73 My Battle to Make the Health Insurers Obey the Law Part 17, Section 4: 29 October 2024

 

Possible Crimes Arising from the Emma Cotterill Letter Dated 29 March 2022(2)

What I said in Blog 72 about the need for a Court to make a finding of guilt in any criminal matter, also applies to the crimes and civil liabilities summarised in this Blog.  Guilt or liability must be decided by the Court.

Abuse of Public Office

Section 142.2 of the Criminal Code makes it a crime for an Australian “public official” to misuse his or her powers as a public official to gain a personal benefit or to cause a detriment to another person. 

Section 142.2 is headed “Abuse of public office” and section 142.2(1) says this.

(1)  A Commonwealth public official commits an offence if:                      (a)  the official:                               (i)  exercises any influence that the official has in the official’s capacity as a Commonwealth public official; or                              (ii)  engages in any conduct in the exercise of the official’s duties as a Commonwealth public official; or                             (iii)  uses any information that the official has obtained in the official’s capacity as a Commonwealth public official; and                      (b)  the official does so with the intention of:                               (i)  dishonestly obtaining a benefit for himself or herself or for another person; or                              (ii)  dishonestly causing a detriment to another person. Penalty:  Imprisonment for 5 years.

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Writing the letter to Lauren Whiting was intended to deter Lauren from telling Lift patients they had a right of complaint to the Ombudsman about the conduct of the health insurers.  The demand was perverse and I believe no reasonable public official could have properly made this demand.  There is an almost irresistible inference that the motivation of the letter was a desire to provide a benefit to the health insurers.

As a minimum, the letter aimed to cause great commercial disadvantage to Lift.  

It was implicit in the letter that the Ombudsman would not properly consider any complaints made by Lift patients.  This would give the health insurers a significant commercial advantage.

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I believe there are strong grounds to believe a crime under section 142.2(1) was committed.

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The suspicion of corrupt conduct by the Ombudsman is very strong. 

I believe that someone working at the Ombudsman clearly acted “dishonestly” to  “cause a detriment” to both Margaret and me and others.

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It was rationally and legally impossible for the Ombudsman to dismiss our complaints unless someone at the Ombudsman committed the offence created by section 142.2(1)

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Misfeasance in Public Office and Other Matters

I believe the Ombudsman letter dated 29 March 2022 amounts to the tort (or legal wrong) of Misfeasance in Public Office.  If correct, Emma Cotterill should be subject to disciplinary action and could be sued by Lift for damages or any other appropriate remedy.

The following information about misfeasance in public office is from Legal Briefing Number 115, issued by the Australian Government Solicitor.  

The following elements are required to constitute misfeasance in public office.

1.      The defendant must be the holder of a public office.

Emma Cotterill says she is “Senior Assistant Ombudsman, Industry Branch” at the “Commonwealth Ombudsman”.  She obviously held public office.

2.      The defendant must have purportedly exercised a power that was an incident of that office. 

In her position as “Senior Assistant Ombudsman, Industry Branch”, Emma Cotterill wrote to Lift saying it should cease “encouraging” its patients to exercise rights given under the very statute which created the Ombudsman.  She said:

It is our expectation that, wherever possible, the hospital and insurer should endeavour to resolve such disputes between them without further inconvenience to the patient (including requiring or encouraging them to exercise a right of complaint to our Office to have the matter resolved

 

These words must be interpreted an official order for Lift to stop informing its patients about their legal rights.

3.      The defendant’s exercise of power must have been invalid or otherwise lacking lawful authority.

A direction such as the Emma Cotterill gave was clearly unlawful. 

It was unlawful for Emma Cotterill to exercise her authority under the Ombudsman Act to try and persuade people not to exercise their legal rights.

4.      The exercise of power must have been accompanied by one of the following types of ‘bad faith’:

4.1.         The defendant must have exercised the power knowing that it was in excess of power AND with the intention of causing harm (sometimes referred to as ‘targeted malice’).

4.2.         The defendant must have been recklessly indifferent to whether the act was beyond power AND recklessly indifferent to the likelihood of causing harm.

4.3.         The exercise of power must have been productive of loss.

I believe these requirements are satisfied. 

