Ombudsman Act 1976

The complaint may be about:

any matter arising out of or connected with a private health insurance arrangement; or

any matter arising out of or connected with Chapter 2 of the Private Health Insurance Act 2007.

A complaint against a health care provider must, in addition to being about a matter in subsection (1), also:

be about either or both of the following:

the application of a private health insurance arrangement to goods or a service provided, or goods manufactured or supplied, by the health care provider;

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

satisfy at least one of the following:

the complaint must also be made against a private health insurer;

the complainant must be a private health insurer or a person insured under a private health insurance policy;

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.

The Private Health Insurance Ombudsman Rules may prescribe matters about which complaints cannot be made.