Private Health Insurance Act 2007

CHAPTER 3 - COMPLYING HEALTH INSURANCE PRODUCTS  

PART 3-4 - OBLIGATIONS RELATING TO COMPLYING HEALTH INSURANCE PRODUCTS  

Division 93 - Giving information to consumers  

SECTION 93-20   KEEPING INSURED PEOPLE UP TO DATE  

93-20(1)    
A private health insurer must ensure that an ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

adult insured under a ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

complying health insurance policy issued by the insurer is given the ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

private health information statement for the ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

product subgroup that the policy belongs to, at least once every 12 months.

93-20(2)    
A private health insurer must ensure that, if a proposed change to the insurer ' s ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

rules:

(a)    is or might be detrimental to the interests of an insured person; and

(b)    will require an update to the ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

private health information statements for a ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

complying health insurance product of the insurer;

an ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

adult insured under each ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

complying health insurance policy in the product:

(c)    is informed about the proposed change a reasonable time before the change takes effect; and

(d)    is given the updated private health information statement for the ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

product subgroup that the policy belongs to as soon as practicable after the statement is updated.

93-20(3)    
A private health insurer must ensure that, if an ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

adult who is insured under a ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

complying health insurance policy of the insurer asks an ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

officer, employee or agent of the insurer for information about what the policy covers or the benefits the policy provides, the adult is given the information as soon as practicable.

93-20(4)    
If a private health insurer changes the ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

health benefits fund to which a ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

complying health insurance policy of the insurer is ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

referable, the insurer must ensure that:

(a)    before the change takes effect, an ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

adult insured under the policy is given a statement identifying the health benefits fund to which the policy will be referable as a result of the change; or

(b)    within 2 weeks after the change takes effect, an adult insured under the policy is given a statement identifying the health benefits fund to which the policy is referable as a result of the change.

Note:

The health benefits fund to which a policy is referable may change in accordance with Division 4 of Part 3 of the Private Health Insurance (Prudential Supervision) Act 2015 .

93-20(5)    
If more than one ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

adult is insured under a single ^[*]

To find definitions of asterisked terms, see the Dictionary in Schedule 1 .

complying health insurance policy of a private health insurer, the insurer is taken to comply with subsection (1) , (2) or (4) if the insurer complies with the subsection in relation to only one of those adults.