Southern Cross tackles fraud

Stefan Azzopardi, head of finance, risk and compliance for Southern Cross Health Society said, “The vast majority of members and healthcare providers can be relied upon to act honestly and with integrity - however, claiming irregularities for health insurance are real and the society won’t tolerate dishonesty.

“Common sense tells us that when we’re paying 73% of the country’s health insurance claims, we need to be vigilant as any unnecessary costs are ultimately met through premiums.”

The society has a specialist team dedicated to preventing, detecting and investigating suspicious claims, whether they involve deception, poor administrative practices or billing errors.

To date, the work from this team has saved members an estimated $1 million in ongoing annual claims costs - and investigations are often due to member tip-offs.