The Private Health Insurance Code of Conduct (“Code”) is a self-regulatory code to promote informed relationships between Private Health Insurers, consumers, Agents, Brokers and Corporate Brokers.
Our objective is that the Code will maintain and enhance regulatory compliance and service standards across the private health insurance industry including some aspects of overseas student and overseas visitors health insurance products provided by Private Health Insurers out of their health benefits fund. For this purpose the Code is to be a “living Code” which will be progressively reviewed from time to time. We welcome the input of consumers into the Code and its operation. We may also seek the input of consumers from time to time, including through consulting with the Private Health Insurance Ombudsman (PHIO).
The Private Health Insurance Code of Conduct is a voluntary industry Code. Funds who are signatories to the Code agree to:
- work towards improving the standards of practice and service in the private health insurance industry;
- provide information to consumers in plain language;
- promote better informed decisions about their private health insurance products and services by:
- ensuring that policy documentation is full and complete;
- providing clear explanations of the contents of their policy documentation when asked by a consumer; and
- ensuring that persons providing information on health insurance are appropriately trained
- ensure information between consumers and the fund is protected in accordance with privacy principle
- provide information to consumers on their rights and obligations under their relationship with the consumer, including information on this Code of Conduct; an
- provide consumers with easy access to the fund’s internal dispute resolution procedures, which will be undertaken in a fair and reasonable manner and to advise them of their rights to take an issue to an external body such as PHIO
The Private Health Insurance Code of Conduct 2014 (including the Self Audit Guide for health funds) can be found here.