The Private Health Insurance Code of Conduct (Code) is a self-regulatory and voluntary code to promote informed relationships between Private Health Insurers, consumers, agents, brokers and corporate brokers.
The Code’s objective is to maintain and enhance regulatory compliance and service standards across the private health insurance industry including some aspects of overseas student and visitors health insurance products provided by Private Health Insurers.
The Code is progressively reviewed from time to time to reflect industry growth and development. We welcome input from 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).
Private Health 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
Download The Private Health Insurance Code of Conduct 2016 (including the Self Audit Guide for health funds)