Commonwealth Consolidated Acts

OMBUDSMAN ACT 1976 - SECT 20D

    The Private Health Insurance Ombudsman has the following functions:

  (a)   dealing with complaints under Division   3;

  (b)   conducting investigations under Division   4;

  (c)   publishing (in written form and on the Private Health Insurance Ombudsman's website) a report, called the State of the Health Funds Report, as soon as practicable after the end of each financial year providing comparative information on the performance and service delivery of all private health insurers during that financial year;

  (d)   collecting and publishing (in written form and on the internet) information about the complying health insurance products available to people, in order to assist people to understand the entitlements and benefits available under those products;

  (e)   publishing, in aggregate form, information (not personal information) about complaints under Division   3;

  (f)   reporting and making recommendations to the Health Minister under sections   20R and 20V;

  (g)   reporting to the Health Minister or to the Health Department about the practices of particular private health insurers or private health insurance brokers;

  (h)   reporting (as part of reports mentioned in paragraph   (g)) to the Health Minister or to the Health Department about the practices of particular health care providers, to the extent to which those practices relate to:

  (i)   the application of private health insurance arrangements or classes of private health insurance arrangements to services or goods provided, or to goods manufactured or supplied, by the health care providers; or

  (ii)   private health insurance arrangements or classes of private health insurance arrangements to which those kinds of health care providers may be party;

  (i)   making recommendations to the Health Minister or the Health Department about regulatory practices or industry practices relating to private health insurers or private health insurance brokers;

  (j)   making recommendations (as part of recommendations mentioned in paragraph   (i)) to the Health Minister or to the Health Department about regulatory practices or industry practices relating to health care providers, to the extent to which those practices relate to:

  (i)   the application of private health insurance arrangements or classes of private health insurance arrangements to services or goods provided, or to goods manufactured or supplied, by the health care providers; or

  (ii)   private health insurance arrangements or classes of private health insurance arrangements to which those kinds of health care providers may be party;

  (k)   promoting a knowledge and understanding of the Private Health Insurance Ombudsman's functions;

  (l)   any other functions that are incidental to the performance of any of the preceding functions.