Case Studies

The case studies below are real life examples of the type of complaints we receive and the actions we've taken to help resolve the complaint.

Centrelink

Immigration

Case study 1

On 22 January 2018, the Department of Home Affairs introduced a new visitor management policy which changed the conditions of entry and entry application process for personal and professional visitors to immigration detention facilities.

The Office monitored the implementation of the policy through our complaints, our inspections of immigration detention facilities and our engagement with stakeholders. In October 2018 we provided an issues paper to the department, outlining our concerns about the policy and making 13 recommendations.

We recommended that the ABF clarify elements of the policy on its website, the application information sheet and the Visiting Multiple Detainees request form; clarify which visitor application process applies to volunteer and community groups and which applies to individuals; and explain how the policy changes would affect these groups on both its website and the Visiting Multiple Detainees request form. The department accepted ten of our recommendations.

In April 2019, the department advised us that the ABF website has been updated to clarify and differentiate the process applying to volunteer and community groups and the process applying to individual visitors. The Office has not received any further complaints raising issues about the introduction of the policy.

Case study 2

A complainant approached our Office as they had recently applied to Centrelink for childcare subsidies and was advised that before their application could be approved, they needed the Department of Home Affairs to update their travel record. The complainant had travelled overseas with their parents when they were a child but their return to Australia was not recorded by the department. The complainant contacted the department, provided exit and re-entry dates and requested that their record be updated.

After some time, they raised a formal complaint with the department about the delay in updating their travel record. As the complainant could not access the subsidy from Centrelink, they were in debt with the childcare centre and their child was no longer able to attend. A response was received from the department which advised the record could not be updated because there was no record of their return to Australia.

The complainant contacted our Office. The Office considered that there was more the department could do to assist and transferred the complaint to the department. On the same day it received the transferred complaint, the department located and corrected the travel record and advised both the complainant and Centrelink of the correction.

For more information about how the Immigration Ombudsman can help you click here.

Law Enforcement

AFP Safe Place was established to provide support to people who have suffered sexual harassment or bullying and to give them the reassurance that their concerns will be treated with respect, sensitivity and confidentiality. Safe Place is available to former and current AFP members, who are encouraged to bring matters to the team, even if they have already reported previously through existing processes. In 2017–18, we met with representatives from Safe Place to discuss their management of complaints under Part V of the AFP Act.

In 2018–19, we made recommendations to the AFP regarding Safe Place and the handling of complaints. These recommendations included:

  • The AFP update its policies and procedures to provide both written and verbal information to complainants to ensure they are provided with consistent information and the integrity of the investigation and decision process can be easily established and reviewed.
  • The AFP ensure investigators are aware of appropriate notification practices and procedures.

The AFP undertook to implement our recommendations to improve its policies and procedures in relation to Safe Place. The Office will continue to monitor this program through our reviews under Part V of the AFP Act, regular liaison with the AFP and any complaints we may receive.

Our 2017–18 reviews found the AFP's administration of Part V of the Act to be comprehensive and adequate with matters investigated appropriately. However, we identified some deficiencies in how the AFP responds to practices issues and made several suggestions to improve record-keeping processes, and adherence to legislative requirements and standard operating procedures.

For more information about how the Law Enforcement Ombudsman can help you with the AFP click here.

National Disability Insurance Agency

Case Study 1

A complainant requested a review of the NDIA's decision to decline the request for specialist funding for a wheelchair (in their child's plan). The NDIA undertook the review and confirmed its original decision. Although the NDIA verbally told the complainant the decision, it did not send them or their child a written decision. Without a written decision, they were unable to seek merits review of the NDIA's decision by the Administrative Appeals Tribunal (AAT).

They complained to our Office. We contacted the NDIA and it sent a decision letter to their child. They were then able to exercise their rights to review the NDIA's decision.

Case Study 2

A person contacted our Office due to delays in receiving assistive technology in their NDIS plan. They told us they were in hospital and were waiting for the NDIA to approve funds so they could obtain customised mobility equipment, and have modifications made to their home. Once the modifications were made they could leave hospital and go home. They told us that they had followed all the steps including providing quotes and assessments, and despite calling the NDIA multiple times had waited five months for a decision before approaching our Office.

We investigated their complaint. We noted that the request had been handled by multiple teams and there had been lengthy delays in both processing the request and responding to the participant's attempts in following up the NDIA's decision.

During the investigation, the NDIA acknowledged the complexity of this participant's circumstances. It took action to provide a support coordinator to assist the participant in engaging with the hospital and in obtaining the mobility equipment and the required modifications, so the participant could leave hospital and return home.

For more information about how the Ombudsman can help you with the NDIS click here.

