October 19, 2011

Private Health Insurance Ombudsman Annual Report 2011

The Private Health Insurance Ombudsman’s 2011 Annual Report notes a significant increase in overall complaint numbers

The Ombudsman comments that “the issues in 2010-11 where there was an increase in complaints include level of cover, fund rule changes and general service issues. The increase in complaints about these issues is not across all insurers, but is generally confined to two or three of the larger insurers, who made changes to their products last year that affected large numbers of members.”

The Report makes recommendations and contains case studies relating to communicating changes in hospital cover.

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Posted 19th October 2011 by David Jacobson in legal

August 8, 2011

Handling health insurance complaints

The Private Health Insurance Ombudsman’s Quarterly Bulletin 59 contains some interesting statistics about health insurance complaints: volume, type and by insurer compared to market share.

Your complaints handling procedures should set out in writing:

(a) the procedures and policies for:

  • receiving complaints;
  • investigating complaints;
  • responding to complaints within appropriate time limits;
  • recording information about complaints;
  • identifying and recording systemic issues;

(b) the types of remedies available for resolving complaints; and

(c) internal structures and reporting requirements for complaint handling.

You should provide a copy of the procedures to all relevant staff. A simple and easy-to-use guide to the procedures should also be made available to consumers, either on request or when they want to make a complaint. The information should be placed on your website.

Langes+ have experience in designing complaints and dispute resolution procedures.

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Posted 8th August 2011 by David Jacobson in legal

July 13, 2011

Private health insurance rebate bills re-introduced

The Fairer Private Health Insurance Incentives Bill 2011 and 2 associated Bills have been introduced into Parliament.

If passed, the private health insurance rebate will be income tested from 1 January 2012.

The ATO has produced a useful summary table here.

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Posted 13th July 2011 by David Jacobson in legislation

December 28, 2010

Archived Posts Sitemap: Private health insurers

Welcome to the Archived Posts Sitemap which lists all the posts in this part of our site. We hope that this page makes it easier to find what you are looking for. Also try the search box at the bottom of the left hand navigation bar or the Categories section on the right.

Click on Expand All to show all the posts or Collapse All to just see this month’s posts.

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Posted 28th December 2010 by admin in Uncategorized

December 15, 2010

PHIAC Insurer Obligation Rules amended

The Private Health Insurance (Insurer Obligation) Amendment Rules 2010 (No. 1) will commence on 1 January 2011.

The Rules include increased disclosure, reporting and notification requirements for private health insurers.

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Posted 15th December 2010 by admin in legal, legislation

PHIAC directions

The Private Health Insurance Administration Council (PHIAC) has issued a Standard Operating Procedure (SOP) on “Giving a Council Direction”.

The SOP considers four separate powers which the Council may employ to protect the interests of consumers and to ensure the prudential safety of private health insurers:

  • a direction to prevent or address a contravention of a council supervised obligation, as set out under section 200-1 of the Private Health Insurance Act 2007 (the Act);
  • a direction to comply with a prudential standard, as set out under section 163-15 of the Act;
  • a direction to comply with the capital adequacy standard, as set out under section 143-20 of the Act;
  • a direction to comply with the solvency standard, as set out under section 140-20 of the Act.

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Posted 15th December 2010 by admin in legal, legislation

September 12, 2010

PHIAC consultations

The Private Health Insurance Administration Council (PHIAC) is engaged in a number of consultations at present:

August 1, 2010

Healthcare Identifiers Act

The Healthcare Identifiers Act establishes a national system for consistently identifying consumers and healthcare providers.

The objective is that healthcare identifiers for individuals and providers will be used as part of a national electronic health records system to improve safety for patients and increase efficiency for healthcare providers.

The Healthcare Identifiers Service will be operated by Medicare Australia.

Its functions include:

  • assigning, collecting and maintaining identifiers for individuals, individual healthcare providers and organisations by using information already held by Medicare Australia for its existing functions;
  • collecting information from individuals and other data sources;
  • developing and maintaining mechanisms for users to access their own records and correct or update details;
  • using and disclosing healthcare identifiers and associated personal information,for the purposes of operating the Healthcare Identifiers Service; and
  • disclosing healthcare identifiers for other purposes set out in the Act.

The Act sets out the permitted purposes for which healthcare identifiers may be used or disclosed and the offences relating to the misuse of healthcare identifiers and penalties for breaches of the legislation.

The Federal Privacy Commissioner will provide independent regulation of how healthcare identifiers are handled and the operation of the Healthcare Identifiers Service. This will include handling complaints against Medicare Australia.

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Posted 1st August 2010 by admin in legislation

March 16, 2010

Healthcare Identifiers

The Senate Standing Committee on Community Affairs has recommended the passing of the Healthcare Identifiers Bill 2010 and the Healthcare Identifiers (Consequential Amendments) Bill 2010. (Download report here)

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Posted 16th March 2010 by David Jacobson in legislation

November 20, 2009

Health insurance reform bills re-introduced

On 19 November 2009 the Government re-introduced its reform package:

The Explanatory Memoranda are here, here and here.

UPDATE: The Bills were defeated by a majority vote in the Senate on 24 February 2010.

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Posted 20th November 2009 by David Jacobson in legislation