Senior Assistant Ombudsman Emma Cotterill must have known her position required her to encourage patients with a grievance to exercise their right to complain to the Ombudsman. 

She must have known she was acting in excess of the power given to her as Senior Assistant Ombudsman.  

Even though there is no direct evidence she intended to cause harm to Lift, she was clearly indifferent to the probability this would happen.  She effectively urged Lift to accept the financial loss caused by the unlawful actions of the health insurers.

The Emma Cotterill letter was part of conduct by the Ombudsman which had, at the date of the Cotterill letter, already resulted in serious financial harm to Lift.  The refusal of the Ombudsman to perform its duty caused the accumulation of large debts because of the refusal of the insurers to pay Lift what the law required them to pay.  If the Ombudsman had done its duty, those debts would never have arisen. 

Later that year, a senior Ombudsman officer claimed the eventual payment of the Lift debts by the health insurers was the result of action by the Ombudsman.  This was a direct lie.

I will give details later of my continued “letter war” which eventually forced the insurers to to obey the law.  That payment would have happened much sooner if the Health Department and the Ombudsman had not been running a “protection racket” for the health insurers.

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Another Relevant But Nasty Fact

A very reprehensible aspect of the Cotterill letter is that Lift Cancer Care Services was entitled to make its own complaints to the Ombudsman about the refusal of the health insurers to obey the law. 

If Lift had exercised this right, the Ombudsman would in theory have been legally obliged to accept those complaints and resolve them.  The Emma Cotterill letter made clear that if Lift had exercised its right of complaint to the Ombudsman, there was zero chance those complaints would be assessed impartially. 

As “Senior Assistant Ombudsman, Industry Branch” at “Commonwealth Ombudsman”, Emma Cotterill must have known Lift also had a right to complain to the Ombudsman.  By writing her letter, she effectively nullified that right.

 72 My Battle to Make the Health Insurers Obey the Law Part 17, Section 3: 28 October 2024

 

Possible Crimes Arising from the Emma Cotterill Letter Dated 29 March 2022

 

The only way to establish that a crime has been committed is to institute a proper criminal law process.  The prosecution must lay a charge.  The charge must be heard before a Court, and the Court must make a finding that the charge has been proved.

Before any finding can be made by a Court, there must be an investigation where evidence is uncovered that indicates a crime may have been committed.  I have no powers of investigation and I am unable to predict the result of any prosecution in a Court.

Even with these handicaps, I can identify relevant criminal offences which I believe may have been committed based on the facts known to me.  In the following analysis, I do not assert that specific crimes were definitely committed by anyone.  Instead, I identify specific crimes which I believe may have been committed based on the information I currently have.

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In my opinion, the 29 March 2022 letter from the Ombudsman to Lauren Whiting, Chief Executive of Lift Cancer Care, may have resulted in at least one crime and possibly more than one crime having been committed by the Ombudsman as a statutory corporation and personally by Emma Cotterill, Senior Assistant Ombudsman.  These potential crimes are listed in sections 135 to 142 of the Australian Criminal Code Act, 1995. 

Proper investigation would be needed before specific individuals other than Emma Cotterill could be identified as having also possibly committed crimes. 

In the following sections, I summarise the relevant Criminal Code Act provisions which the letter may have violated. 

It is indeed possible that other crimes created by different laws may also have been violated, but I have not tried to identify other possible crimes.

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Unwarranted demands

Section 139.2 of the Criminal Code makes it a crime for an Australian “public official” to make an “unwarranted demand” in his or her capacity as a public official.  Section 139 is headed “Unwarranted demands”.  Section 139.2 is headed “Unwarranted demands made by a Commonwealth public official”.  Section 139.2 says this.

139.2 Unwarranted demands made by a Commonwealth public official                    A Commonwealth public official commits an offence if:                      (a)  the official makes an unwarranted demand with menaces of another person; and                      (b)  the demand or the menaces are directly or indirectly related to:                               (i)  the official’s capacity as a Commonwealth public official; or                              (ii)  any influence the official has in the official’s capacity as a Commonwealth public official; and                      (c)  the official does so with the intention of:                               (i)  obtaining a gain; or                              (ii)  causing a loss; or                             (iii)  influencing another Commonwealth public official in the exercise of the other official’s duties as a Commonwealth public official. Penalty:  Imprisonment for 12 years.

