Private Health Insurance Ombudsman

About Private Health Insurance Ombudsman

The Private Health Insurance Ombudsman is an Australian statutory body and its powers and functions are set out in Part VIC of the National Health Act 1953 (Cth). The main role of the Ombudsman is to provide private health insurance members with an independent service for health insurance problems and enquiries. Hospitals, medical practitioners (including some dentists) and health funds can also approach the Ombudsman about problems with any health fund, private hospital or medical practitioner, although all complaints must be about a health insurance arrangement. Other functions of the Ombudsman include: providing advice about private health insurance to consumers; providing feedback to health funds and Government about issues causing problems for consumers; and dealing with disputes about prostheses arrangements.