7th Mar 2018

Private health insurance complaints rise by 30 per cent

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Private health insurance complaints rise by 30 per cent
Leon Della Bosca

The Ombudsman's 2017 State of the Health Funds Report was released earlier this week, revealing a shocking 30 per cent increase in complaints to the Private Health Insurance Ombudsman.

In 2016-17, there were 5750 complaints – an increase of over 1300 complaints – about issues such as incorrect direct debits to hospital exclusions, although nearly half of all these grievances were about Medibank.

Health fund premium hikes to the tune of 70 per cent over the past decade, increasing gaps and decreased inclusions fuelled the frustrations of Australian health fund holders.

Perhaps the most telling aspect of the report is the membership retention rates, which are usually a reliable indicator of customer satisfaction with their fund. HBF had the highest retention rate at 97 per cent, compared to HIF, GU Corporate, GMHBA, health.com.au and Transport Health, which all had retention rates below 70 per cent.



Private Healthcare Australia Chief Rachel David believes the overall number of complaints are relatively low compared to the number of policy holders.

"Health funds are making a considerable investment to help consumers navigate a complex system, including making it easier to choose health fund products based on cost and need," said Dr David.

Had the Australian Dental Association’s Time2Switch complaints been added to the list, the total number of complaints would have been just under 8900.

The Ombudsman does not include campaign-related complaints in the report, much to the ADA’s chagrin.

“The ADA disagrees with this – a complaint is a complaint and should be noted as such by the Ombudsman,” said ADA President Dr Hugo Sachs.

“The campaign sought to raise awareness and encourage complaints about how private health insurers’ practice offer little rebates compared to premium increases consumers have to keep paying.”

The latest tally of complaints constitutes the biggest rise in a decade.

“These complaints are a symptom of why customers are leaving private health insurance,” said Medical Technology Association of Australia Chief Ian Burgess.

Are you happy with your health insurance? Did you have any complaints about your health fund last year?

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COMMENTS

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Linda
7th Mar 2018
11:08am
Private insurance costs a lot these days, and even if you have it, there are places in Australia where the private system reduces their services during the major holidays such as between Christmas and New Year. Word to the wise, don't ever get sick during a holiday, it could cost you your life. Gurr.
MICK
7th Mar 2018
6:01pm
Health Insurance is a scam Australians feel they cannot do without. The real question is how much is the industry contributing to political election campaigns via donations to buy compliance and support from government elected by the people to govern for the people?

It would be far better for Australians to set up a savings account where they put in money rather than give it to a cannibalistic health industry.
Rae
7th Mar 2018
11:14am
It will be interesting to see which private health funds implode now that the boomers who have paid in for decades with few claims are hitting a point where they will start needing to make claims and use the system in greater numbers.

Perhaps they will prove to be massive government supported ponzi schemes.
MICK
8th Mar 2018
1:51am
Obvious dear Watson. The rates will double and the things covered decrease.
floss
7th Mar 2018
12:07pm
What a farce are we the most expensive country in the world, not good when you are on a fixed income.A lot of people have not had a pay rise rise in years how do they cope.Some thing will have to go i hope it is the stupid government that is attempting to run this country. Heath insurance is on the way out for ordinary Australians and where do we go now Malcom.
Triss
7th Mar 2018
12:54pm
It’s a vicious circle, premiums go up so people opt out which lowers private health care’s profits...so premiums go up and more people opt out. And so it goes on.
MICK
8th Mar 2018
1:53am
ANd eventually greedy and cannibalistic health care providers will go broke...as they should....with much of your money in their possession. What ever changes?
Sceptic
7th Mar 2018
12:54pm
The article is about complaints have increased by 30%, but the responses so far seem to indicate that the responders think costs have gone up 30% last year.
KSS
7th Mar 2018
1:02pm
30% increase in complaints in a year, compared with 70% increase in premiums over the past 10 years.

Doesn't seem that many complaints to me!
MICK
8th Mar 2018
1:54am
30% IN ONE YEAR. It would be a lot higher in 10 years.
disillusioned
7th Mar 2018
1:30pm
I get flamin' all from my health cover - no cover for this, or that, or the other, yet it costs me an arm and a leg to pay each month. Yesterday I was "not covered" for the podiatrist. Stupid me, think I'll just drop it and go on the public hospital waiting list. Seems to work ok for many of my friends!
MICK
8th Mar 2018
1:56am
I have never been in this casino called health insurance. A friend of mine over 20 years ago convinced me never to join when he, with top cover, injured his thumb. It cost him several thousand dollars and he was spewing. So why would anybody have health insurance unless they were chronically ill?
Sceptic
8th Mar 2018
12:50pm
I have been in Private health insurance continuously, since before the national Medibank that became Medicare. In 2009, I required a biventricular defibrillator (ICD) implant to save my life. in October 2013 my wife had a requirement for three valves to be placed in her lungs. In mid-2014 Two tumors were discovered in my neck. In October 2014 my wife had a heart attack requiring two stents to be fitted. In November and December 2014, I had radiotherapy for my tumors. In 2015 I had the battery replaced in my ICD. In 2015 and 2016 my wife had extended stays in hospital due to COPD exacerbation. I have not had to pay one cent of out of pocket costs for any of these incidents. So, Mick, as they say, one swallow does not a summer make.

If you and yours have enjoyed good health and not needed hospitalisation and major procedures, I am happy for you, but up to the first incident, we had also enjoyed good health.

