation rates.
Source: APRA (Data released 14 October 2025)
Claims Admittance Rates for Individual Advised Cover Types (2018-2025)
APRA’s eight year data shows that claims admittance rates for advised policies have been very stable across all cover types. Death cover remains the most consistent performer, holding between 97% and 98% every year from 2018 to 2025.Income Protection has also stayed strong at 95% to 96% throughout the period. TPD has shown slightly more variation, rising from 86% in 2018 to 92% in 2023 before settling at 82% in 2025. Trauma has remained steady within a narrow range of 85% to 87%. Overall, the long term results show that advised policies deliver high and predictable claim acceptance outcomes.
% Admitted By Cover Type Over Time
Source: APRA (2018 – 2025)
Dispute Lodgement Ratios for Individual Advised Cover Types (2018-2025)
The dispute lodgement ratios for advised policies have increased across all cover types over the past eight years, with the most noticeable growth in Income Protection. Disputes for IP rose from 124 per 100,000 lives insured in 2018 to a peak of 364 in 2024, before easing slightly to 289 in 2025. TPD disputes also increased steadily from 28 in 2018 to 99 in 2025, reflecting the ongoing complexity of disability assessments. Trauma disputes grew from 35 to 61 over the same period, while Death cover remained the lowest and most stable, moving from 6 in 2018 to 12 in 2025. Overall, the trend shows a clear rise in dispute activity as claims become more complex and policy definitions continue to evolve.
% Disputes Lodgement Ratio By Cover Type Over Time
^ The dispute lodgement ratio represents the number of disputes lodged during the reporting period per 100,000 lives insured.
Source: APRA (2018 – 2025)
* The data used in this article has been sourced from the Australian Prudential Regulation Authority (APRA) Life Insurance Claims and Disputes data, spanning from 2018 to 2025.
Frequently Asked Questions and Answers
What is the acceptance rate for APRA claims?
APRA does not publish a single overall acceptance rate for all claims. Instead, it reports separate rates for each type of cover and distribution channel. For advised policies, which are fully underwritten and assessed according to the policy’s terms and the evidence provided, the 2025 acceptance rates were 97.2 percent for Death cover, 82.9 percent for TPD, 86.0 percent for Trauma, and 94.4 percent for Income Protection. These results reflect broad industry outcomes and vary by insurer, cover type, and the nature of the claim.What percentage of TPD claims are successful?
In APRA’s 2025 results, 82.9 percent of advised TPD claims were accepted. This number generally reflects the complexity of TPD assessments, which require evidence that a person is unlikely to ever return to work due to illness or injury. Success rates vary between insurers, with the strongest performers reaching the high eighties, while others sit closer to the industry average. TPD remains the most complex major cover type, which is why its acceptance rate is lower than that of Death or Income Protection claims.Which insurance company is best at paying claims in Australia?
No single insurer leads in every category, but several insurance providers stand out in APRA’s 2025 advised data. MLC performs well across multiple categories and has the fastest average processing times for Life, TPD, and Trauma claims. NobleOak shows very strong results in Trauma and Income Protection acceptance rates, and Resolution Life leads in TPD acceptance. Best” depends on many factors, including policy terms, definitions, claim evidence, the type of cover, and the claimant’s compliance with disclosure obligations. Performance also varies significantly across insurers and product types.What percent of life insurance claims are denied?
Life (Death) cover is generally the most reliable type of claim. In the 2025 APRA dataset, advised Life cover had an acceptance rate of 97.2%, meaning only around 3% of claims were declined. Most insurers operate within a narrow range close to this figure, reflecting the clear and objective nature of Life insurance claims, where eligibility is usually more straightforward to assess.What is a good claims paid ratio?
A good claims paid ratio is generally one that sits above the industry average for that specific cover type. For lump-sum policies such as Death, TPD, and Trauma, ratios above 90% are typically considered strong. For Income Protection, where claims are assessed on an ongoing basis, acceptance rates above 94% indicate good performance. It is helpful to consider this ratio alongside dispute rates and processing times, as together these metrics show how consistently and efficiently an insurer handles claims.