Oversight of government agencies

Case Study: Australian Securities and Investments Commission (ASIC)

A complainant complained to our Office that the Australian Securities and Investments Commission (ASIC) had deregistered their company because they had not paid the annual review fees. They told us that even though they had advised ASIC of a change to the address for their company, the annual company review fee invoices were sent to the old address and as a result, they had not paid the annual fee. Once they became aware of the error, they paid the annual review fee. They complained it was not fair to have to pay fees for late payment of the annual review fee.

We conducted preliminary inquiries and asked ASIC for information on how it processed the request to change the company address. After receiving our preliminary inquiry, ASIC realised it had not properly processed the change of address for the company. It reassessed its handling of the matter and agreed to reinstate the company's registration and waive the fees relating to the late payment of the annual company review fee.

Case Study: Fair Work Ombudsman (FWO)

A complainant was a participant in the jobactive program and was referred to a position as a labourer by an employment service provider.They found out they were being underpaid, and their provider referred them to the Fair Work Ombudsman (FWO) who advised they had a right to leave the position and assisted them in doing so.

The complainant told their provider they had left, but the provider lodged a non-compliance report to Centrelink, resulting in their Newstart Allowance being suspended. When they complained to the National Customer Service Line (NCSL), they were told to contact the Fair Work Ombudsman.

They then made a complaint to our Office. Our investigation identified errors on the part of the provider and found that on the basis of the information that was provided in the complaint to the NCSL, it would have been appropriate for the NCSL to refer the complaint to the provider for further investigation. The complainant's payment was restored, with back pay, and their record corrected.

Postal Industry

A complainant sent a box containing 12 bottles of wine overseas through Australia Post and purchased Extra Cover in case of damage. Some of the bottles were damaged in transit and a damage claim was made. Australia Post rejected the Extra Cover claim on the basis that the article was inadequately packaged and did not have a wine certificate (a requirement when sending more than 2 bottles).

The complainant complained on the basis that the Post Office knew at time of lodgment that the box contained wine and how it was packaged. Australia Post did not mention anything about a wine certificate and sold them Extra Cover. Australia Post did not change its decision so the complainant approached our Office.

We transferred the dispute back to Australia Post to respond to the complainant's concerns. Australia Post acknowledged that it should have identified that the article should not have been accepted for carriage as only two bottles of wine can be posted, additional amounts require a wine certificate and alcohol deliveries were also on the prohibited list for the country the box was addressed to.

Australia Post offered the complainant compensation to cover the damage and postage.

For more information about how  the Postal Industry Ombudsman can help you click here.

Private Health Insurance

Case Study 1

A complainant was told by a medical specialist that their child needed elective surgery. They had purchased hospital cover from a health insurer less than 12 months earlier. They called the insurer to check whether the costs associated with the surgery would be covered. Based on the verbal information from the insurer, they booked the surgery for their child.

The complainant used family's savings to pay for the procedure and made a claim with the insurer for reimbursement. Two weeks later, the insurer told them that the claim could not be paid. They explained that an independent medical advisor had assessed their child's condition to be pre-existing.

The complainant came to our Office for help. We contacted the insurer and asked for copies of all communication with the complainant. We found that the insurer had told them not to worry about the pre-existing conditions (PEC) process because the surgery was a 'standard procedure'. It was only three months before the end of the PEC waiting period when they said this to the complainant.

The PEC process requires an assessment by a medical practitioner appointed by the health insurer. Insurers can impose a 12 month waiting period on benefits for hospital treatment for a PEC. If the insurer had properly explained the PEC process and how pre-existing conditions are defined, the complainant may have delayed the surgery until the waiting period was finished. We asked the insurer to consider this issue and they agreed to pay the hospital costs because they had not given adequate information.

Case Study 2

A complainant started a health insurance policy in June. A government rebate was automatically applied to their policy, reducing their premium. The insurer asked them to complete a rebate form to confirm the reduced premium. The complainant thought they had returned the form, and did not hear anything more about it.

In late October, the insurer again asked the complainant to complete a rebate form. The complainant thought they returned the form a second time. Ten days later the insurer wrote to the complainant asking for the rebate form or else their premium would increase from their start date. Six days later, the insurer wrote to the complainant, saying that their premium had increased from June because their rebate had been removed. The letter went on to explain that they were now in arrears.

The complainant could not afford to pay the arrears so they cancelled their direct debit payments and started a new policy in late December with a different insurer. The second insurer applied new waiting periods because the complainant's first policy had ended more than two months earlier.

The complainant was not in good health and was receiving medical treatment. They contacted our Office and asked us to help. The first insurer gave us their records of communication with and admitted they should not have allowed five months to pass before following up on the rebate form. The first insurer offered to accept 50 per cent of the arrears and to issue a new end date certificate so the second insurer could remove the waiting periods on the complainant's new policy.

For more information about how the Private Health Insurance Ombudsman (PHIO) can help you click here.