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Lengthy and complicated claims processes could leave Aussies out of pocket on January 1

4 min read
30 Nov 2017

With the new year fast approaching, Australians could be left out of pocket next year for forgetting to lodge their health insurance claims before January 1, when insurers reset their annual claims benefit. New research indicates 35 per cent of Aussies have not claimed on their insurance, largely because they forget, think their doctor will do it for them, or they find the claims process lengthy or complicated.

The survey of an independent, nationally representative panel of 1000 Australian adults with private health insurance[1] was commissioned by leading insurance comparison service to find out how many people could be out of pocket in the new year, and gauge sentiment about the claims application process.

The survey asked respondents if they had forgotten to lodge any health insurance claims, and a surprising 30 per cent said they had. Forty-one per cent of respondents assumed any new doctor or specialist they go to charges their health fund directly for all costs, when they might not.

Of the 75 per cent of respondents who said they have had to pay their medical bill in full and then seek a health insurance or Medicare rebate afterwards, 40 per cent found the claims application process lengthy and 28 per cent found it complicated. spokesperson Abigail Koch, said: “With most health insurers resetting their annual benefits on January 1, Aussies with claims that haven’t been lodged should do so as soon as possible or they might waste this year’s benefit pot. Policy holders should also book any necessary appointments before the end of the year and lodge their claims before December 31 to take advantage of this year’s annual limit. Waiting until next year could potentially leave you out of pocket if your health expenses are high. The fact that over 40 per cent of our survey respondents find the claims process lengthy could be a reason they are forgetting and putting off making their claims.”

It seems that millennials are the age group getting the least amount of value out of their private health insurance. More than half (56%) of 18-24s and 43 per cent of 25-34s forgot to lodge a claim in the past, and this incidence lowers as people get older: at 20 per cent of 55-64s and just 12 per cent of over 65s. Over half (56%) of 18-24s and 51 per cent of 25-34s also find the claims process lengthy, compared with 38 per cent of 55-64s and 28 per cent of over 65s.

Finding the claims process lengthy or complicated isn’t the only headache among Australians, they also don’t understand how to lodge their claims. Again, this was highest for the younger generations. Over half (66%) of 18-24s and 62 per cent of 25-34s assumed their new doctor or specialist will charge their health fund, compared with 51 per cent of 35-44s, 34 per cent of 45-54s, 26 per cent of 55-64s and 22 per cent of over 65s.

To find how much policy holders could be left out of pocket in the new year for forgetting to lodge a claim, also asked how much respondents had been waiting on for the longest period of time. For more than half of Aussies (57%), this amount was over $100, this includes 17% who were waiting on more than $300, and 9% over $500.

Abigail says, “Christmas is an expensive time of year so it is a good idea to claim now to get some extra money in your pocket ahead of the festive season. It is also wise to do a health insurance check up to make sure you are getting the best benefit limits from your health provider. We recommend comparing policies side-by-side on to find a policy that covers your health needs and fits in with your new year budget.”


About is an online comparison service that takes the hard work out of shopping around. We help Australians to quickly and easily compare and buy products from a wide range of providers. Our easy-to-use comparison tool enables consumers to find a product that best suits their needs and their back pocket. We’re also in the business of comparing personal finance products, utilities and can help find the lowest fuel prices in your area. Whether it’s car, health or home & contents insurance, we provide a completely free service, that empowers Australians to make buying decisions with greater trust, knowledge and savings. We’ve got your back, simples.


[1] Survey conducted by Pureprofile

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avatar of author: Hannah Twiggs

Written by Hannah Twiggs

Hannah (or Twiggs as she's known by most of her colleagues) is a non-stop talker, avid snack eater, dog lover and passionate writer. When she's not chatting to journalists or writing up new story angles, Hannah enjoys a good Netflix binge, going away camping with friends and big brunches - preferably with extra bacon.

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