62 My Battle to Make the Health Insurers Obey the Law Part 15: 20 October 2024

By March 2022, it was obvious HCF was deliberately ignoring the law.  Although court action might ultimately solve the problem, the legal system offered multiple ways through which HCF could delay any result.  If HCF delayed matters, it would win because Margaret would be dead and Lift perhaps driven out of business long before a final court result happened..  I would not ignore possible court action, but I needed a faster, more reliable plan.

Conventional methods like asking HCF to obey the law had failed and were unlikely to succeed.  I I needed to act differently if I wanted to fix this situation..  I decided to use the “stimulus system”.  The key was to make it more painful for HCF to disobey the law than to obey it.

I needed to intensify it significantly so the health insurers had no alternative except obey the law.  I needed to jam a metaphorical broomstick so far up the HCF corporate arse that it caused overwhelming pain.  If I did this often, HCF would be forced to obey the law – and so too would the other health insurers.

I had been polite and I had been patient.  This had got me nowhere, so it was time to escalate matters as much as possible.  The more HCF ignored me, the more I would escalate.  I was determined to stop the atrocious behaviour by the health insurers and I would do whatever had to be done to achieve this– so long as I kept all patients as protected as possible.  I mentally prepared myself for a media campaign.  If government agencies refused to take action, I would embark on a public campaign of naming and shaming HCF and the other health insurers.

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HCF continued to ignore me throughout March.  Because my previous attempts to persuade HCF to obey the law had failed, I stopped trying to persuade HCF to obey the law.  After my visit to HCF Marion on 8 March, it was clear that HCF had no intention of voluntarily obeying the law.  This Table summarises the correspondence I did send to HCF in March 2022.  It was confined to lodgement of claims seeking reimbursement for treatments given to Margaret by Lift.  I expected no response from HCF and I received zero response during that March.

 

Letter Details	Length of Correspondence	How Sent	Date of Response	Length of Response	What Did Response Say?
Letter dated 10 March 2022 addressed to Junita Lindsay, Complaints Resolution Officer	1 page	Email to jlindsay@hcf.com.au  sent at 10:28 am on 10 March 2022	No reply ever received	Zero length	No reply ever received
Letter dated 19 March 2022 addressed to Junita Lindsay, Complaints Resolution Officer		Email to jlindsay@hcf.com.au  sent at 11:04 am on 19 March 2022	No reply ever received	Zero length	No reply ever received

 

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I had discovered clear evidence that HCF had broken the law.  The Health Department and the Ombudsman were uninterested in doing anything, but there were other agencies that might help.  I wrote to the Australian Competition and Consumer Commission (ACCC) because it had a reputation as an effective agency and I had clear evidence of false and misleading conduct by HCF.  Perhaps I could persuade the ACCC to act.

I started drafting the letter to the ACCC on Thursday 10 March and had a draft completed by the afternoon of Monday 14 March.

As well as drafting the letter, I prepared two other documents –

·         Table I summarised our HCF official claims’ history as at 10 March 2022 according to our on-line member account.  It compared the official HCF record to the actual Lift treatments provided to Margaret, highlighting the falsity of the official claims’ history.

·         Table II analysed the HCF official advice for acceptance or rejection of treatments provided to Margaret by of Lift.

I was about to vigorously apply the Stimulus System to HCF when an unforeseeable accident prevented me from acting quickly.

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Commencement of the Stimulus System to HCF was interrupted when I had by a bad fall in the early morning of Tuesday 15 March. 

After leaving hospital for the final time in July 2021, I had begun making my daily walk early in the morning - often before daylight.  I initially did this because my sleep rhythms had been so severely disrupted by my illness.  After my illness had been resolved, I continued waking up much earlier than ever before so I decided to turn the early morning wake ups into a positive by doing my walk much earlier than before.

I found that the early starts resulted in me having more usable time every day; what had started out as an accidental result of illness became a preference.  Having more time available during the day was useful as I continued to batter at the brick wall HCF had erected against me.

I was about 1 kilometre away from home at about 5:30 am when my shoe caught on the edge of a cut in the path where a trench had been dug and then repaired.  The repair left a tiny vertical space of less than 13 millimetres (½ inch) where the two edges of the path had been rejoined.  My shoe caught on the edge and I fell face first as if I was a tree toppling over.  I shielded my face with my wrists and limited my visible damage to grazes on my face and knees, plus some cuts inside my mouth where my mouth was sandwiched between the concrete and my teeth.  Most of the shock from the fall was absorbed by my left wrist, which immediately started aching.

There was nothing else to do so I picked myself up and kept walking.  It was dark and I was alone.  After I returned home and had breakfast, the left arm became swollen and was very sore for some days.  Typing was temporarily impossible, so dealing with HCF had to wait.  The physical trauma to the arm initiated an angry rash which burned like fire.  The rash started on my right forearm and then spread to my left arm and belly.  I ignored the sore arm pain and splashed cream over the rash.  An X ray on Friday 18 March confirmed I had no broken bones in the arm or wrist.  The rash cleared after a four week period.

I thought the occurrence of the fall and the timing of it were interesting.  The crack responsible for the fall was tiny and the likelihood of tripping over the crack was very small.  Interestingly, the fall happened just as I had commenced a concerted effort to make HCF obey the law, starting with a request for intervention by the ACCC.