89 The Ombudsman Denies It Acted Corruptly (4): 9 November 2024

As promised on 7 November, this is a summary of the criminal offences that I believe may have committed by staff at the Commonwealth Ombudsman.

Dishonest Influencing of a Public Official

Section 135.1 of the Criminal Code is headed “General dishonesty”.  Section 135.1(7) is headed “Influencing a Commonwealth public official”.  Section 135.1(7) says this.

(7) A person commits an offence if:                      (a) the person does anything with the intention of dishonestly influencing a public official in the exercise of the official’s duties as a public official; and                      (b)  the public official is a Commonwealth public official; and                      (c)  the duties are duties as a Commonwealth public official. Penalty:  Imprisonment for 5 years.

My experiences with the Ombudsman convinced me that the Ombudsman made no attempt to carry out the its duties under the Ombudsman Act.

At no time did the Ombudsman show any interest in the facts of my complaints or in the requirements of the health insurance legislation.

The Ombudsman never pretended to act as an “independent umpire”.  In my experience, the Ombudsman only ever acted as a mouthpiece for HCF.

I doubt this could have occurred unless the Ombudsman had been improperly influenced by HCF and (probably) by other health insurers.

I gave the Ombudsman a complete set of all correspondence for every Lift service Margaret had.  The documents I gave the Ombudsman completely disproved any claim that Lift had been asked for additional information but had not provided it.  Although it had all of the necessary proof to the contrary, the Ombudsman still told me what it knew was a lie.  It claimed HCF had requested and not been given additional information about Margaret’s claims.

I believe there is a probability that as yet unidentified people acted on behalf of HCF with “the intention of dishonestly influencing” the Ombudsman in the performance of its duties.  These people must have been closely connected to HCF.  Some of these dishonest influencers may even have been employed in the Health Department and/ or the Ombudsman. 

An in depth investigation by the Australian Federal Police would be needed to establish if there is enough evidence lay charges for offences in breach of subsection (7) of section 135.1 of the Criminal Code.  I believe multiple breaches took place.

The email dated 5 April 2022 is inexplicable unless dishonest influencing of Ombudsman staff occurred.  

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Conspiracy to Defraud

Section 135.4 of the Criminal Code is headed “Conspiracy to defraud”.  Section 135.4(7) is headed “Influencing a Commonwealth public official”.  Section 135.4(7) says this.

(7) A person commits an offence if:                      (a) the person conspires with another person with the intention of dishonestly influencing a public official in the exercise of the official’s duties as a public official; and                      (b)  the public official is a Commonwealth public official; and                      (c)  the duties are duties as a Commonwealth public official. Penalty:  Imprisonment for 10 years.

I believe there is a probability that as yet unidentified people acting on behalf of HCF conspired with “the intention of dishonestly influencing” one or more “public officials” at the Ombudsman in the performance of their official duties.  At least some of those people must have been closely connected to HCF.  Some of them may have been employed either in the Health Department or in the Ombudsman.

An in depth investigation by the Australian Federal Police would be needed to establish if there is enough evidence lay charges for offences in breach of subsection (7) of section 135.4 of the Criminal Code.  I believe multiple breaches took place.

Unless an unlawful conspiracy took place, it is difficult to find a logical explanation for the 5 April 2022 email.

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Making False or Misleading Statements (1)

Section 136.1 of the Criminal Code is headed “False or misleading statements in applications”.  Section 136.1(1) is also headed “False or misleading statements in applications”.  Section 136.1(1) says this.

(1) A person commits an offence if:                      (a)  the person makes a statement (whether orally, in a document or in any other way); and                      (b) the person does so knowing that the statement:                               (i)  is false or misleading; or                              (ii)  omits any matter or thing without which the statement is misleading; and                      (c) the statement is made in, or in connection with:                               (i)  an application for a licence, permit or authority; or                              (ii)  an application for registration; or                             (iii)  an application or claim for a benefit; and                      (d) any of the following subparagraphs applies:                               (i)  the statement is made to a Commonwealth entity;                              (ii)  the statement is made to a person who is exercising powers or performing functions under, or in connection with, a law of the Commonwealth;                             (iii)  the statement is made in compliance or purported compliance with a law of the Commonwealth. Penalty:  Imprisonment for 12 months.

I believe it is completely certain that as yet unidentified people acting on behalf of HCF made false and misleading statements to the Ombudsman knowing that these statements were false.  It is obvious that someone at HCF falsely told the Ombudsman that claims for insurance benefits payable under our HCF policy for services provided to Margaret by Lift had not been paid because Lift had been requested to provide additional information, but had failed to provide it.  

I have no doubt that these false or misleading statements were made to the Ombudsman in connection with “an application or claim for a benefit” by HCF.  The benefit sought by HCF was the rejection by the Ombudsman of the complaints I had made to the Ombudsman about the unlawful conduct by HCF in failing to obey the law and pay our claims for the Lift services provided to Margaret.  Rejection of the complains meant that HCF could continue to disobey the law and continue to disobey the law and continue to refuse to pay claims for benefits that the law required it to pay.

I anticipate it might be argued that the words “application or claim for a benefit” confine this offence to situations where the “application” may result in payment of money by the Australian government.  I think this proposition clearly wrong.  By lying to the Ombudsman, HCF stymied the “investigation” by the Ombudsman.  This meant HCF could continue to avoid paying health insurance claims that the relevant health insurance legislation said it had to pay.  HCF clearly received money by making its false and misleading statements to the Ombudsman.

Unless HCF made false or misleading statements, it would have been impractical for the Ombudsman to dismiss my complaints –and it is clear that senior staff at the Ombudsman certainly wanted to dismiss all complaints concerning Lift.  Unless false or misleading statements were made to the Ombudsman on behalf of HCF, the 5 April 2022 email could not have been sent.

An in depth investigation by the Australian Federal Police would be needed to establish if there is enough evidence lay charges for offences in breach of subsection (1) of section 136.1 of the Criminal Code.  I believe multiple breaches took place. 

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This was Margaret receiving immunotherapy treatment on 22 January 2023.  Margaret was so very near death in January 2023.