Complaints AndFeedback

Complaints and Feedback

As Australia’s largest not-for-profit health fund, our members are at the heart of everything we do. We’re always looking for ways to improve our products, services and the overall experience for our members. So if you’ve got feedback, or if we haven’t met your expectations, then let us know.

Here are the different levels of registering a complaint with HCF.

1. PROVIDE YOUR FEEDBACK

We’re always here to help and will do our best to resolve any misunderstandings or concerns with you as soon as possible. You can chat to us in person, by phone, email or online.

2. MAKE A COMPLAINT

If we are unable to resolve your concern at first point of contact, we‘ll assign your complaint to a Resolution Officer.

Please provide as much information as possible to help us get to the bottom of your concern. If you can, please include: 

  • a clear description of your concern, and what you believe caused it;
  • whether your concern relates to a specific claim or interaction;
  • your desired outcome; and
  • any special arrangements you would like us to follow, such as how to contact you or any support needs which you may have.

To make a complaint:

Response Time

We’ll let you know that we’ve got your concern within 2 business days.

Then, we’ll complete our review and get back to you within 5 business days from when we first heard from you. If we need more information or time to complete our review, we’ll be in touch. We will advise you of the reasons for this and the expected timeframe to resolve your complaint.
 

3. INTERNAL REVIEW

If you’re not happy with the outcome, you can ask that your complaint is escalated for an independent review within HCF.

Response time

We’ll let you know that we’ve got your complaint within 2 business days and aim to resolve it within 5 business days. If we need more information or time, we’ll be in touch.
 

4. EXTERNAL REVIEW

If you’re still not satisfied, you may wish to contact the relevant Ombudsman. An Ombudsman is an independent body that helps resolve complaints and provide information.

If your complaint is about health insurance, contact the Private Health Insurance Commonwealth Ombudsman:

If your complaint is about life insurance, contact the Australian Financial Complaints Authority (AFCA):

Once you’ve requested an external review of your complaint, we’ll give PHIO or AFCA all the relevant information. We’ll try to resolve any issue as soon as possible.

Response time

We’ll give PHIO a detailed response within 3-10 business days.

AFCA generally requires a detailed response from us within 45 calendar days.


MORE INFORMATION

For more information on how to make a complaint and our process, see our Complaint Management Policy. For a copy of this policy, visit your local branch.

For general information about private health insurance, see www.privatehealth.gov.au.

Your Privacy

Throughout the complaint process, we will protect your privacy and handle your personal information confidentially and in accordance with our Privacy Policy at hcf.com.au/privacy