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Unpicking The Ombudsman Email of 5 April 2022 (3)
24.15
Ombudsman Uninterested in Awful Behaviour by HCF
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“You
advised our Office that HCF were now no longer accepting any claims from
Lift.” |
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Translation ↓ |
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On
page 15 of my letter dated 21 February 2022,
I gave the Ombudsman details of the HCF scam. “Adding
to the seriousness of the “scam” in which HCF is engaged are two other
equally serious factors. ·
It has placed a “block” on its computer
system to try and prevent any claims at all from being lodged for services
provide by Lift Cancer Care Services; and ·
It simply ignores claims at random, not
responding in any way to the fact that they have been lodged. I
reiterate something already known to the Ombudsman about a FUNDAMENTAL DUTY
OF ALL HEALTH INSURERS. That
fundamental duty is the duty to permit claims to be lodged and to provide a
response – positive or negative – to those claims. If the response is negative, a reason
contemplated by the relevant legislative provisions MUST be provided.” In this portion of the email, the Ombudsman explicitly
acknowledged I had told it HCF was ignoring its duty to enable claims to be
lodged. I had thought the Ombudsman
would be concerned that HCF was breaking the law. The response by the Ombudsman amounted to - “How very uninteresting.
Why should we be interested in this?” The regulator had zero interest in law enforcement. Was the Ombudsman corrupt or “merely” very lazy. I formed the belief they were probably corrupt as well as lazy. |
****
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“Our Investigation* Investigation revealed …” * The bold
lettering replicates the bold used in the email |
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Translation ↓ |
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The
Ombudsman wanted to create the false impression
that it had investigated my complaint and rejected it – so the Ombudsman
lied. The Ombudsman carried out no
“investigation”. The
Ombudsman wanted to give the impression Lift was to blame for the behaviour
of the HCF. Instead of investigating the facts, the Ombudsman was a mouthpiece
for the health insurers. Perhaps the most misleading aspect of the email lies in the
heading “Our Investigation”. It proclaims
the Ombudsman had conducted its own investigation. When
I got this email, I certainly thought the Ombudsman had done an
investigation. I researched the Ombudsman Act many months later. I then realised there HAD NEVER BEEN any
investigation by the Ombudsman. Section 20P of the Ombudsman Act forbids
“investigations” by the Ombudsman except in limited circumstances. The
Ombudsman can conduct investigations if mediation has failed – and the Ombudsman
never suggested mediation in our case. The Ombudsman can conduct an investigation if it is “not satisfied with the outcome of” an investigation done
by the health insurer. The 5 April email insisted HCF had done no wrong, so the Ombudsman
was definitely not dissatisfied with “the outcome of any investigation” conducted by HCF. After
realising it was impossible the Ombudsman could have conducted any investigation
at all, I noted the careful wording immediately beneath the heading “Our
Investigation”. It is deliberately
deceptive. It does NOT say “Our
investigation revealed …”. It says
“Investigation revealed …”. Given the heading “Our Investigation”, these words give the
impression the Ombudsman did an investigation - but very carefully avoids
saying this. Government agencies are careful in their word selection and the
way they use those words. My conclusion
given the omission of the word “our” before the word “investigation”, is that
the only “investigation” was that conducted by HCF. This word formula was meant to deceive. I was definitely deceived when I received
this email. **** The
courts don’t substitute their own decisions for decisions reached by
bureaucrats, but they do exert some controls over bureaucratic decisions. If a decision is so unreasonable that no bureaucrat could have made it, the
courts say no valid decision has ever been made. In the case of my complaints, the Ombudsman was able to conduct an
investigation of its own – but only if it was “not satisfied with the outcome
of” of an investigation conducted by HCF.
Quite obviously, Ombudsman WAS satisfied with the “investigation”
conducted by HCF. Once it became “satisfied” with the “investigation” carried out by
HCF, the Ombudsman became unable to do its own investigation – and it clearly
didn’t. The Ombudsman decision not to carry out its own investigation falls
within the court concept of invalid decisions that no reasonable bureaucrat
could make. The Ombudsman’s refusal to
investigate my complaint was invalid. Given the documentation I had given the Ombudsman, it was legally impossible
for the Ombudsman to accept the HCF lies.
The evidence I sent to the Ombudsman in February 2022 refuted any
HCF assertions that it had asked Lift for further information which had never
been provided. |
****
The Ombudsman Blames the Victim
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“Our
Investigation Investigation revealed that
due to claiming issues with various insurers LCC had applied to the Department of Health to
have their ‘Tier 2’ hospital status
removed. Removal of this status allowed LCC to bill patients for
services directly rather than having to submit claims directly with a
patients insurer. This application was approved, and explains why you
were required to pay upfront for services and then claim directly from
your insurer from December 2021 onwards” |
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Translation ↓ |
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Having falsely claimed it had conducted
an “investigation” into my
complaints, the Ombudsman then resorted to a well know tactic – blame the
victim. The Ombudsman told us something
irrelevant. Before Lift could ask us
to pay on Margaret’s treatment days, the Health Department had to change its
hospital registration status. I doubt the Ombudsman told us this for
an innocent reason. This was designed
to blame Lift for making us pay for treatments HCF refused to pay for. The Ombudsman wanted us to think if Lift
had done nothing, we wouldn’t have had to pay for Margaret’s treatments. This was misleading on multiple
levels. The Ombudsman
was unconcerned that HCF ignored the law. The
Ombudsman was unconcerned about the need for Lift to be able to pay its own
expenses. If Lift
ceased to be able to operate, none of its patients could have got
treatments. Without the
treatments, Margaret and other Lift patients would probably die earlier than
they otherwise might. The
Ombudsman thought it was preferable for Lift patients to die because this
meant it would not have to enforce the law.
The
Ombudsman was unconcerned about Lift patients dying so long as it could avoid
doing its job. |
****
Above - Margaret at Anne Ryan's home in Ireland 13
December 2017
****
Above – Maeve O’Byrne 13 December
2017; in her funeral eulogy, she forgot that Margaret had ever known me and
that she had been our marriage celebrant.
****
Above – Anne Ryan. In her video funeral eulogy, she forgot Margaret
had ever known me. She gave me and Margaret the finger.
Above – Peter
Hussey. In his video funeral eulogy, he
forgot Margaret had ever known me.
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