SUSAN PHILLIPS HEALTH INSURANCE CONSULTANCY PTY LTD
ABN: 41 100 088 382
INTERNAL DISPUTE RESOLUTION PROCEDURE
DATED: The First Day of July 2016
Susan Phillips Health Insurance Consultancy Pty Ltd is committed to complying with the following complaints handling standards and guidelines:
Where we receive from a client a request for the resolution of a dispute or a request for a response in writing in relation to the dispute, we will promptly reply to the client – within 5 working days. In the event that a dispute is considered by the client to be unresolved, we will advise the client of the availability of the external dispute resolution by the Private Health Insurance Ombudsman.
Private Health Insurance Ombudsman
The Private Health Insurance Ombudsman (PHIO) provides an independent service to help clients with health insurance problems and enquiries.
The Ombudsman can deal with complaints from health fund members, health funds, private hospitals or medical practitioners. Complaints must be about a health insurance arrangement. Complaints need to be about private health insurance or a related matter. They can be about a private health fund, a broker, a hospital, a medical practitioner, a dentist or other practitioners (as long as the complaint relates to private health insurance).
What should I do if I want to make a complaint?
You should first contact your health fund or the body you are complaining about. They may be able to resolve your complaint for you.
What information does the Ombudsman need?
When you contact the Ombudsman you should provide the following information:
• a clear description of your complaint;
• the name of your health fund and your membership number; and
• what you think would resolve the matter for you.
What can happen after I make a complaint?
The Ombudsman’s staff will contact your health fund or the body you are complaining about to get their explanation and any suggestions they have for fixing the problem.
The Ombudsman will deal with most complaints by phone, email and fax and most can be settled quickly.
Where complaints are more complex, the Ombudsman will write to the health fund or other body, seeking further information or recommending a certain course of action. The Ombudsman’s staff will keep you regularly informed, usually by telephone and will give you their name and contact number, in case you need to contact them.
Private Health Insurance Ombudsman contact details
Telephone 1300 362 072
Email http://www.ombudsman.gov.au/contact