Most complained about Aussie health funds revealed (2024)

Most complained about Aussie health funds revealed (1)

Stewart Perrie

·Senior Journalist

Updated ·2-min read

The most complained about health funds have been revealed as Australians are expected to pay more for health insurance than ever before. More than 14 million Australians were delivered a premium blow this month, making it more important than ever to make sure you're getting value for money.

The Commonwealth Ombudsman has published data that shows how many customers lodged a formal complaint about their insurer in the 2022-23 financial year. Two companies sat clear above the rest.

Medibank was the most complained about insurer, raking in 29.9 per cent of all complaints.

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However, the ombudsman suggested this was due to the data breach that involved at least 9.7 million customers having personal data, in some cases including sensitive medical information, stolen two years ago.

"The Office received 186 complaints related to the Medibank data breach, a relatively small number given the size of the issue, but it is reasonable to assume that most complaints about the matter were made to the Office of the Australian Information Commissioner," the ombudsman said.

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Five most complained about Australian health funds

The ombudsman released data on the percentage of total complaints received about particular funds. Here's the biggest offenders:

  1. Medibank (29.9 per cent)

  2. BUPA (23.7 per cent)

  3. HCF (13.5 per cent)

  4. NIB: (10.1 per cent)

  5. Australian Unity: (4.7 per cent)

Two health funds - CDH and Onemedifund - managed to record zero complaints in the 2022-23 financial year, while others recorded quite low numbers. These are often much smaller funds.

Least complained about Australian health funds

  1. CDH (0 per cent)

  2. Onemedifund (0 per cent)

  3. CBHS Corporate (0.1 per cent)

  4. HCI (0.1 per cent)

  5. MDHF (0.1 per cent)

  6. Phoenix (0.1 per cent)

  7. Transport Health (0.2 per cent)

  8. CUA Health (0.3 per cent)

  9. QCH (0.4 per cent)

  10. St Lukes (0.5 per cent)

  11. Peoplecare (0.5 per cent)

  12. Westfund (0.5 per cent)

All up, the Ombudsman received close to 3,500 complaints in that financial year, which was a 27 per cent increase from the 2021-22 year.

"During 2022–23, the most common issues in consumer complaints related to service, benefits, and membership," it said in a statement.

"When consumers contact us about an insurer’s service, it is rarely the sole reason for their complaint. In our experience, they usually flow from another issue which, when combined with poor customer service, inadequate or delayed responses and poor internal escalation processes, cause policy holders to become increasingly dissatisfied."

Service and membership were two complaint areas that have increased year on year since 2020.

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Most complained about Aussie health funds revealed (2024)
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