Australian Private Health Insurers

Private Health Insurance Ombudsman Annual Report 2011

David Jacobson — Wed, 19 Oct 2011 01:18:41 +0000

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.

Handling health insurance complaints

David Jacobson — Sun, 07 Aug 2011 19:14:20 +0000

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

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.

Private health insurance rebate bills re-introduced

David Jacobson — Tue, 12 Jul 2011 19:49:40 +0000

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.

Archived Posts Sitemap: Private health insurers

admin — Tue, 28 Dec 2010 04:03:43 +0000

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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October 2011 (1)
- 19: Private Health Insurance Ombudsman Annual Report 2011
August 2011 (1)
- 08: Handling health insurance complaints (0)
July 2011 (1)
- 13: Private health insurance rebate bills re-introduced
December 2010 (3)
September 2010 (1)
- 12: PHIAC consultations (0)
August 2010 (1)
- 01: Healthcare Identifiers Act
March 2010 (1)
- 16: Healthcare Identifiers
November 2009 (2)
- 20: Health insurance reform bills re-introduced
- 20: Health service providers are not credit providers
October 2009 (3)
September 2009 (1)
- 11: Fairer Private Health Insurance Incentives Bill 2009 defeated in Senate
August 2009 (2)
- 06: Senate report on private health insurance changes
- 02: National Health Act updated
July 2009 (4)
June 2009 (2)
- 06: Private health insurance coverage
- 06: Senate Inquiry into Private Health Insurance
May 2009 (1)
- 31: PHIAC corporate governance standards

PHIAC Insurer Obligation Rules amended

admin — Wed, 15 Dec 2010 04:54:35 +0000

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.

PHIAC directions

admin — Wed, 15 Dec 2010 04:45:29 +0000

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.

PHIAC consultations

admin — Sun, 12 Sep 2010 04:03:45 +0000

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

Healthcare Identifiers Act

admin — Sun, 01 Aug 2010 04:10:44 +0000

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.

Healthcare Identifiers

David Jacobson — Mon, 15 Mar 2010 19:49:36 +0000

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)

Health insurance reform bills re-introduced

David Jacobson — Thu, 19 Nov 2009 22:08:40 +0000

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.