The ACCC is one of many organisations that have a role in health sector consumer protection issues. Others include health complaints offices in each of the states and territories and the Private Health Insurance Ombudsman. You can search our Consumer & business directory (see the link in the menu on the left) for contact details of other organisations in the health industry.
Misleading or deceptive conduct by health insurance funds
You have a right to complete, honest and accurate information when purchasing health insurance or transferring between health funds. Health funds need to ensure they do not mislead or deceive you about premium levels payable for their health insurance products, the criteria for eligibility, waiting periods, or the benefits that you are entitled to when making a claim with the fund. This includes representations made to you by health fund staff or information contained in fund brochures, letters to members, TV or print advertisements and the fine print contained in membership application forms and advertisements.
You should note that although other legislation may affect prices payable by you for health insurance, there is nothing in the Competition and Consumer Act that regulates the premiums charged by health funds.
The Australian Government Department of Health and Ageing has published a Private Patients’ Hospital Charter. The Charter is a guide to what it means to be a private patient in a public hospital, a private hospital or a day hospital facility. It also sets out what you can expect from:
the doctor(s) providing treatment
the hospital where the treatment is provided
you health insurance fund.
In addition, the Charter provides information on what to do if you have a complaint about the standard of care you received or private health insurance.
If you are concerned about the conduct of a health fund, you should contact the Private Health Insurance Ombudsman (search our Consumer & business directory for contact details).
Misleading or deceptive conduct regarding health products or services
We recognise that misleading or deceptive conduct toward consumers of health care products or services could cause a consumer to suffer long-lasting physical, psychological or financial effects. In contrast, honest, accurate and clearly presented information can help consumers to decide on products and services and to choose between providers.
Rights to refunds for consumers for health products
Under the Competition and Consumer Act, you have a right to a refund when goods are not fit for the purpose they were intended for or are not of merchantable quality. If the health product does not meet these requirements, under the Competition and Consumer Act, consumers of these products have a right to receive a refund when returning the products to the place of purchase. In cases where it is unclear where the goods were purchased, evidence of the place of purchase may be required.
Further information on these rights can be found in our page on Warranties, guarantees and refunds. You can also download some useful brochures from this page to help you understand your consumer rights.
How is the Trade Practices Act enforced?
Legal proceedings
Individuals (such as consumers), health practitioners, professional associations or other organisations can take providers of health services to court for breaching the consumer protection, fair trading or restrictive trade provisions of the Trade Practices Act. In fact, a large amount of litigation under the consumer protection (Part V) of the Trade Practices Act is private litigation—not involving public agencies such as the ACCC. These cases can range from individuals taking legal action to recover loss or claim damages, to class actions on behalf of a group of consumers affected by similar conduct in breach of the Act.
The ACCC can also institute proceedings for a breach of the Act. If a court decides that the law has been breached, it may make orders including:
fines or penalties
damages
injunctions
refunds
corrective advertising.
Enforceable undertakings
Rather then instituting legal proceedings, the ACCC, and the party engaging in the conduct, may choose to settle a matter administratively. This can be done by accepting enforceable undertakings from an organisation or person who the ACCC alleges has breached the Trade Practices Act. Once entered into, the party engaging in the conduct must adhere to an enforceable undertaking. If the undertakings are not honoured, the ACCC will ask the court for an order instructing the organisation or individual to comply with the undertaking. Ignoring such a court order would be contempt of court, and this in turn may lead to fines or imprisonment.
Enforceable undertakings may include requirements that involve:
