Contact us about health insurance

Our complaints process

We want to know if you are dissatisfied with our products or services, so that we can work with you to resolve your concerns. If you want to make a complaint, you can:

• Use our online complaints form
• Call us on 0800 800 181
• Write to us at: Complaints, Southern Cross Health Society, Private Bag 99934, Newmarket, Auckland 1149

We will work towards resolving your concerns in a timely manner and will get back to you within 3 working days. If it takes longer than this to resolve your issue, we will keep you informed of our progress while we work towards a resolution for you.

So that we can best address your complaint, we may refer your complaint to different teams within Southern Cross Health Society. If you ask us to, we will respond to you in writing with the outcome of our investigation in a way that is fair, transparent and within a reasonable timeframe.

Not satisfied with the outcome?

If you are unhappy with the response you receive from us, you can request that your complaint be reviewed by our Chief Operating Officer. Our Chief Operating Officer will review the matter and make a final determination in respect of your complaint, which will be communicated to you without undue delay.

Still not satisfied?

We belong to the Insurance & Financial Services Ombudsman’s approved dispute resolution scheme (IFSO). The IFSO Scheme is a free and independent dispute resolution service available to consumers that may help investigate or resolve complaints if not able to be resolved through our internal complaints process.

If your complaint has been fully investigated by us, we have issued you with a letter of deadlock, and you’re still not satisfied with the outcome, you can refer your complaint to IFSO for review.

You can contact the IFSO Scheme on 0800 888 202, email at info@ifso.nz or by visiting their website www.ifso.nz. Alternatively, you can write to the following address: Insurance & Financial Services Ombudsman, PO BOX 10 845, Wellington 6143.

Is your complaint about your membership of Southern Cross?

Refer to the Rules of Southern Cross which outlines the process to resolve membership disputes. You can get a copy of the Rules from southerncross.co.nz/rules

You can pass on the details of any suspicious health insurance claiming by:

• Calling our toll free number 0800 420 055
• Or emailing integrity@southerncross.co.nz

Thanks for letting us know, and rest assured that we will do our best to ensure any information you supply will be treated confidentially. If you have a general enquiry about Southern Cross Health Insurance membership, please use our enquiry forms.

How you can help

Below are some examples of activity which we would investigate.

• Altered documents.
• Claims submitted for different treatment than what was provided – eg. for a more expensive procedure.
• Billing for services not provided to obtain reimbursement.

Our approach

If suspicious claiming practices are suspected, the Society investigates and where appropriate takes steps to recover funds. The Society has a range of actions that it is able to take against members and providers. In extreme cases, where fraud or ethical issues are suspected, matters may also be referred to the police or an appropriate medical body.

To support our approach:

Never sign a blank form and leave it with anyone – even a healthcare provider. Carefully check the details on invoices and your Claim update to ensure they match the treatment received and costs paid. Don't be afraid to ask questions, report issues and query invoices.