Health insurance became the largest category of disputes investigated by the Insurance and Financial Services Ombudsman Scheme for the first time in the year to June.
The number of health insurance disputes increased by 91 percent, overtaking disputes involving house and motor vehicle insurance.
Insurance and Financial Services Ombudsman (IFSO) Karen Stevens said rising healthcare costs and increasing pressure on the health system were probably contributing to the high number of disputes.
“Many of the disputes we considered involved disagreements about policy exclusions, benefit eligibility, limits, or changes to policy terms. Consumers generally do not realise how those factors affect their cover until they need to make a claim,” said Stevens.
Overall, the Ombudsman Scheme handled 3977 cases during the year, including 2602 complaints.
It completed a record 833 dispute investigations – up 46 percent on the previous year.
More than 92 percent of disputes accepted by the Scheme were insurance-related.
“While there have been no recent major natural disasters driving complaint volumes, we continue to see record levels of disputes coming to the IFSO Scheme.”
Travel insurance disputes also increased, rising 32 percent. Some complaints were linked to travel disruptions caused by conflict in the Middle East, while others involved policy exclusions and the extent of cover.
“This dispute highlights the importance of understanding policy exclusions and checking what events may not be covered before travelling,” she said.
The scheme recorded payments to consumers totalling more than $1.39 million during the year.
Disputes were investigated and completed in an average of 46 days.