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PART 4—WHAT WE DO Complaints about Private Health Insurers Table 5 shows the number of complaints and disputes 6 received about registered private health insurers, and compares these to their market share. A high ratio of complaints or disputes compared to market share usually indicates either a less-than-adequate internal dispute-resolution process, especially for complex issues, or an underlying systemic or policy issue. Table 5: Complaints by registered private health insurer, by market share 2015–16 2015–16 Complaints Percentage of Complaints Disputes Percentage of Disputes Market Share ACA 0 0.0% 0 0.0% 0.1% Australian Unity 195 5.1% 33 4.8% 3.1% BUPA 834 21.7% 196 28.6% 26.8% CBHS 35 0.9% 9 1.3% 1.4% CDH (Cessnock) 2 0.1% 0 0.0%
National Health Benefits (Onemedifund) Complaints Percentage of Complaints 2015–16 Disputes Percentage of Disputes Market Share 1 0.0% 0 0.0% 0.1% Navy 2 0.1% 0 0.0% 0.3% NIB 301 7.8% 42 6.1% 7.9% Peoplecare 6 0.2% 1 0.1% 0.5% Phoenix 0 0.0% 0 0.0% 0.1% Police 1 0.0% 0 0.0% 0.3% Queensland Country Health 2 0.1% 0 0.0% 0.3% Railway and Transport 15 0.4% 1 0.1% 0.4% Reserve 0 0.0% 0 0.0%
Page 1 and 2:
ANNUAL REPORT 15-16
Page 3 and 4: HIGHLIGHTS In 2015-16 we received a
Page 5 and 6: CREDITS Date of publication: Septem
Page 7 and 8: GUIDE TO THE REPORT GUIDE TO THE RE
Page 9 and 10: CONTENTS PART 1—REVIEW BY THE OMB
Page 11 and 12: PART 1— REVIEW BY THE OMBUDSMAN
Page 13 and 14: Private Health Insurance The integr
Page 15 and 16: PART 2—OVERVIEW OF THE OFFICE PAR
Page 17 and 18: PART 2—OVERVIEW OF THE OFFICE vi.
Page 19 and 20: PART 2—OVERVIEW OF THE OFFICE Geo
Page 21 and 22: PART 3— REPORT ON PERFORMANCE
Page 23 and 24: Annual Performance Statement As req
Page 25 and 26: The office is required to carry out
Page 27 and 28: Methodology The extent to which the
Page 29 and 30: Strategic Objectives Objective 1 Pr
Page 31 and 32: PART 4— WHAT WE DO
Page 33 and 34: The office investigated seven per c
Page 35 and 36: When someone receives an employment
Page 37 and 38: compliance reviews; and the creatio
Page 39 and 40: Figure 3: All approaches for Austra
Page 41 and 42: efore arrival at Australia Post’s
Page 43 and 44: who wish to claim a refund of the G
Page 45 and 46: Figure 6: Number of reports receive
Page 47 and 48: Information sharing Limitations on
Page 49 and 50: Figure 7: Overseas Students Ombudsm
Page 51 and 52: Student Feedback “Hi, Thank you v
Page 53: PRIVATE HEALTH INSURANCE OMBUDSMAN
Page 57 and 58: INFORMATION Complaints: 599 Key iss
Page 59 and 60: Issue Sub-issue 2013-14 2014-15 201
Page 61 and 62: Complaints about hospitals, doctors
Page 63 and 64: Complaint outcomes Most cases (72 p
Page 65 and 66: Inspections of covert, intrusive or
Page 67 and 68: and templates. They are based on le
Page 69 and 70: Of these cases, the office finalise
Page 71 and 72: PIDs received The overall number of
Page 73 and 74: Once an internal PID is allocated f
Page 75 and 76: Of the 29 PIDs which we accepted, 1
Page 77 and 78: indicate a high level of satisfacti
Page 79 and 80: 2. Australian Postal Corporation 14
Page 81 and 82: 10. Australian Broadcasting Corpora
Page 83 and 84: 43. Department Foreign Affairs and
Page 85 and 86: 41. Corporations and Markets Adviso
Page 87 and 88: Table 15: PID investigations comple
Page 89 and 90: 9. Attorney-General’s Department
Page 91 and 92: PART 4—WHAT WE DO The Members and
Page 93 and 94: CASE STUDY—Commonwealth Ombudsman
Page 95 and 96: PART 5—MANAGEMENT AND ACCOUNTABIL
Page 103 and 104: PART 6— APPENDICES
Page 105 and 106:
2015-16 | COMMONWEALTH OMBUDSMAN AN
Page 107 and 108:
OFFICE OF THE COMMONWEALTH OMBUDSMA
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Note 5: Non-Financial Assets Proper
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Page 127 and 128:
Note 8: Provisions 0 0 $'000 $'000
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Page 133 and 134:
Page 135 and 136:
Appendix 2— Statistics Office of
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Finalised Remedies Received Cat 1 C
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Appendix 4—Entity Resource Statem
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PART 7— REFERENCES
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Term Complaint Controlled operation
Page 145 and 146:
Term Lifetime Health Cover (LHC) Me
Page 147 and 148:
Term The office The Ombudsman Unlaw
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Figures Figure 1: Executive and Sen
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Ref 17AD(c) 17AD(c)(i); 16F 17AD(c)
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Ref 17AG(4)(c)(iii) Part of report
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Ref 17AD(f) Part of report Descript
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Australian Commission for Law Enfor
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complaint investigations, 16, 24, 5
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detention inspections, 48 Detention
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I IDP Education Brisbane Internatio
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L lack of notification (private hea
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P Pacific Governance and Anti-Corru
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Q Queensland Ombudsman and PID Wiki
Page 171:
T Telecommunications (Interception
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