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The writing of the letter to Lauren Whiting contained a clear demand that she not tell Lift patients they had a right to make complaints to the Ombudsman .  This demand was even more menacing because it was made by the Ombudsman to Lift.  On the assumption the Ombudsman was familiar with its own legislation, Ms Cotterill must have known that Lift Cancer Care Services was itself entitled to make complaints to the Ombudsman . 

The underlying threat in the letter was clear.  Unless Lift did as the letter demanded, it would receive zero help from the Ombudsman if it ever made its own formal complaints.  

The letter include these words –

In line with our role to handle complaints about private health insurance arrangements, we will continue to take and assess complaints from members regarding the non-payment of claims for services provided by Life Cancer Care

 

these words did nothing at all to alleviate the clear message in the letter that:

·         The Ombudsman had no objectivity in relation to Lift;

·         The Ombudsman would act to injure Lift if it kept telling its patients they had the right to complain to the Ombudsman.

The inherent threat contained in the letter is particularly potent given that the “Public Health Insurance Ombudsman” (to which complaints about the health insurers had to be formally addressed) was and still is a sub division of the “Office of the Ombudsman”. 

I believe there was a clear threat contained in the letter.  

Unless Lift complied with the demands in the letter, Emma Cotterill, Senior Assistant Ombudsman, implied she would use her influence in her capacity as an officer at the Commonwealth Ombudsman to –

o   Cause loss or injury to Lift Cancer Care Services; and/ or

o   Influence officers working in the Private Health Insurance Ombudsman to perform their duties in a manner which would have undesirable consequences for Lift Cancer Care Services and any of its patients who might complain to the Public Health Insurance Ombudsman.

Making the demand made in the letter was perverse and no public official performing his or her official duties could have reasonably made this demand.  The letter raises gives a strong impression that it was motivated by a wish to give a substantial and unlawful advantage to the health insurers. 

This is particularly so given that as at the date of this letter, the stated reason for refusal to pay the Lift Cancer Care Services claims were definitely known to be false by the Ombudsman .  The Ombudsman knew the stated reasons were false because I had already told the Ombudsman this. 

According to the Ombudsman, the stated reason for non payment – was that requests for additional information had been ignored by Lift. 

I had provided the Ombudsman with complete documentation for every one of Margaret’s claims.  This documentation conclusively proved the falsity of the claim that requests for additional information had been ignored.

The Ombudsman knew this claim was a completely lie.

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In my opinion, when Emma Cotterill, Senior Assistant Ombudsman, wrote and sent the 29 March 2022 letter to Lift Cancer Care Services, the requirements for commission of a crime under section 139.2 of the Criminal Code were satisfied..

 71 It’s A Long Way from Lancashire to Here, Part 2: 27 October 2024

I once asked Cliff why the family had migrated to Australia.  His answer was that before WW II, Liverpool had been an economic basket case.  While the war raged, Liverpool had boomed and the boom had continued after the war had ended.  Although the boom continued after the war, Cliff said that he had not been fooled for a moment by this.  He knew Liverpool would soon return to being an economic basket case.  When the Australian Government invited migrants for Australia – and offered to pay most of the fare to get there – he couldn’t apply fast enough.

There must be elements of truth in this explanation, but the underlying reasons must have been more complex than this, but Cliff didn’t want to talk about the real reasons for migrating.

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Cliff wove Melbourne Cup folklore around our arrival in Australia.

The Melbourne Cup publicity machine describes the Melbourne Cup as “The Race That Stops a Nation”.  Supposedly, everything stops while the horse race called the Melbourne Cup is being run.  Cliff claimed that when the New Australia had docked in Fremantle, Western Australia, he wandered through the Fremantle streets and they became empty.  Cliff wondered where everyone had gone, until he entered a shop where he found people huddled around the radio listening to the Melbourne Cup.  Supposedly, everyone in Fremantle had stopped could listen to the broadcast of the Melbourne Cup.

Cliff’s story uses believable and enjoyable folklore; I wish he had not made it up.

