Don’t Hold Your Breath When Claiming
Made a legitimate claim on February 15 and nib is still prevaricating on March 2. I have never experienced a system which appears so blatantly to delay paying claims. They aren’t the slightest bit apologetic. Avoid nib - there are better alternatives.
Unbelievable Out-of-Pocket Expenses
We've been with NIB for nearly 15 years. My husband had a simple umbilical hernia surgery last month and NIB only paid $105 for the surgeon fee of $1075 and only paid $52 of the anaesthetist fee of $1100. Yet every year we pay NIB over $4000 in insurance premiums. Like the other reviews on this forum the surgeon told us NIB doesn't pay them near as much as the other insurance companies and that is why he doesn't participate in the NIB MediGap. We are very disappointed and will be changing Insurance companies this month.
Delay refund for profit
Needed to get a refund on my insurance as I was switching to another provider. Was told that it requires around a month to process the request. Talked to my new provider and they say this is not really ok. It has been more than a month now and my request still hasn't been processed. They take you
I had a baby birth at private hospital.
I received an invoice of $1200 seperate which made a claim and was rejected. I called them and they told me to provide hopital documents. I did and again rejected claim. I called them back and they said my insurance doesn't cover the claim. I had to tell them the whole history of my insurance upgrades. Then they agreed to pay but didn't received. I called them again and they still asked hopital documents. Then i called the hopital to send documents to my insurance but they had already send it long ago.
Everytime i called the insurance, they would put me in hold for around 30mins.
I'm so annoyed.
Pretend Health Insurance
I just had knee surgery and thought I was only going to be out of pocket $500 excess for hospital cover and then whatever the anesthetist charges (in this case, $1000). Unfortunately, I was very wrong. Although my level of cover does include ACL reconstructions, I just copped a bill for $4000 of which I only get back $2000. So in total, I am out of pocket $3500. I was told by my surgeon's receptionist that NIB is the only health fund that doesn't cover the full fees, no matter what level of cover you're on. Needless to say, I'm switching funds.
Unpaid claim for the last 10months!!
Unpaid claim for the past 10months and still following up.everytime i ring am told it will get sorted as soon as possible.i dont feel my policy was a good value.i have been getting endless emails from the hospital regarding the unpaid invoices and its driving me nuts.horrible service and wouldnt recommend it to anyone!
NIB Call centre is a complete DISASTER
I have been with NIB for over 10 years. Once of the reasons I had stayed was because their call centre was easy to get hold of and was able to efficiently answer any queries that I had on my policy.
They now appear to have outsourced their call centre to the Philippines (presumably to save some dollars) and based on my experience today it is now a complete DISASTER.
I rang the call centre today to ask some simple questions about why they had not paid out the amount I was expecting for my gym membership claim. The call centre consultant was r...obotic, seemed unable to properly understand my questions and didn't have a decent knowledge of the policy. I have just spent 45 minutes on this call and my questions have still not been answered. I now have to wait a further 24 hours for a supervisor to call me back and hopefully they can then explain why my claim was not fully paid. Believe me my questions were not hard. When NIB had a decent call centre, I expect this matter would have been resolved in 5 minutes. God knows what this would be like if I had to make a claim for a complex medical issue. I think I would go mad dealing with this call centre.
- Verified customer
Absolutely shocking customer service
I flew to Brisbane to have scar treatments with [Name Removed] and it was partially rebated by medicare. Called up customer service to confirm the item numbers were applicable. Put through a claim via NIB online along with my medicare statement. Got a response back claiming its not on the medicare statement and that I didn't receive the treatment in person (presumably because the genius at the claim department saw that my address and the claim was in different states without calling the clinic or myself personally to verify)
Called up custome...r service, spoke with an Aussie and let them know that its on page 2 of the medicare statement that I uploaded. The rep told me to hold on the line. I waited for over 20minutes without hearing back from her and hung up. Called up again immediately and cancelled my insurance after speaking with [Name Removed]. These guys are an absolute disgrace to deal with. Stay away!!! Claim reference 2602492 Customer reference 46045690
NIB is a joke, 15 years of paying premiums and they don't cover anything
I've been paying over a hundred bucks a month for fifteen years, enquired about a minor day surgery and was told I have to upgrade my plan to be covered for this now urgent surgery, but it won't kick in for 12 months. My plan info sheet clearly states "DAY SURGERY" as covered (with no additional conditions listed), but when I called the call centre they go "Oh no that just means day surgeries we cover, not day surgeries we don't cover." That statement is so unbelievably stupid that I lost four IQ points just by hearing it.
