Code of Conduct
The GMF Health Code of Conduct is designed to help our members by providing clear information and transparency in our dealings with them. The Code covers four main areas of conduct in private health insurance. They are :-
- That people selling private health insurance are properly trained;
- That members are aware of the internal and external dispute resolution procedures available in the event that they have a dispute with GMF Health;
- That policy documentation contains all the information that our members require, in a way that enables them to make a fully informed decision about their purchase;
- That members purchasing health insurance from persons other than GMF Health employees, understand the nature of the arrangement between GMF Health and the person selling the insurance on behalf of GMF Health.
Our obligation to you under the code:
We will endeavour to:
Work towards improving our standards of practice;
- Provide information to our members in plain language;
- Promote better informed decisions about our private health insurance products and services :-
- By ensuring that our policy documentation is full and complete;
- By providing an effective and clear verbal or written explanation of the contents of the policy documentation;
- By ensuring that our employees who provide information on health insurance are appropriately trained.
- Provide information to members on their rights and obligations under their relationship with GMF Health, including information on the GMF Health Code of Conduct;
- Provide members with easy access to our internal dispute resolution procedures, which will be undertaken in a fair and reasonable manner, and advise them of their rights to take an issue to an external body such as the Private Health Insurance Ombudsman.
How the Code Helps Members:
Apart from promoting improved standards in clarity and usefulness of information given to members, the Code is designed to help solve problems between members and GMF Health. GMF Health has a complaints handling process for members who may have a dispute with GMF Health. Examples of disputes include :-
- contents of advertising by GMF Health;
- representations made to the member when they purchased a product;
- features of their product;
- benefits paid under their product.
You can access GMF Health’s complaint handling process by calling us on 1300 653 099 or by writing to
PO Box 513
Kalgoorlie WA 6433
If you are not satisfied with the outcome of your concern you can ask to have it reviewed by the Internal Dispute Resolution process (IDR).
Complaints should be addressed to:
Member Relations Manager
PO Box 513
Kalgoorlie WA 6433
If a resolution is still not reached to your satisfaction you can :-
- contact the Private Health Insurance Ombudsman by calling toll free on 1800 640 695, or write to 2202/580 George Street, Sydney NSW 2000;
- forward the problem to a health care complaints commission or fair trading body in your State of residence;
- report GMF Health’s behaviour to the Australian Competition and Consumer Commission.
A full copy of the Code is available by calling a GMF Member Service Advisor on 1300 653 099 or by visiting:
http://www.privatehealth.com.au/codeofconduct