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New Australia arrived in Fremantle, Western Australia on Friday 23 November 1952.  The Melbourne Cup always happens on the first Tuesday in November.  In 1952, the Cup took place on Tuesday 4 November.  The winner was Delray.  New Australia arrived in Fremantle 18 days after the Cup had been run.  We also arrived in Australia on a Friday and not a Tuesday.

We landed in Fremantle scant days after my brother Bill turned 5.  New Australia arrived in Melbourne on Thursday 27 November 1952.  In 1952, Christmas Day was on Thursday 25 December; we finished our voyage to Australia precisely 4 weeks before Christmas 1952.

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Late November 1952 was not a good time to arrive in Australia.

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New Australia docked at Station Pier in Port Melbourne.  There used to be a railway station on Station pier.  When we docked, Cliff spent his last threepence buying a paper to look for a job.

I suspect this story is true.  If it is, Cliff wasted his money.

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The New Australia Passenger List gave our address as “C/O Commonwealth Department of Immigration, 8 Elizabeth Street. Melbourne”.  We knew no one in Australia and we had zero money; there were no welfare payments in Australia in 1952 and we had nowhere to live except where the Immigration Department dumped us.  We also knew nothing at all about Australia.

We discovered the Immigration Department would not be housing us in Melbourne.  We were ushered from the ship onto a train at the Station Pier railway station.  The train took us to Bonegilla Migrant Hostel.  Bonegilla is 340 kilometres (212 miles) north of Melbourne and located near Australia’s longest river, the River Murray.  The nearest town to Bonegilla is Albury, which in 1952 was a very small country town.  Bonegilla had no public transport except the train to Melbourne.  Bonegilla is still not a town - or even a village.  Wiki rather enigmatically calls Bonegilla a “bounded rural locality”.   Bonegilla is a lump of rural land in the north of the State of Victoria.  It is not much else.

Bonegilla’s only distinguishing feature is the now historic museum preserving the remains of Bonegilla Migrant Hostel.

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Bonegilla was a great clearing house for migrants entering Australia.  Those who could not speak English were given English lessons and attempts were made to give survival skills to the new arrivals,.

Because Bonegilla is so far north of Melbourne, it is noticeably warmer than Melbourne.  For those used to European summers, Bonegilla in December was oven like in temperature.  Bonegilla was a very hot, hard to Australia.  We stayed in Bonegilla for 2 weeks while Cliff vainly tried to find work.

Most records of those who passed through Bonegilla (including ours) no longer exist, but the remnants of Bonegilla Migrant Hostel still exist.  Bonegilla is now an historical museum maintained and operated by friendly volunteers.  I visited Bonegilla in November 2016 for the first time since 1952.  The sign outside Visitor Reception said it operated from 1947 to 1971 and that 300,000 people had “passed through” Bonegilla.  The descendants of the 300,000 supposedly numbered 1,500,000 people when I visited.

The surviving Bonegilla accommodation surviving is significantly better than what we got after we left Bonegilla just before Christmas 1952.  I doubt Bonegilla had got better.  It is more likely that Fisherman’s Bend Migrant Hostel – the next hostel where we were dumped – simply had far worse accommodation on offer.

I took this photo of Bonegilla in November 2016.

In 2016, Bonegilla looked clean and orderly – and so very much better than it ever did in 1952.

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Just prior to Christmas 1952, the Hankin and Bellew families were bussed to Bonegilla Station and bundled onto a train back to Melbourne.  Our permanent, Australian Government provided accommodation had been selected.

Until we found our own place to live, we were stuck at Fisherman’s Bend Migrant Hostel in Port Melbourne.

Fisherman’s Bend was named after bend on the south side of Melbourne’s main river, the Yarra.  In 1952, the area called Fisherman’s Bend contained docks, lots of heavy industry and an airport. 

The gaps between the docks, the factories and the airport were occupied by swamps. 

The main local shopping area for Fisherman’s Bend was Bay Street, Port Melbourne.  Bat Street was 3.9 kilometres (2.4 miles) away from the Hostel.  This is not far if you have a car.  It is a long way to walk.  We did not have a car.

1952 was a year of full employment in Melbourne, but we arrived at the worst possible time to find work.  In 1952, every factory in Australia shut down for a Christmas break.  Annual leave during the Christmas/ New Year shut down period was compulsory and factories and most businesses closed for 4 weeks during the Christmas/ New Year period. 

