Document ID: chunk:federal_register_of_legislation:C2015A00057:clause:1_20g
Version: federal_register_of_legislation:C2015A00057
Segment Type: clause
Provision Reference: sch 1 cl 20G
Character Range: 13519–14875

20G  Grounds for complaint
 (1) The complaint may be about:
 (a) any matter arising out of or connected with a private health insurance arrangement; or
 (b) any matter arising out of or connected with Chapter 2 of the Private Health Insurance Act 2007.
 (2) A complaint against a health care provider must, in addition to being about a matter in subsection (1), also:
 (a) be about either or both of the following:
 (i) the application of a private health insurance arrangement to goods or a service provided, or goods manufactured or supplied, by the health care provider;
 (ii) a private health insurance arrangement to which the health care provider is, or was at the time of the incident to which the complaint relates, a party; and
 (b) satisfy at least one of the following:
 (i) the complaint must also be made against a private health insurer;
 (ii) the complainant must be a private health insurer or a person insured under a private health insurance policy;
 (iii) if the complainant is another health care provider or a private health insurance broker—a private health insurer or a person insured under a private health insurance policy must also be a complainant in relation to the complaint.
 (3) The Private Health Insurance Ombudsman Rules may prescribe matters about which complaints cannot be made.

Subdivision B—Dealing with complaints