Health insurance complaints on the rise

The private insurance watchdog has received a decade-high number of complaints, with industry giant BUPA largely responsible for the spike.

The 3427 complaints made to the Private Health Insurance Ombudsman is a 16 per cent jump on the previous 12 months, and the biggest since the 3568 recorded in 2002-03.

In the watchdog's 2013-14 annual report, Ombudsman Samantha Gavel attributed the spike to product and policy changes made by BUPA, the country's second-largest insurer.

There were 1040 complaints about BUPA, up from 662 the year before.

"It is important to note that the increase in complaints this year was not industry wide," Ms Gavel said.

Benefits and the level of cover was the most significant grievance, accounting for 1039 of all the complaints.

The main issues were unexpected exclusions and restrictions on hospital cover, delays in payment and insurer rules that limited payouts.

The second-highest category related to information from providers, with misunderstandings over oral advice a major gripe.

The soon-to-be privatised Medibank had 622 complaints made against it, about the same as the previous year.

COMPLAINTS ABOUT PRIVATE HEALTH INSURANCE IN 2013-14

* 3427 complaints, up 16 per cent on the previous year.

* 1039, or 28 per cent, related to benefits or level of cover.

* 641, or 18 per cent, concerned the information provided to consumers.

* 552, or 15 per cent, were over membership issues such as premium payments or policy cancellations.

* 90.3 per cent of complaints resolved within 30 days, with only 1.8 per cent taking longer than 90 days.

(Source: Private Health Insurance Ombudsman Annual Report 2013-14)