For Health Funds
The Private Health Insurance Code of Conduct (Code) is a self-regulatory and voluntary code to promote informed relationships between health funds and consumers.
The Code has been introduced to complement the existing regulations funds work under and to enhance the relationship between consumers and health funds by adopting voluntary industry self-regulation.
The Code is reviewed annually to reflect industry growth and development. The Code was last reviewed in October 2023.
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 principles;
- provide information to consumers on their rights and obligations, including information on this Code of Conduct; and
- 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 the Commonwealth Ombudsman.
Log in to the Private Health Insurance Code of Conduct Portal