The Private Health Insurance Ombudsman’s Quarterly Bulletin 59 contains some interesting statistics about health insurance complaints: volume, type and by insurer compared to market share.
Your complaints handling procedures should set out in writing:
(a) the procedures and policies for:
- receiving complaints;
- investigating complaints;
- responding to complaints within appropriate time limits;
- recording information about complaints;
- identifying and recording systemic issues;
(b) the types of remedies available for resolving complaints; and
(c) internal structures and reporting requirements for complaint handling.
You should provide a copy of the procedures to all relevant staff. A simple and easy-to-use guide to the procedures should also be made available to consumers, either on request or when they want to make a complaint. The information should be placed on your website.
Bright Law have experience in designing complaints and dispute resolution procedures.
