HCF tries to cover its arse while agreeing it will obey the law.
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Margaret on the 30th of August 2016 in Ketchikan Cultural Centre, Alaska.
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En route to Alaska by boat on the 31st of August 2016.
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The letter from Mark Johnson, dated 13th of May 2022.
As I said in Blog 165, on the 13th of May 2022, I received a letter from HCF Chair Mark Johnson.
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Analysis of the Mark Johnson Letter
This is my analysis of the Mark Johnson letter. The letter itself can be seen via the attached link.
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My Complaints Discussed by the HCF Board
Dear Mr Hankin, I refer to your letter to me dated 5 May 2022. As I mentioned in my brief acknowledgement earlier this week, I can confirm that the HCF Board is in receipt of your letters and this matter has been investigated internally, including being reported to the HCF Board. |
Translation ↓ |
The opening paragraph said the HCF Board had discussed my letter and a report had been given to the Board. It is unclear whether the letters I sent to the Directors on 11 April 2022 had been relayed to them prior to my Mark Johnson letter dated 5 May 2022. I suspect they were (at least initially) suppressed. |
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Never Plead Guilty – Even When You Are!
HCF is aware of its obligations under the Private Health Insurance Act 2007 (Cth) and its rules and we are very confident that the law has been correctly applied when reviewing Type C certificates submitted by Lift Cancer Care. |
Translation ↓ |
I have to say this. What else can I say? I can’t just say HCF is guilty! |
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We Are Looking After Our Members!
It is important for members that there is proper control over the use of member funds and accordingly we have diligent processes in place to ensure payment is made only when claims meet regulatory requirements. |
Translation ↓ |
Because we were members of HCF, HCF was actually looking after us when it refused to obey the law. In reality, perhaps Margaret and I wanted HCF to screw us when Margaret attended lift! Meaningless words inserted by the lawyers. |
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(1) Everyone We Can Screw, We Do Screw!
HCF treats all providers equally when reviewing the completeness of Type C certificates. |
Translation ↓ |
We obey the law for all health services providers who are large enough to be able to force us to obey the law. Everyone else gets screwed. |
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(2) Everyone We Can Screw, We Do Screw!
With very few exceptions Type C certificates and claims submitted to HCF are compliant with the legal requirements and paid when first assessed. |
Translation ↓ |
The Type C certificates submitted by Lift Cancer Care Services do not comply with the law because HCF says they do not comply, even if they follow the exact wording suggested by the Department of Health. |
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HCF Is Not Even Handed: We Have Only Screwed Lift!
To date, Lift Cancer Care has been the outlier in non-compliance with these requirements. |
Translation ↓ |
The paid HCF management has assured me that no other health provider has been treated in the same way as Lift. We have not treated anyone else in the same manner that we have treated Lift. I am fully aware you think this is rubbish. |
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Forget What Sheena Jack Said
HCF has always been willing to pay benefits claimed by Lift Cancer Care provided that it can provide a Type C certificate with the information which would make the certificate compliant. |
Translation ↓ |
The paid HCF management hope you forget that Sheena Jack put forward a completely different and nonsensical set of reasons for refusing to pay the Lift claims. The lawyers who drafted this letter want me to rehash the same lies that HCF has already peddled to the Ombudsman. Please forget the completely different set of lies put forward by Sheena Jack in her letter dated 3 May 2022. |
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(1) The Lawyers Insist I Say This
We have communicated our requirements to Lift Cancer Care numerous times, however they have not provided this information to HCF. |
Translation ↓ |
The lawyers insist I say this. We both know this is bulls**t, but I have to say it. |
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(2) The Lawyers Insist I Say This
HCF does not agree with your allegations that HCF and its employees have acted “illegally and improperly” or breached any laws in our refusal to pay benefits to Lift Cancer Care on the basis of the Type C certificates that we have received. |
Translation ↓ |
The lawyers also insist I say this. |
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(3) The Lawyers Insist I Say This
HCF also does not agree with your allegation that it has tried to make Lift Cancer Care claims “disappear” or pretend “they never existed” – all claims submitted by Lift Cancer Care are traceable on our systems. |
Translation ↓ |
The lawyers were most insistent that I say this. We both know it is bulls**t. Please forget about our false online official claims’ histories. |
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We Will Pay Because We Have No Choice
While HCF maintains its view is the correct legal position, to avoid further member distress and cost, HCF has, without any admission of liability, subsequently paid claims on an “ex-gratia” basis, including reimbursement for claims paid by your wife Margaret. |
Translation ↓ |
It has become too difficult for HCF to continue to ignore the law, so we will now obey the law. |
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We Didn’t Do a Dirty Deal with the Ombudsman!
Your allegation that payment of Margaret’s claims as an “ex-gratia” payment is because of a “dirty deal” with the Private Health Insurance Ombudsman, is not correct, rather it was a reimbursement of Margaret’s claims made at our discretion, despite the failure of Lift Cancer Care to provide a complying Type C certificate. |
Translation ↓ |
We definitely did not do a dirty deal with the Ombudsman and the Ombudsman definitely did not ask us to make a payment to you so that the Ombudsman could dismiss your complaints. I know this makes no sense but just ignore the fact the Ombudsman told you it had dismissed your complaints because HCF had given you some money. |
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Will You Now Bugger Off?
Lynette Macks (HCF Head of Membership) sent you a reconciliation of your claims to date on 12 May 2022. If you have further queries on this matter they might best be addressed by the HCF Chief Officer – Member Health (Julie Andrews, jandrews@hcf.com.au). Yours sincerely Mark G. Johnson |
Translation ↓ |
Now please, please bugger off! |
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