'The ACCC has instituted proceedings in the Federal Court against Bupa HI Pty Ltd (Bupa) for breaches of the Australian Consumer Law in relation to members’ entitlements to private health insurance benefits for certain claims, affecting thousands of consumers over a period of more than five years.
Bupa has admitted to engaging in misleading or deceptive conduct and making false or misleading representations by advising members they were not entitled to private health insurance benefits for their entire claim, when in fact this was not the case. Bupa has also admitted to engaging in unconscionable conduct in connection with its assessment of 388 Mixed Coverage Claims.
Most of the claims impacted by the admitted conduct were claims for hospital treatment, in which two or more procedures were performed at the same time. In cases where part of the treatment was covered by a member’s policy and part of the treatment was not covered, Bupa incorrectly rejected the entire claim.
The ACCC and Bupa will jointly ask the Court to order Bupa to pay a total penalty of $35 million and make other orders. It is a matter for the Court to determine whether the penalty and other orders are appropriate.' https://www.accc.gov.au/media-release/bupa-in-court-for-unconscionable-conduct-and-misleading-consumers-about-health-insurance-benefits-entitlements #ACCC #consumerlaw #Bupa #auslaw #auspol
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Dave J
Matthew Rimmer
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