Ombudsman Act 1976

The Private Health Insurance Ombudsman may, on his or her own initiative, investigate the practices and procedures of a private health insurer or a private health insurance broker.

The Private Health Insurance Ombudsman may, on his or her own initiative, investigate the practices and procedures of a health care provider together with an investigation of a private health insurer under subsection (1), if:

the investigation relates to a matter arising out of or connected with a private health insurance arrangement; and

the practices and procedures relate to either or both of the following:

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

a private health insurance arrangement to which the health care provider is, or was in the period to be investigated, a party; and

the Private Health Insurance Ombudsman considers, having regard to the object of this Part, that investigation of the health care provider together with the private health insurer is necessary or appropriate in order to consider the matter effectively.

An investigation may include mediation (see section 20X).