Disputes and complaints

Members are at the heart of everything we do, so if we haven’t met your expectations, we need to hear from you.

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Member-owned, not-for-profit

We’re proud to be a not-for-profit health fund, driven by the needs of our members to deliver the best possible health insurance.

 

 

If you have a complaint or dispute, please get in touch with us.

Phone: 1300 654 123.

Email: complaints@cbhs.com.au

Post: CBHS Health Fund Limited, Locked Bag 5014, Parramatta, NSW 2124

Our aim is to continually improve our level of service and products. When it comes to complaints, we are committed to achieving a fair and reasonable outcome for all our members. You can contact us any of the ways below.


Disputes and complaints policy

Fairness: You have a right to be heard and respected.  Our internal complaints procedures are designed to:

  • Explain the complaint or dispute process to you if necessary
  • Carefully consider all relevant information about your complaint or dispute
  • Tell you about the progress of the complaint or dispute
  • Respect your privacy and those of other persons you have given us written permission to talk to
  • Make a fair and reasonable decision in the circumstances
  • Provide general reasons for the outcomes we have reached

Members’ rights: We recognise, promote and protect complainants' rights, including the right to comment and complain.

Resources: We 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: We will acknowledge receipt of each complaint immediately and will make every attempt to resolve complaints and disputes within three days of receipt. We will also keep you informed of the progress.

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

We will address all aspects of complaints and disputes and where appropriate, we 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


Escalation of complaints and disputes

Under our internal complains and disputes procedures, you can refer your unresolved complaints to the relevant manager, and if necessary, to our Dispute Resolution Committee.

Referral to the Private Health Insurance Ombudsman

If you disagree with CBHS’s Dispute Resolution Committee, you or CBHS may refer the complaint to the Private Health Insurance Ombudsman (PHIO). 

Contact PHIO on 1300 362 072 (option 4 for private health insurance) or write to:

The Private Health Insurance Ombudsman
Office of the Commonwealth Ombudsman
GPO Box 442
CANBERRA ACT 2601

Phone: 1300 737 299
Fax: (02) 6276 0123
Email: phio.info@ombudsman.gov.au
Website: www.privatehealth.gov.au

See also PHIO Complaints Process for further details.


Privacy complaints

You can also make a complaint if you believe we have breached any of the Australian Privacy Principles in the Commonwealth Government’s Privacy Act 1988  or any requirement in the CBHS Privacy Policy.

First, lodge your complaint with us following the procedures stated above. If you are not happy with the outcome, then you may refer the complaint to PHIO (as above) or to the Office of the Australian Information Commissioner (OAIC).

Contact OAIC on 1300 363 992 or 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:

https://www.oaic.gov.au/privacy/privacy-complaints/