Health insurance remediation action

We’ve identified that some of our members, both past and present, have been negatively affected by internal issues with their Southern Cross health insurance which require action from us to put right.

We’re currently in the process of contacting our affected members to advise of how they have been impacted, and the action we are taking to remediate the issues. This includes any monetary payment that the member may be entitled to.

Here at Southern Cross, we pride ourselves on being with our members. That’s why we take the extra step to make sure that any disadvantage we may have put our members in is corrected as soon as possible.

What to do if you’re entitled to a payment

If you are entitled to a payment, you may receive an email or letter from us to confirm your next steps:

• If we have your bank account on record, we’ll confirm that account as the one we’ll be paying the money into. If you’re happy for the payment to be deposited into that account, you won’t need to do anything.
• If you want the payment to go into a different bank account, you need to complete this form or call us within 10 working days of the date on your letter or email. If we don’t hear from you within that time period, the payment will be deposited into the bank account set out in our letter / email.
• If we don’t have your bank account details, we’ll request that you complete this form, or to call us with your preferred account details within 30 working days of the date on your letter or email. Once we receive your nominated bank account details, we will pay you within 10 working days.
• In the event we attempt a payment and it bounces, we will communicate with you again to request valid account details for the money to be paid into.
• Sometimes, proof of bank account is required if your payment is over a certain amount, and we don’t have an account on file for you (or you’d like the payment made into a different account to the one we have on file). You will need to submit proof of your account details on this form.

If you receive payment from us without communication
Sometimes, we may pay compensation without sending an email or letter. This is because the amount being paid is below the threshold we have set that would trigger a communication from us. If you receive an unexpected payment from Southern Cross and would like more information, feel free to contact us.

Note: Account information that you submit in relation to receiving remediation payment will only be used for the purposes of that payment. To change the account your claims are paid into, or change the account that premiums are paid from, you still need to login to My Southern Cross or contact us.

If you’re dissatisfied with the service provided by or on behalf of Southern Cross, you can raise your concern directly 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 transparent and 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 and 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 the IFSO for review.

You can contact the IFSO Scheme on 0800 888 202, email at [email protected] or www.ifso.nz.

Alternatively, you can write to: Insurance and Financial Services Ombudsman, PO Box 10845, Wellington 6143.

Our duties

Southern Cross and its nominated representatives are bound by the duties set out in the Financial Markets Conduct Act 2013 to:

• give priority to your interests (by taking reasonable steps to ensure that our financial advice is not materially influenced by our own interests)
• exercise care, diligence and skill in providing advice to you; and
• meet the standards of ethical behaviour, conduct, client care and competence, knowledge and skill set out in the Code of Professional Conduct for Financial Advice Services. These standards are designed to make sure we treat you as we should and give you suitable advice. The Code of Conduct standards can be read here: fma.govt.nz.

This statement was prepared on 1 July 2021.

Southern Cross Medical Care Society (trading as Southern Cross Health Society), Level 1, Te Kupenga, 155 Fanshawe Street, Auckland City 1010. Phone: 0800 800 181.

Southern Cross Medical Care Society (trading as Southern Cross Health Society) is a licensed insurer and a licensed financial advice provider. For more information about the financial advice service we provide and a copy of our public disclosure statement please visit southerncross.co.nz/disclosure-statement.

Southern Cross Medical Care Society (trading as Southern Cross Health Society) has an A+ (Strong) financial strength rating given by Standard & Poor’s (Australia) Pty Limited. The rating scale is: AAA (Extremely Strong), AA (Very Strong), A (Strong), BBB (Good), BB (Marginal), B (Weak), CCC (Very Weak), CC (Extremely Weak), SD or D (Selective Default or Default). Ratings from ‘AA’ to ‘CCC’ may be modified by the addition of a plus (+) or minus (-) sign to show relative standing within the major rating categories. Full details of the rating scale are available at www.spglobal.com/ratings/en/about/intro-to-credit-ratings. Standard & Poor’s is an approved rating agency under the Insurance (Prudential Supervision) Act 2010.