Top 5 Health Insurance Complaints: More Issues Than Ever

There were a record number of complaints about health insurance last quarter. Find out what so many people are complaining about.

Australia’s Private Health Insurance Ombudsman (PHIO) has revealed it received a total of 1,683 complaints over the July to September quarter, 2016. This was the largest number of complaints over a single quarter in the PHIO’s history.

To put things into perspective, last quarter (April-June) received 1,367 complaints while the September quarter in 2015 experienced only 1,052 complaints.

So there’s been a 60% increase in complaints from the same quarter last year. So what do we complain about?

According to PHIO, large increases in complaints about service and membership were the biggest sources of the rise.

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1. Service delays (281 complaints)

This includes delays in the insurer updating membership records, sending tax certificates or responding to general customer queries and complaints.

Medibank’s computer issues over the quarter generated a large increase in these types of complaints.

2. Transfer/clearance certificates (148 complaints)

Complaints about clearance certificates included incorrect details and late delivery. Clearance certificates are supposed to be issued to departing members within 14 days so they don’t have to complete first-time waiting periods on their new fund.  It also allows for the correct lifetime health cover loading to be applied on their new policy.

3. Oral Advice (139 complaints)

This was the top complaint issue from last quarter. Oral advice complaints generally involved customers misunderstanding what they were told about their policy’s benefits during phone consultations and branch visits.

4. Membership cancellation (107 complaints)

Membership cancellation complaints typically arose from delays and problems in relation to processing requests to cancel membership and handling the payments and refunds associated it.

5. Premium payment problems (103 complaints)

Common premium payment complaints mainly concerned direct debits from bank accounts and debit cards. Issues included incorrect debit amounts, irregular debits and accidental cancelling of direct debit arrangements.

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CANSTAR compares health insurance on price and value to help customers find a policy that’s suitable for them. To get started, check out our interactive comparison table here. Below we have provided a snapshot of this table which features a couple of current low premium policies available. Please note that this table was formulated based on a single male seeking hospital only cover in NSW.

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