HCi Factsheet

Making health insurance easy!

Health insurance fraud

June 2023

As a not for profit private health insurer, HCi is committed to protecting our members’ interests, while ensuring claims are paid quickly and efficiently. Our objective is to minimise losses from fraud and errors so that we can maximise the amount payable for claims payments to you.

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HCi is committed to protecting members from health insurance fraud

We use an independent, experienced service provider and our own investigative team to review suspected instances of claims fraud, billing errors, and cases of overcharging experienced by our members. Such incidents are thoroughly investigated and rectified with the aim of recovering any erroneous amounts, and deterring any potential fraudulent activity.

This ensures we are not incurring additional costs on your behalf, costs that may ultimately push up the cost of your health insurance premiums.

How can members help protect against claims fraud?

The easiest way for you to help us is to simply be aware of what you are being billed for. Make sure that you:

  • treat your HCi membership card like a credit card – keep it safe – and if you lose it, please report it to us straight away,
  • are aware of what you are being billed for and that you received the treatment recorded, and
  • tell us immediately if you see anything suspicious in your claims history (available via HCi OMS – https://members.hciltd.com.au/)

If you have reason to suspect fraudulent activity, please contact our Membership team on 1800 804 950, providing as much detail as possible. You can choose to remain anonymous if you prefer.

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HCi used its best endeavours to ensure this information was accurate at the time of publication. From time to time, circumstances relating to the subject matter may change which may impact the accuracy of the information. This information is also general in nature and does not take into account any specific health or financial situation. Before making any decisions in relation to this information, you should consider your own financial and health situation and seek professional advice. Health Care Insurance Ltd ABN 43 009 579 088. A Registered Private Health Insurer.

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