Defence Health is a private health insurer, providing hospital and general treatment insurance for Australian Defence Force (ADF) families and the wider Defence community. The not-for-profit health insurer currently covers almost 300,000 people nationally, with more than 140,000 policies. This represents a market share of around 2% of the total private health insurance market.
Private health is a vital element of Australia’s overall health system. People with private hospital insurance have access to a network of more than 500 private hospitals. They can choose their own specialist and receive the treatment they need, without having to join the lengthy public hospital elective surgery waiting list. According to the Australian Medical Association, the public health system “would likely collapse” without the contribution of the private sector. On average, 6000 elective surgeries are performed in Australia every day. Two-thirds of these operations take place in a private hospital. In addition to hospital insurance, Defence Health also provide benefits towards general health care services through ‘extras cover’. Examples of these services include dental treatment, optical care, physiotherapy, speech therapy, occupational therapy and podiatry.
Defence Health, like many other not-for-profits, keeps its costs low by centralising its service delivery. The fund operates from an inner-Melbourne office and engages with members and prospective members over the phone, online and by email or post. The contact centre is divided into teams trained in sales, claims assessment and general member enquiries. Health insurance is a complex product in a highly regulated industry. Every conversation and member interaction requires a high level of expertise and attention to detail from the customer-facing staff.
Staff are currently preparing for the most significant product reforms since hospital insurance was introduced. All hospital policies, industry-wide, will begin to be classified in the tiers of gold, silver, bronze or basic. The language used and the treatment covered within each tier will, for the first time, be consistent across the industry. The aim of the government-led reform is to improve transparency and help people better understand what’s included in their hospital cover. All insurers have until April 2020 to comply with the changes. Defence Health has enthusiastically embraced the member-centric focus of the reforms. It has adapted its product offering, trained all staff and informed members of the changes the insurer will present to the market.
Defence Health is renowned for its industry-leading customer satisfaction ratings. Satisfaction is measured independently each year by Discovery Research. Since 2006, the satisfaction of Defence Health members has not fallen below 96%. It is the combination of genuine concern for members, competitive premiums and valuable benefits that sets Defence Health apart from its much larger and louder competitors.
Defence Health is also known for the quality of its product offering. In 2018, for every dollar received in premiums, Defence Health returned $0.94 to members in benefits (compared to the industry average of $0.86). Defence Health members also had a higher percentage of their hospital-related medical charges fully covered by the fund (90.6% compared with the industry average of 88.1%).