Private health insurers to cooperate on COVID-19 coverage and deferral of premiums

8 April 2020

Private health insurers have been granted conditional interim authorisation to co-ordinate on providing financial relief to policy holders during the COVID-19 pandemic, and broadening insurance coverage to include COVID-19 treatment, tele-health and medical treatment provided at home.

The ACCC granted interim authorisation after receiving an application lodged by Private Healthcare Australia (PHA), Members Health Fund Alliance and the members of both groups.

The interim authorisation is conditional on details of proposed measures being provided to the ACCC in advance. It also excludes agreements to increase premiums, and specifies that any agreements reached must terminate when authorisation ceases. 

“Providing financial relief for policy holders during this pandemic is an important and welcome measure. We are also pleased to see moves to cover tele-health consultations, so that policyholders can still safely consult health professionals,” ACCC Chair Rod Sims said.

“However, we are concerned there is a risk that some of the proposed arrangements may have a long-term anti-competitive effect, especially as this authorisation covers a majority of private health insurers.”

“We have imposed conditions on this authorisation to help minimise this risk by preventing insurers from coordinating to increase premiums, and ensuring agreements entered into under the authorisation cannot last longer than necessary because of the COVID-19 pandemic,” Mr Sims said.

“We also remind health insurers of the need to keep their policy holders appropriately informed about any changes, including any impact on their coverage and entitlements.”

Under the interim authorisation, individual insurers will still be able to compete on price and coverage.

The ACCC can revoke interim authorisation at any time.

Having granted interim authorisation for the arrangements, the ACCC will now seek feedback on the application for final authorisation which is sought for a period of six months from the date of authorisation. More information, including the ACCC’s interim authorisation decision, is available at Private Healthcare Australia Limited.

Background

PHA is the Australian private health insurance industry’s peak representative body, and represents the majority of people covered by private health insurance.

Notes to editors

ACCC authorisation provides statutory protection from court action for conduct that might otherwise raise concerns under the competition provisions of the Competition and Consumer Act 2010.

Section 91 of the Act allows the ACCC to grant interim authorisation when it considers it is appropriate. This allows the parties to engage in the proposed conduct while the ACCC is considering the merits of the substantive application.

The ACCC may review a decision on interim authorisation at any time, including in response to feedback raised following interim authorisation.

Broadly, the ACCC may grant a final authorisation when it is satisfied that the likely public benefit from the conduct outweighs any likely public detriment.

Release number: 
72/20
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