Private Health Insurance

The Commonwealth Ombudsman protects the interests of private health insurance consumers. We carry out this role in many ways, including:

  • assisting health fund members to resolve complaints through our independent complaint-handling service
  • identifying underlying problems of private health funds or health care providers
  • providing advice to government and industry about issues affecting consumers in relation to private health insurance
  • providing advice and recommendations to government and industry about private health insurance, including the performance of the sector and the nature of complaints
  • managing PrivateHealth.gov.au, Australia’s leading source of independent information about private health insurance for consumers.

We can take complaints from:

  • health fund members
  • health funds
  • hospitals, or
  • medical practitioners.

Complaints must be about a health insurance arrangement.

We cannot take complaints about the quality of service or treatment provided by a health professional or a hospital. These complaints should be directed to the health care complaints body for your state or territory.

Our service is free to consumers. We are independent and impartial. We do not represent consumers, insurers, hospitals or health services.

We also offer important consumer information and advice on private health insurance through:

Before you make a complaint

You should try to resolve the complaint with your private health insurer before contacting us.

How to make a complaint

Contact us if you, or someone you know, has an issue or complaint about a private heath insurer.

Visit our publications page for annual report information, facts and advice, brochures and more.

Visit PrivateHealth.gov.au for independent private health insurance information and to compare health insurance policies from every Australian health insurer.