Private health insurance report 2019-20

This report provides an update on key competition and consumer developments and trends in private health insurance between 1 July 2019 and 30 June 2020. It focuses on insurer responses to the COVID-19 pandemic, but also provides an update on ACCC enforcement action and other developments relating to the health sector.

Insurers to be authorised to continue relief measures for small businesses

The ACCC is proposing to allow insurance companies and brokers to continue coordination and implementation of temporary COVID-19 relief measures for certain small businesses.

The authorisation will apply to Suncorp, Allianz, QBE Insurance and other insurers or insurance brokers who have notified the ACCC.

Under an urgent interim authorisation granted by the ACCC on 2 April 2020, insurers and brokers were granted temporary permission to coordinate a range of relief measures to eligible policyholders whose insurance premiums fall due before 30 June 2020.

Insurers to offer deferred payments, refunds under small business relief package

Insurance companies and brokers will be able to work together to implement COVID-19 relief measures for certain small businesses following the ACCC’s granting of interim authorisation today.

The authorisation applies to Suncorp, Allianz, and QBE Insurance, as well as any other insurers or insurance brokers who choose to take part, as long as they notify the ACCC.

Private health insurance report 2018-19

This report analyses key competition and consumer developments and trends in the private health insurance industry between 1 July 2018 and 30 June 2019, including ACCC enforcement and other actions relating to the health sector.

Medibank in court for alleged misrepresentations to members about benefits

The ACCC has instituted proceedings in the Federal Court against Medibank Private Limited trading as ‘ahm Health Insurance’ (Medibank), alleging that Medibank made false representations about benefits covered by its health insurance policies, in breach of the Australian Consumer Law.

The ACCC alleges that Medibank falsely represented to members holding ahm “lite” or “boost” policies, who were making claims or enquiries, that they were not entitled to cover for joint investigations or reconstruction procedures, when in fact their policies covered these procedures.

Full Federal Court dismisses ACCC appeal against Medibank

An appeal by the ACCC against a Federal Court judgment in relation to Medibank Private Limited (Medibank) has been dismissed by the Full Federal Court.

The ACCC alleged Medibank made false, misleading or deceptive representations and engaged in unconscionable conduct in relation to its failure to notify Medibank’s, and its subsidiary ahm’s, members of its decision to limit benefits for in-hospital pathology and radiology services, despite representing across a number of its communication and marketing materials that it would.