The difference in ...premiums for the upgraded cover was less than seven dollars a month which I don't care about at all, but this surgery is now urgent as I am literally unable to use my right hand. NIB are forcing me to wait 12 more months for this urgent surgery over $7 a month, which I even offered to backpay for the past year or however long it would take. The lady on the phone was not helpful at all, she might as well have said "Too bad, enjoy not being able to write for a year." I've tried to have stuff covered before and they're an absolute joke, they don't cover anything. I had a serious accident a few years ago and was admitted to the ER, my "hospital" cover that I've been paying for since I was a teenager didn't cover a single thing so the taxpayer footed the bill for that one. I've spent about $20,000 with NIB over the past 15 years, but come time to cough up for something I need and they just don't care at all.
Provided proof that a condition was NOT pre-existing and they denied. The worst service ever. They make up rules and have a couldn't care less attitude. Waited over 3 months to get reimbursement for my sons knee surgery and of the $1200 fee I got $189. I also made a complaint with the ombudsman and NIB gave me 2 free weeks- because it was cheaper than actually paying the claim on time. NIB are cold, uncaring and only interested in taking your money. Do not insure with NIB.
They are a nightmare to deal with. Save yourself the heartache
If you complain about the amount of calls you get a week they will increase the number of calls out of spite. They tell you that you need to identify yourself to get them to stop calling you twice a day to “talk about your policy”. Dont do business with them
I recently joined NIB and it’s one of my biggest regrets. I have been trying to claim for recent surgery and it’s been so difficult. I have submitted my documents online as requested three times now and each time they tell me they require the exact documents I’m sending and receiving a confirmation for. I called to try and get some assistance. I was on hold for 27 minutes and when I finally spoke with someone, she said she couldn’t see my documents yet. Today I submitted them again and Emma from Messenger tells me she can’t see anything and ap...ologises for the inconvenience. My belief is they do this so they don’t have to pay out claims. Oh, and today they took another premium from me. Whatever you do, DO NOT JOIN NIB. They have been the worst organisation to deal with. I will be canceling my membership ASAP.
You’d be better off lighting your money on fire once a month.
Terrible value. Terrible service. You’d be better off lighting your money on fire once a month. On multiple occasions I called to ask how much I would get back on a claim, then went and paid for the health service and when I submitted the claim they would pay me a tiny fraction of what they’d quoted me ($250 of $1500 in one instance). When I called to ask why this was they would basically say it’s all my fault for trusting their word instead of combing through the policy for every loophole like they had. Absolutely furious. Do not use this “service” (if you could even call it that).
Fantastic customer service
Having recently being admitted to hospital, I found the journey with NIB to very easy. In fact, I simply paid the excess and the hospital and NIB liaised directly with no headaches for me to contemplate.
In saying this, I'd advise everyone to ensure their policy covers their respective item numbers provided by their surgeon - this way you eliminate any surprises such as; gap fees or not being covered at all. I did my research well before committing to a health insurer and a lot more calls between NIB and myself prior to surgery to ensure I wa...s covered 100%. My tip - obtain all information from your surgeon/specialist and then follow up with NIB to discuss the quote, gap fees, anaesthesists costs etc. Most people leaving a low review should not make assumptions upon admission that all will be paid and spend time beforehand ensuring they are aware of their out of pocket costs. All in all, i was very surprised with the service as I had read all these 1-2 stars posted previously.