Cliff borrowed £10/-/- from another migrant to carry us over until he could find a job.  In 1952, £10/-/- was about 2 weeks’ wages. 

We were so desperately poor.

We were saved by good luck.  An urgent order at the nearby General Motors Holden factory allowed Cliff to start work before the closure period ended.

 70 It’s A Long Way from Lancashire to Here, Part 1: 26 October 2024

My name is John Hankin.  

I was born in Liverpool in 1949 when Liverpool was still part of the County of Lancashire.  Mum and dad would tell me that I came from Liverpool, Lancashire, England.  My older brother Bill was also born in Liverpool.  As from 1 April 1974, the County of Lancashire was abolished and the part of Lancashire which once included Liverpool became the Metropolitan County of Merseyside.

My dad was Thomas Clifford Hankin.  He was a sheet metal worker who served with the RAF from 27 September 1940 until 21 May 1946.  Cliff served until early in 1944 as a Ground Crew member of Bomber Command.  Ground Crew ensured the planes flew, patching them up when they managed to return from bombing enemy targets.

Cliff tried to enlist in the British Army when World War II broke out on 1 September 1939, but the Army rejected him.  Cliff had become a qualified tradesman shortly after 25 February 1938 when he turned 18.

The government had decided qualified tradesmen would be more useful if they worked in their trade.  There were plenty of potential soldiers but there were not enough qualified tradesmen.  Cliff’s skills were in high demand during the War.

Serving as a tradesman in the RAF was an extremely hard career choice, but early in 1944, Cliff’s RAF service got harder.  In 1943, Bomber Command suffered shocking casualties and dad was asked to volunteer for service as aircrew.  Cliff did volunteer, had a short training course from 13 to 19 February 1944, and subsequently served as an aircrew member with Bomber Command.  He served as an “Observer”; his job was to spot German aircraft before they shot his own plane down.  Cliff survived the war.

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Cliff was born on 25 February 1921, the second of four brothers.  He was 19 when he joined Bomber Command.  Cliff grew up in extreme poverty in a Liverpool ravaged by the 1930s Great Depression.  Cliff begam an apprenticeship with Charles Howson and Company shortly after he turned 14 on 25 February 1935. Charles Howson were ship repairers based at Huskinson Dock, Liverpool.  He told me his parents had to pay £10/-/- before his employer would accept him as an apprentice.  In 1924, this was the equivalent of £694.140.  It was deducted from his wages.  Cliff was special; his older brother Bill didn’t get an apprenticeship.

Cliff never talked about his war experiences unless he was very drunk; Even then, he said very little.

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My mum was Josey Wood; she was born on 9 May 1924.  Her father William George Wood, was born in 1891.  His father Bill Wood had been a labourer, but when electricity arrived in Liverpool, Bill Wood became an electrician.  My grandfather William George Wood became a ship’s electrician.  He was Chief Electrician on the MV Leighton in 1938 when he had a heart attack.  Grandfather was put ashore in Antwerp, Belgium and died on 20 May 1938.  Josey had turned 14 just 11 days before her dad died. 

William George Wood died at age 46, leaving my grandmother Annie Grant responsible for 6 children who were then aged 23, 18, 16, 14, 12 and 10.

Josey was sent to work at the local fish and chip shop.  Grandmother let Josey keep six pence – the equivalent of £1.67 in 2019 currency.  Even in 1938, this was a lousy pittance.  The extreme shortage of money while she was young had a lasting effect on how Josey treated her own children.

When the war started, Josey was working for Littlewoods Pools Company.  Littlewoods was a gambling agency.  It made money by taking bets on football and other sports.  When the war broke out, the Littlewoods main building was requisitioned; it became a factory for making bombs, barrage balloons and woollen material.  

Josey spent the war working in munitions factories.  

Munition factories were prime targets for the Luftwaffe. 

Apart from Luftwaffe attacks, munitions factories were very dangerous places to work in.  If mishandled, munitions do what they are supposed to do – they blow up, killing and maiming those nearby.

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Cliff and Josey married on Saturday 10 March 1945.  At the time of their marriage, even if he had wanted to talk about his war experiences, the Official Secrets Act forbade Cliff from, talking about his experiences except to colleagues within the RAF. 

