Ombudsman Act 1976

The Private Health Insurance Ombudsman may report and make recommendations under this section after completing an investigation of a complaint against a particular subject under Subdivision D.

The Private Health Insurance Ombudsman may report to the Health Minister on the outcome of the investigation (including any recommendations made to the subject of the complaint and any responses to those recommendations).

The Private Health Insurance Ombudsman may recommend to the Health Minister either or both of the following:

general changes in regulatory practice or industry practices relating to the kind of subject of complaint;

possible means of dealing with specific problems arising in relation to the particular subject of the complaint.

The Private Health Insurance Ombudsman may make recommendations under paragraph (3)(b) concerning health care providers or a particular health care provider only to the extent to which the recommendations relate to:

the application of a private health insurance arrangement or a class of private health insurance arrangements to services or goods provided, or goods manufactured or supplied, by that kind of health care provider; or

a private health insurance arrangement or a class of private health insurance arrangements to which that kind of health care provider may be party.

Before reporting to the Health Minister under this section, the Private Health Insurance Ombudsman must:

inform the subject of the complaint that the Private Health Insurance Ombudsman proposes to make the report and of the nature of any criticism of the subject’s conduct that will appear in the report; and

invite the subject to comment on such criticism, before the end of the period specified in the invitation.