The Commonwealth Ombudsman has released a report into the performance of health funds in 2019, showing an improvement in the performance of private health insurance schemes.
The Ombudsman, Michael Manthorpe (pictured) said the State of the Health Funds Report 2019 revealed an 11 per cent decrease in complaints about private health funds during 2018-2019.
“Our Office received 4,042 complaints during 2018-2019, an 11 per cent decrease on the previous year’s 4,553,” Mr Manthorpe said.
“Concerns about benefits, membership and service were the major cause of complaints to our office,” he said.
“Overall, the number of complaints to the Office about almost all issues reduced compared to the previous year, showing a general improvement across the industry.”
Mr Manthorpe said the purpose of the Report was to provide consumers with additional information to assist them to make decisions about private health insurance.
“One of the significant complaint issues was a Benefit issue – unexpected hospital policy exclusions and restrictions,” Mr Manthorpe said.
He said some basic and budget levels of hospital cover excluded or restricted services that many consumers had assumed were routine treatments or standard items.
“However, with the continued implementation of the private health insurance reforms during 2019–20, which were introduced to standardise clinical categories and give consumers more certainty about their benefits, we anticipate that the number of complaints about Benefits will continue to reduce in future years,” Mr Manthorpe said.
He said the Report made note of the new private health insurance reforms that took effect from 1 April 2019 and which would become mandatory from 1 April this year.
The47-page Report can be accessed at this PS News link.