Specialists Not Participating with NIB Access Gap Scheme....Out of Pocket over $1000. BEWARE
After being loyal customers for 26 years we have changed. Most specialists in Brisbane will not participate in NIB'S Access Gap Scheme which left us out of pocket over $1000. Only a small gap paid with other funds. BEWARE.
pretty happy with extras
I am with NIB for 5+ years (extras only). pretty happy with them.
Get free dental check-ups and gap-free treatment.
I like their dental clinics in Sydney but here in Canberra they only have 1 center and almost impossible to get a suitable appointment there. it is good that private dental clinics offer gap-free checkups.
Claimed a few times for ambulance and glasses, everything was done quick and easy.
their phone app is a disaster! never can logging from my phone for months. it just keeps asking me to log in again and again.
- Verified customer
Essential items not covered
Until now, my NIB policy covered 75% of the cost of prescription glasses up to the specified limit, including the lens thickness specified by the optometrist.
Costs were increasing, so I shopped around and found I could get equivalent lenses for half the price at Specsavers. But apparently NIB requires different codes and NIB won't pay the stated 75% of the cost of the lenses I'm advised I need. A policy that excludes essential items isn't worth the paper it's printed on!
Good vision is important. Anyone who needs good eyecare products ...shouldn't be with NIB. Update: The NIB policy booklet is 56 pages long. It states that they don't cover fitting new lenses into an existing frame (discriminating against people who can't afford new frames) as well as tinting, coating and hardening of lenses (to make them last longer, perhaps save policyholders money in the long run) but there are no stated exclusions the lenses that I'm told I need. So if don't go with NIB if unless you want nasty surprises about unfair, arbitrary exclusions that aren't even stated in the policy.
Questions & Answers
I’m on work Visa, I've been with nib for 4 years. Does NIB cover surgical or liposuction lipoma removal.
Thank you for your question Paul, We have sent a response to your inbox.
Please contact our nib International Working & Visitors Cover team (OVHC) to discuss your cover on Phone: 1800 775 204, Email: email@example.com, webpage: www.nib.com.au/overseas-working-visitors. Our International Businesses teams are available 8:30am to 6pm weekdays (AEST).
Kind Regards, Richard.
I was diagnosed with breast cancer in July this year and underwent a double mastectomy and reconstruction through the private system as we had health insurance through your fund and were of the understanding that we were covered for this. That was until we tried to make a claim. Did you not only decline this claim for the surgery you also declined the hospital stay.
This has put additional stress on my family and myself for which we do not and did not need. Thanks to you we have been left out of pocket by $30 000. We always knew there would be out of pocket expenses but for your company to simply decline everything is just callous and wrong. We always paid our premiums on time and you did not seem to have a problem taking our money for that, but once we tried to claim fo something that was life saving we come up against a big red stop sign from you.
You have left us broken and struggling when we were once just a normal family living a good life. This year has already been tough enough due to COVID19.
Let me tell you about myself, I was 49, no direct family history of breast cancer, i have 2 teenage children and a husband who would do anything for our family. This diagnosis turned myself and my family upside down.
I have been staying behind the scenes while my husband has been trying to get you to reconsider your decision but the time has come that I can no longer keep silent about this as it is tearing us apart. I am also embarrassed to be put in this situation.
A company such as yours who made a huge profit this financial year and sprout that health insurance should be easy to claim and good value really need to reconsider this statement because there has been nothing easy about this.
I just hope that there are not other people out (your members) there that are facing the same situation as us.
I would welcome you to contact me but I doubt that will happen and I know this post will probably be deleted. I feel people need to know how you treat your members while your CEO pays himself a nice tidy bonus while we are left struggling to now make ends meet.
All we ask for is a fair go, not too much to ask for .
I have been diagnosed with severe sleep apnea. Can I claim for my CPAP machine when I buy it ?
Hello Margot, Sorry to hear about your diagnosis.
Please contact us using link below & we will be happy to discuss your eligibility to claim.
Kind Regards Richard.
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