Health insurance fraud under the microscope

Private health insurers have agreed to establish an integrity register to tackle fraud and undesirable billing practices in health insurance, believed to cost $29 million in claims every year.

The insurers are members of the Health Funds Association. HFANZ estimates up to 5% of health insurance claims are fraudulent which costs $22 in premiums for every private health insurance member.

The register will be maintained by PriceWaterhouseCoopers, and will enable members to tackle fraud on a more consistent basis and will give the industry a clearer idea of its scale, ensuring a very clear zero-tolerance message is delivered to those who knowingly commit it.

“Health insurers are trying to keep a lid on rising premiums and eliminating fraudulent claims would help this,” HFANZ chief executive Roger Styles says.