On that Saturday in March 1945, WW II had not yet finished, Cliff was 24 and Josey was 20.  Cliff’s RAF service did not finish until 14 months after the wedding.

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Cliff, Josey, my brother Bill and I migrated to Melbourne, Australia in 1952.  We sailed on the New Australia.  Back them, the Australian Government required migrants aged 19 or more to pay £10/-/- towards their travel costs to Australia.  This was the “Ten Pound Poms” scheme.  Children under 13 travelled for free,.  For children aged 14, 15, 16 and 17, £5/-/- each had to be paid.

In addition to the travel cost contribution, Cliff and Josey had to pay £2/-/- “landing money” to the Australian Government.  The £2/-/- “landing money” was repayable on arrival at the “reception centre” in Australia.  Cliff and Josey had to find £22/-/- to migrate to Australia. 

£22/-/- is now a trivial amount of money, but finding £22/-/- in 1952 was nearly impossible.  In 1952, £22/-/- was the equivalent of at least £657.95.  Cliff filled out the paperwork for approval to migrate on Wednesday 21 March 1951 and subsequently worked in 2 jobs to save the £22/-/-.

Approval for our migration came on 16 June 1952.  Once a sailing date had been fixed, Australia paid our railway fares from Liverpool to London and then from London to Southampton, where we boarded the New Australia.

New Australia left Southampton on Wednesday 29 October 1952.  I remember our departure.  There were dozens of brightly coloured streamers strung out between the ship and the dock.  The streamers broke as the ship pulled away from the dock. 

Liverpool. Lancashire, England faded from my memory.

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Travelling with us on New Australia were Vera Bellew, her husband Harry Bellew and their children Jim and Dennis.  Vera was mum’s sister.

On leaving England, Cliff was 31, Josey was 28; Bill was not quite 5 and I was 3.  Harry Bellew was 36; Vera Bellew was 32 and Jim and Dennis were 8 and 2.

For most of my life, Uncle Harry, Aunt Vera and Jim and Dennis were the only close relatives apart from my own family that I ever knew.

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Except for the Bellews, I grew up without relatives - no grandparents, aunts, uncles, cousins or relatives of any description.

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None of us knew it then, but we had accepted one way tickets to a place from which there could be no return to the life we had known.

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Without knowing it, we had set sail to the Moon.

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It was 1998 before I saw England again. 

Dad visited Liverpool only once – in 1972. 

Mum also visited Liverpool only once.  By then, dad was dead and mum had been severely mentally ill for decades.

  69 My Battle to Make the Health Insurers Obey the Law Part 17, Section 2: 24 October 2024

 

Unpicking the Ombudsman Letter Dated 29 March 2022

 

Unpicking That the Ombudsman Knows Lift Tells Patients About the Ombudsman

We are aware your facility is encouraging patients with outstanding claims to contact the Office of the Commonwealth Ombudsman (the Office) to lodge a complaint about their insurer.

 

What an extraordinary sentence.  Of course, Lift told its patients that they had a right to complain to the Ombudsman.  Parliament gave the patients that right under the Ombudsman Act.  Did the Ombudsman think this was a guilty secret which needed to be exposed?  Explaining the legal rights given to all is a basic feature underpinning all countries that are ruled by law.

 

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Unpicking the Reluctant Acceptance by the Ombudsman that Patients Had the Legal Right to Complain to Ombudsman

 

In line with our role to handle complaints about private health insurance arrangements, we will continue to take and assess complaints from members regarding the non-payment of claims for services provided by Life Cancer Care.

 

This is where the Ombudsman begins to spell out what it really wants.

This piece of bureaucratic bullshit means this –

Because the Ombudsman Act gives us no option, we will continue to formally accept complaints from people asserting that their health insurers refuse to obey the law.  We will also continue to refuse to enforce the law and all complaints will be treated in the same contemptuous manner as all complaints made to us so far.

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Unpicking Ombudsman Letter – “Cease and Desist” or Else!

 

However, in our view, the concerns raised in these complaints reflect a broader dispute between your facility and certain insurers. It is our expectation that, wherever possible, the hospital and insurer should endeavour to resolve such disputes between them without further inconvenience to the patient (including requiring or encouraging them to exercise a right of complaint to our Office to have the matter resolved). Further, with respect to informed financial consent, we expect the hospital to advise patients about any costs for which they may be liable prior to the commencement of treatment, to mitigate any risk of patients receiving unexpected bills afterwards.

