Are You Being Wronged by Your Health Insurer? See Why Complaints Are Skyrocketing!

Are you frustrated with your health insurer? You're not alone. Complaints against private health funds have surged in recent years, leaving many Aussie seniors questioning if they're getting value for money*.

The latest ‘State of the Health Funds Report’ from the Commonwealth Ombudsman revealed a whopping 26.8 per cent increase in complaints over the past year.



So, what's behind the rising tide of dissatisfaction? Let's take a deeper look at the key issues causing complaints to spike.

The Alarming Rise in Complaints

The Ombudsman's report showed a staggering 27 per cent increase in complaints about private health insurance in 2022-23. This surge can be attributed to several factors.

The Medibank Data Breach: The massive data breach at Medibank in October 2022 resulted in the theft of personal information from nearly 10 million customers, leading to a surge in complaints to the Ombudsman's office.

Cancellation Issues: A rise in cancellation complaints, particularly related to Peoplecare Health Limited (Allianz), contributed to the increase. Peoplecare, which provides health cover for overseas visitors and students, experienced a high volume of cancellation and refund requests as pandemic travel restrictions eased.



Premium Hikes Outpacing Inflation: Kate Browne, Compare Club’s Head of Research*, had this to say: ‘It’s understandable why people are dissatisfied with their health fund,’ explaining this happens ‘when premiums rise higher than inflation, but the service older Australians receive doesn’t match the price.’
She continued, ‘Everybody’s got a different perception of what good looks like, so the one question health fund members need to ask is, do you feel you’re getting value for money from your insurer? Loyalty is a two-way street. If you’re happy and are paying a fair price, great, but don’t be silent if you’re not.’


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Are you happy with your health insurance? Image Credit: Shutterstock



Which insurers received the most complaints?

Looking at raw numbers, Medibank came out ‘on top’ of the complaints table, with 29.5 per cent of all complaints (27.1 per cent market share). This placed them ahead of BUPA (23.7 per cent complaints with a 24.9 market share), HCF (13.5 per cent with a 12.5 per cent market share), and NIB (10.1 per cent with a 9.6 per cent market share).

Others ranking high on the complaints list include:
Australian Unity – 4.7 per cent (2.2 per cent market share),
HBF – 3.7 per cent (7.7 per cent market share), &
Teachers Health – 2.3 per cent (2.6 per cent market share).

What does market share mean in this context? The report states that 'where an insurer’s share of complaints was higher than its market share, this indicates that members of that insurer were more likely to complain than those of other similar sized insurers.'



According to Ms Browne, the report ‘highlights just how confusing Aussies find health insurance – even those who’ve held it for decades’.

‘My advice would be if you’re not sure about anything on your policy, ask … your fund, broker or expert*. The more informed you are, the more satisfied you’ll be when you find a good policy.’

Key Takeaways

  • The Commonwealth Ombudsman's annual report shows a 26.8 per cent increase in complaints about private health insurance.
  • A significant contributor to the spike in complaints was the Medibank data breach in October 2022.
  • Premium increases exceeding inflation and issues with cancellations and refunds are also causes for customer dissatisfaction with health insurers.
  • Medibank had the highest number of complaints.

How to change insurers*

If you feel unhappy with your health insurer, know that you have options. You can try reaching out to customer service to explain exactly where you see room for improvement. If you’re still unsatisfied, don’t hesitate to switch providers* or lodge a formal complaint.

One of the easiest ways to ensure you’re getting a good deal is to use an expert comparison service*. Compare Club is one of our long-term partners* with whom we have personally compared health insurers! You can read about Maddie’s experience here*.



The team at Compare Club* will make sure you have the health cover you need while paying a price you’re comfortable with*.

You get the peace of mind that comes with working with trusted professionals who have the years of experience* needed to navigate the complicated health insurance system and keep you from any further confusion.

You won’t lose anything by comparing; it’s completely free, and you only stand to save*! After all, if you don’t like the quote you receive from Compare Club*, you don’t have to do anything.

Have you had reason to complain against your health insurer, or have you recently changed insurers? Were you satisfied with the outcome?

Disclaimer: Advice given in this article is general in nature and not intended to influence readers’ decisions about investing or financial products. They should always seek their own professional advice that takes into account their own personal circumstances before making any financial decisions.

*Please note, members, that this is a sponsored article. All content of ours that has an asterisk next to it means we may get a commission to write an article or post a deal. We do this to assist with the costs of running the SDC. Thank you!
 
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I have found that Compare are not helpful and rude. I have contacted them on two ocasions. On both occasions the suggested new funds did not give the same level of cover and were not that much cheaper. I wanted cover for joint replacement Compare's recommendation only covered joint reconstruction which is not the same. The people you talk to do not appear to have a medical background. So not same for same cover. When I declined to proceed with their suggested fund the person stated in a annoyed tone "you declined last time too". My understanding is that Compare offer this service with no commitment or expectatioin on my part to accept their suggestions. I no longer trust them of have faith in what they suggest and I do not like the fact that they keep a record of my previous encounter with them. The persons who I spoke with on both occassion were very pushy, pressuring me to proceed with their recommendations. Although time consuming I rather do the research myself.
 
We certainly can’t complain about Bupa. Ted has been well & truly getting our money’s worth over the last 7 years. Its peace of mind knowing that we can access specialists of our choice and private hospitals when needed. Without private health I shudder to think how Ted would be, or if he’d still be alive without it.
 
We are with GMHBA and have been for many many years. We have found them honest, reasonable and very contactable for any questions in the many times hubby and I have been in hospital for this operation or that and being in our senior years find it comforting not having to worry about the health fund side of things.
 
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Yes I have recently changed after receiving numerous requests asking me to compare. I am startled to see that Bupa where I have just transferred to, are listed as the second one with numerous complaints!!!! What can I say???
 
We certainly can’t complain about Bupa. Ted has been well & truly getting our money’s worth over the last 7 years. Its peace of mind knowing that we can access specialists of our choice and private hospitals when needed. Without private health I shudder to think how Ted would be, or if he’d still be alive without it.
How do you get access to specialists to be an advantage? I have never received a contribution to my Specialist fees apart from Medicare and there is usually a massive gap. I’m with Bupa now. - just rejoined
 
Going to a compare site is useless. They do not include all health funds, just the ones they have on their files. We do pay a lot but at 80 there have been so many hospital and specialist visits. We pay no excess
 
How do you get access to specialists to be an advantage? I have never received a contribution to my Specialist fees apart from Medicare and there is usually a massive gap. I’m with Bupa now. - just rejoined
Maybe Teds specialists only charge the scheduled fee, will have to ask him. A lot of specialists in Launceston only operate in private facilities or clinics and the fees charged are always covered by Bupa & possibly some by Medicare. It seems to be rare that we have to pay extra, but then we wouldn’t want to with the cost of premiums. We have been with Bupa (MBF) since we both left school & have never had any complaints about them.
 
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Oh BUPA I found a deduction to my bank account from BUPA never had them or talked to them.Tried to get my money back as a happy medibank gold member customer that I am, and was told NO cant help you as we cant verify you ,of course you cant verify me ,what a performance ...Yes got it back eventually thru the banking system.
 

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