Contact us about health insurance

Complaints process and disputes resolution scheme

If you’re dissatisfied with the financial advice service provided by or on behalf of Southern Cross, you can raise your concern directly with any of our nominated representatives, or by:

• Calling us on 0800 800 181
• Using our online complaints form
• Writing to us at: Complaints at Southern Cross, Southern Cross Health Society, Private Bag 99934, Newmarket, Auckland 1149.

We’ll acknowledge receipt of your complaint within two working days of the date we receive it (or if it is not practicable to do so, as soon as practicable after that time). We’ll aim to resolve your concerns in a timely manner and we’ll keep you informed of our progress.

So that we can best address your complaint, we may refer your complaint to different teams within Southern Cross. We will respond to you with the outcome of our investigation in a timely, fair and transparent way.

If you’re unhappy with our response, you can request that your complaint be reviewed by the Chief Operating Officer of Southern Cross. The Chief Operating Officer will review and make a final determination in respect of your complaint, which will be communicated to you as soon as possible.

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 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 at www.ifso.nz.

Alternatively, you can write to: Insurance and Financial Services Ombudsman, PO BOX 10 845, Wellington 6143.

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.