Putting members’ health before profit

hirmaa funds show customer care and service delivering for members

The customer centric ethos of not-for-profit and member owned health funds has again been highlighted in the latest Private Health Insurance Ombudsman (PHIO) Quarterly Bulletin.

This Bulletin shows that over the January to March quarter hirmaa funds, which comprise approximately 9.5% of the private health insurance market, accounted for only 4.9% of all complaints.

In comparison, the ‘big’ three for-profit private funds, Medibank Private, Bupa and NIB, which comprise approximately 63.3% of the private health insurance market, accounted for 70.6% of all complaints and 70.4% of the more serious level 3 complaints.

Of particular note were significant increases relating to membership and service issues compared to the same time last year.

Matthew Koce, CEO of hirmaa, the peak body for 19 not-for-profit, member owned and community based health funds, has urged Australian consumers look carefully at which health insurers have an established record of customer satisfaction.

“Consumers need to be aware that there is a stark contrast between the not-for-profit hirmaa health insurers and the rest of the industry.”

“Unlike the big for-profits, the smaller not-for-profit health insurance funds don’t have to serve shareholders and are entirely focused on meeting the expectation of their members. That is why not-for-profit hirmaa funds consistently lead the industry when it comes to customer satisfaction and member retention” Mr Koce said.

“It is important that consumers understand that there is a big difference between the for-profit and not-for-profit insurers. They are not all the same, some health insurers are better than others and consumers should look very carefully at the Ombudsman’s report when choosing a health insurer.”

“The strong consumer performance of the not-for-profit hirmaa insurers is backed up by independent research conducted by Discovery Research. An average overall customer satisfaction score of 97 per cent was recorded across the more than 21,000 responses received through participating not-for-profit hirmaa insurers.”

“Whether it be quality of health cover, communication to members, fast payment of claims, value for money or price competitiveness, all the evidence suggests that the not-for-profit and member owned hirmaa funds are leading the health insurance industry,” Mr Koce said.

hirmaa is the peak industry body for nineteen private health insurers which are member-owned and not- for-profit. In all, the hirmaa funds provide private health insurance for over one million Australians.

A copy of the latest Private Health Insurance Ombudsman (PHIO) Quarterly Bulletin can be found here.

Download a copy of this media release here: 2016-08-04-MEDIA RELEASE – PHIO complaints