Disputes and complaints

CBHS have a comprehensive disputes and complaints policy that governs our complaints and disputes handling team.

How to lodge a complaint or dispute with CBHS

CBHS is committed to the effective implementation of this policy to achieve a fair and reasonable outcome for our members. 

We recognise the value of complaints as an important tool in monitoring and responding to customer expectations and will use this type of feedback to improve the level of our service and our products.

If you have a complaint or dispute, you can submit it to us in the following ways:

  • Phone - Call Member Care on 1300 654 123.
  • Fax - Fax your complaint to 02 9843 7676.
  • Email - Send your email to complaints@cbhs.com.au
  • Post - Send your complaint letter to CBHS Health Fund Limited, Locked Bag 5014, Parramatta, NSW 2124 

Disputes and complaints policy

This policy aims to increase member satisfaction with CBHS and enhance our relationship with members. It also establishes a framework for managing complaints and disputes and as a point of reference regarding interpretation.

Fairness: Complainants have a right to be heard and respected.  CBHS will carefully consider all information provided by a complainant, tell the complainant about the complaints and disputes handling process and how the complaint/dispute is progressing, and respect a complainant's privacy.  CBHS will make sure that the complainant is fully informed about any decisions or outcomes from the complaint/dispute including the general reason for the outcome. If a member asks someone who is not included in their membership to complain on their behalf, we may ask the member to give us permission in writing to talk to that person.  This ensures that we meet our obligations to protect our members' privacy.

Member's rights: CBHS recognises, promotes and protects complainants' rights, including the right to comment and complain.

Resources: CBHS will have appropriately selected adequately trained and well supported staff to handle complaints and disputes and will use this policy as part of their induction program.

Responsiveness: CBHS will acknowledge receipt of each complaint immediately and will make every attempt to resolve complaints and disputes within 3 days of receipt. CBHS will also keep the complainant informed of the progress of their complaint.

Monitoring: We monitor all complaints and disputes so that we can improve the quality of our products, services and communication: including complaints of unclear policy documentation and changes to entitlements to benefits.

Fees: CBHS does not charge a fee for dealing with complaints and disputes.

Remedies:  Responding to a complaint or dispute will, where possible, include a remedy appropriate to the situation. Remedies include:

  • refunds
  • information
  • referral
  • financial assistance
  • apology

All aspects of complaints and disputes will be addressed and where appropriate, CBHS will consider offering the same remedy to others who may have had a similar experience but who have not lodged a formal complaint/dispute.

See also: CBHS Complaints Handling and Disputes Resolution Policy - Dec 2015
See also: CBHS Remedies Policy - Jun 2015
See also: CBHS Disputes Resolution Committee Charter and Powers - Jun 2015

Visibility:  This policy has been published on cbhs.com.au and in information brochures.

Escalation of complaints and disputes

CBHS has clearly articulated procedures for referring unresolved complaints to the relevant Manager, then on to the Dispute Resolution Committee. 

Referral to the Private Health Insurance Ombudsman

If the complainant disagrees with CBHS’s Dispute Resolution Committee, CBHS may refer the complainant to the Private Health Insurance Ombudsman (PHIO). 

PHIO can be contacted on 1800 640 695 or a member can write to:

The Private Health Insurance Ombudsman

Suite 2, level 22, 580 George Street
SYDNEY NSW 2000

Phone: 1800 640 695
Fax: (02) 8235 8778
Email: info@phio.org.au

See also PHIO complaint brochure for further details:

http://www.phio.org.au/downloads/file/PublicationItems/MakingAComplaint.pdf

A customer can make a complaint in relation to CBHS breaching the Australian Privacy Principles (APP) or the CBHS Privacy Policy.

In the first instance, a customer must lodge their complaint with CBHS following the procedures stated above, and if they are not satisfied with the outcome of our processes, then the complainant has the right to lodge the complaint with PHIO.

If the complainant is still not satisfied with the outcome, then the complaint may be taken to the Office of the Australian Information Commissioner (OAIC).

OAIC can be contacted on 1300 363 992 or a member can write to:

The Office of the Australian Information Commissioner
GPO Box 5218
Sydney, NSW 2001

Phone: 1300 363 992
Email: enquiries@oaic.gov.au

See also OAIC privacy complaint brochure for further details:

http://www.oaic.gov.au/privacy/making-a-privacy-complaint