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I spent many years in the legal profession and saw many surprising things.  I never encountered a letter with demands such as this. 

I will break this paragraph into “bite size portions” to help digest what it is really saying.  Bear in mind that this letter came from one of the two official government agencies with the official job of enforcing the law in the area of private health insurance.

This is more readable and this is what the Ombudsman was actually saying.

We have known since before February 2020 that the health insurers have been refusing to pay for treatments provided by Lift.

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Even though we are one of the designated regulators of private health insurers, we at the Ombudsman refuse to enforce the law.

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Because we the Ombudsman refuses to enforce the law, you have to enforce the law yourself.

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Even though we the Ombudsman know that the health insurers have refused to obey the law since before February 2020, you should try and persuade the health insurers to obey the law.

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Even though the health insurers are highly likely to continue to refuse to obey the law, do not tell your patients they have a right to complain to the Ombudsman – we do not want to deal with any more complaints.

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This sentence deserves special attention..

Further, with respect to informed financial consent, we expect the hospital to advise patients about any costs for which they may be liable prior to the commencement of treatment, to mitigate any risk of patients receiving unexpected bills afterwards.

In the email I got from Junita Lindsay on 21 January 2022, HCF offered a “resolution” of my complaints which involved a one off payment.  That offer was subject to me agreeing to provide HCF with “Confirmation in writing that Lift Cancer Care Services did not provide a list of estimated costs” before Margaret had her treatments

In the final sentence of this fifth paragraph of its letter, the Ombudsman – officially a regulator but in reality a mouthpiece for the health insurers – attempted to revive the total lie that Lift had misled its patients about cost. 

In effect, the Ombudsman said in this part of its letter that if Lift suffered any financial hardship because the health insurers refused to obey the law, Lift had inflicted that hardship on itself – presumably, patients should be told that the health insurers refused to obey the law!

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Unpicking the Breathtaking Hypocrisy of the Ombudsman

 

We understand the Department of Health contacted you previously to provide information about the operation of Type C Certificates. We suggest you continue to liaise with the Department about this matter, ideally with a view to obtaining its advice about the relative merits of the positions held by your facility and the various private health insurers regarding payment for these claimable Type C services.

This final paragraph of the Ombudsman letter is breathtaking in its “go away, don’t bother us” hypocrisy.

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The Type C Certificates provided by Lift to the health insurers mirrored the wording suggested by the Health Department – and the health insurers continued to refuse to obey the law. 

The Health Department was aware that the Certificates followed the wording suggested by the Health Department. 

The Health Department was well aware that the health insurers refused to obey the law. 

Despite knowing all relevant facts, the Health Department - like the Ombudsman - ignored what was going on.

The Ombudsman was well aware that the Health Department knew all the relevant facts and the Ombudsman knew the Health Department refused to do anything.  When the Ombudsman suggested Lift seek help from the Health Department, it already knew no help would be provided by the Health Department.

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Unpicking the Ombudsman Letter – Don’t Bother Us Again (1)

 

If you wish to discuss this matter further, please contact Elle Starbuck via email (elle.starbuck@ombudsman.gov.au).

 

The person nominated as the contact to discuss the Ombudsman letter was not the person who signed the letter.  The only way in which any “discussion” could take place was by email addressed not to the signer of the letter but to a different person – someone whose position in the Ombudsman was left unidentified.

 

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Unpicking the Ombudsman Letter – Don’t Bother Us Again (2)

 

Kind regards [Illegible Signature]   Emma Cotterill Senior Assistant Ombudsman Industry Branch

 

The sign off at the end of the letter was also breathtaking in its hypocrisy.

Having comprehensively insulted and attempted to demean Lauren Whiting, Chief Executive of Lift, Emma Cotterill actually said “Kind regards”.  This gave me a clear image of someone smirking while sticking two contemptuous fingers in the air. 

The ludicrously insincere “Kind regards” came from a woman with a very important sounding title. 

Emma Cotterill was “Senior Assistant Ombudsman, Industry Branch”.