The Private Health Insurance Ombudsman (PHIO) has recommended that information in websites and brochures relating to accident cover be made "clear and upfront", and not just left to fill the end of the brochure or in fine print on a website.
This advice comes after being published in the quarterly bulletin for the period of April 1 2012 – June 30 2012.
The PHIO stated that it receives regular complaints from people who have suffered an accident requiring treatment and have their claims denied by their insurer because of the strict definition of what qualifies as an accident.
The ombudsman has expressed concern on the way in which some health insurance policies are advertised, and how information is presented to members about them.
The quarterly bulletin published several cases in which people were denied accident cover, with the complainant believing that they were covered for almost anything where an accident occurred. They didn't have a clear understanding of the definition their treatment would need to meet or the time restrictions it incurred.
It is important to have a thorough understanding of the policies in your private health cover, so that if you were to encounter an accident you can rest assured that your treatment will be covered.