8. Providing information to policy holders

1. For the purposes of paragraph 40 (1) (a) of the Act, the following requirements are specified:

(a) the insurer must provide information about increases under Part 2-3 in the amounts of premiums payable for the policy holder’s hospital cover in respect of the policy holder, if requested by the policy holder;

(b) the insurer must provide the following information to a policy holder affected by section 34-1 or section 34-5 of the Act, if requested by the policy holder:

(i) the amount by which the policy holder’s premiums payable for hospital cover are increased as a result of the operation of those sections;

(ii) the private health insurer’s record of the number of days the policy holder has not had hospital cover since his or her lifetime health cover base day, other than days to which paragraph 34-20 (1) (a) of the Act applies.

Note: Paragraph 34-20 (1) (a) of the Act deals with permitted days without hospital cover.

2. Information provided in accordance with this rule may be provided:

(a) in the form of a record based on an age notionally attributed to the policy holder as the age from which the policy holder will be treated as having had continuous hospital cover; and

(b) as a notice, or included with other information, sent to the policy holder.

Note: The information may be included in a statement issued in accordance with the Private Health Insurance (Incentives) Rules 2012.

3. The information required to be provided by subrule 8 (1) must:

(a) be provided:

(i) by post; or

(ii) if the policy holder has requested that the information be provided in another manner—if reasonably practicable, in the manner requested by the policy holder; and

(b) in the case of joint policy holders, set out the details applying to the joint policy holder making the request; and

(c) be provided to the policy holder within 14 days of receipt of the request.

Example: For subparagraph (a) (ii), if requested by the policy holder, the information may be provided in an electronic format, including via a web page.