Like all insurances, you do not need it until you need it.
Raphael
7th Mar 2018
1:44pm
An analysis of that the complaints were about would have been useful
Most could be complaining about a refund amount because they didn’t read their policy - lots of dumbasses in this world
Knows-a-lot
7th Mar 2018
3:47pm
Not so "dumbass" when the fine print is tiny and expressed in impenetrable legalese replete with arcane medical jargon.
Raphael
7th Mar 2018
5:57pm
Can't help you if you hand over your earned money without understanding what your'e paying for.
Pathetic !
OnlyGenuineRainey
8th Mar 2018
3:32pm
We have two choices: sign unconscionable and incomprehensible agreements written to allow thieves to escape their obligations, or go without insurance. Neither is particularly palatable to many. It's hardly the victim's fault when they lose a David and Goliath battle because they were denied any protection against a monster's evil deeds.
Raphael
8th Mar 2018
3:46pm
More government beauracracy is NOT the answer.

Government should stop subsidising health insurance. It should also privatise all medical services except for emergency health

This would put more dollars back in the taxpayers pockets and reduce the cost of insurance and medical services through competition

The ignorant and greedy lefties keep wanting the government to do more - where does it end - until ver are a 100% socialist country
Didnt work in Russia , didnt work in Cuba, not in Venezuela ....

but these left wing idiots want it here and make everyone poor
Knows-a-lot
7th Mar 2018
3:43pm
Three words about private health insurance: IT'S A SCAM!
Big Al
7th Mar 2018
4:53pm
So is car insurance, home insurance, contents insurance etc... go ahead and drop it K-A-L - dare you to!
Raphael
7th Mar 2018
5:57pm
Khows sweet F.A. is a clown
Triss
8th Mar 2018
12:09am
Hey, Raphael, wasn’t it you who said you believe in healthy debate not insults?
MICK
8th Mar 2018
1:58am
Good one Triss. Pretty sick of Raphael with his mud throwing devoid of all debate, facts and justification.
Raphael
8th Mar 2018
3:13am
It’s you socialist who want government to subsidize everything that makes causing health insurance costs through the roof
Remove government subsidies and let the free market provide everything except emergency medical services and you will see how well private enterprise steps in to provide competitive seriviced
The money left in individuals pockets from wasted taxes would more than pay for the medical services and insurance citizens need
OnlyGenuineRainey
8th Mar 2018
3:30pm
Yep. Government should step aside and let the medical profession charge whatever they like. When only the filthy rich can afford health care and the peasants are all dying, the would-be feudal lords like Raphael will be content, maybe!
Hairy
12th Mar 2018
12:11pm
Agree.put money super or investments for medical expenses in later life .insurance is a rip off.fine print is a disgrace you need a lawyer to decifer,
Polly Esther
7th Mar 2018
4:09pm
Well no wonder if someone is advising us to get our cholesterol count way up high if we want to reach the magic ton. :-)) oh my goodness
Ductape
7th Mar 2018
4:26pm
If those whom attach themselves in all respects to the health industry weren't allowed to become so greedy, health care costs could be slashed immensely. When specialists, surgeons and the like are compared to the ordinary man in the street whom might be lucky to earn $25 an hour - or a qualified tradesman who earns $125 an hour - those pampered messiahs in the medical game seem to have no difficulty charging ten times that amount and more! Show me a health professional type person and I can guarantee you'll be looking at someone who'll have no difficulty counting themselves as millionaires - often several times over! No-one is saying hard work shouldn't be rewarded, but these jokers - despite the halos around their heads -
when compared to every other procession, aren't worth that much! It's their insatiable appetite for dosh that puts health costs through the roof.
Ductape
7th Mar 2018
4:30pm
'profession' - not the other one! Fat fingers - sorry.
MICK
8th Mar 2018
2:01am
You are starting to chip away at the problem. The current big business controlled government and its dictator in waiting believe in the "free economy". That means turn a blind eye and don't worry if ordinary people are held hostage to a monopolistic industry.
OnlyGenuineRainey
8th Mar 2018
3:28pm
A friend was recently quoted $2200 for a relatively minor procedure by a specialist who boasts he performs 4 such procedures per hour - 24 per day on average. The Medicare rebate is $525. If the specialist bulk billed, he'd be receiving over $63,000 per week, but he's drawing $264,000 a week by ripping off patients. Tell me anyone can justify charges like that.

No, Raphael, removing government interference wouldn't fix the problem, because it's GREED like this that's causing it. How is any government or health fund supposed to deal with that kind of unmitigated selfishness?
Raphael
8th Mar 2018
3:52pm
There is no competition in the medical profession.
It's bvecasue socialists like you have shafted all Australians with your warped thinking
You can't demand socialised medicine and resulting reduced competition and then expect prices to come down
The medical profession in Australia is a monopoly - restricting entry into the profession by unfair practices
If you removed all government interference and the ability of the medical profession to restrict their numbers, you'd see the wonder of competition at work and top class medical services for all
George
8th Mar 2018
8:46pm
Any Complaints statistic is simply an analysis of the tip of the iceberg which they can see. I am sure there are thousands more complaints which never reach the Ombudsman due to the effort involved and vagueness of policies.

Govt has an absolute duty to step in - Define MAXIMUM charges for each item (or at least the normal Rebate + say 50% as the Maximum), force Private Insurance to have NO GAPS, and make all Insurers offer STANDARD PRODUCTS which cover all or part Govt-controlled list of services by Consumer Segment.
Only then we can have a working Private Health Insurance System with competition based on Standard Products. Any sensible Political Party out there willing to make such obvious changes?
patti
10th Mar 2018
4:07pm
I dropped my private health cover a few years ago when I was due for a knee replacement. I would have had to find $6000 gap fee. I had struggled for years to pay full health cover on a pension. At that point I quit hospital cover, and took my chances in the public health system. Since then, have always had good and timely treatment for my ailments. I do still retain extras cover, and although they don't cover all the costs of dental, optical etc, it certainly helps.


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