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The worse insurance company in Australia, no service and difficult to deal with

1 out of 5, reviewed on Jun 17, 2018

Worse insurance company the staff are very difficult to deal with the service are worse ever I have experienced. They try to get the money for nothing. The documentation was not probably filed and they are not able to find the authorisation form that I have been sent twice by email. They had been very very difficult to deal with.... I will never ever to buy insurance from this company, If I can choose, no ever a star for this company.

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Insurance claim made

Waste of money

1 out of 5, reviewed on Jun 11, 2018

I had top hospital cover for three years paying over $200 per month. When I had to have emergency surgery I finally thought that I’d be able to put it to good use. Apparently not. The surgeon went over some limit that I knew nothing about and of a $3500 surgery bill, NIB paid $177. What a joke. When i questioned them about it I was told “oh yeah, if it’s an emergency you should always just go public then you’ll have no out of pocket expense”. So remind me again what the point of having top hospital is? Waste of money.

Was this review helpful? Yes

Comments
NIB Official

Hi Sara,

We're sorry to hear about your experience with us. If you would like to get in touch please contact us on 13 16 42 and we can look into this for you.

Thanks

Insurance claim made

Months of misinformation

1 out of 5, reviewed on Jun 10, 2018

We have spent the last 3 months fighting for NIB to cover costs for surgery following an accidental injury - we sought emergency treatment and could meet the criteria to be covered, unlike some of the other posts I've seen. But, NIB's first response was that we weren't covered for the surgery. Luckily I knew we were covered for accidental injury and could argue for our rights throughout the ridiculous process that followed. In order to prove it was an accidental injury we were told we had to get the Dr at Emergency to fill in a form...I asked to speak to a manager as that sounded ridiculous...turns out we needed discharge notes from the hospital and to complete a form. BUT, the form could only be emailed from a certain team at NIB and they weren't there - so you need a form but you can't get it. We had to call again to ask them to send the form. We filled in the form, provided the requested paperwork and didn't hear anything. Each time we called them to follow up (and there were a lot of phone calls!), we were given a different story, told they would call back after getting advice from the hospitals team
and/or given a new hoop to jump through...including filling in a new form and re-sending paperwork they said they didn't receive. We have finally received the amount owed (for the upfront hospital costs we paid) but we really had to fight to get it and this caused substantial stress, particularly when we had a hospital threatening to refer us to a debt collection agency to recover outstanding costs that NIB told us they would pay. It really shouldn't be this hard - we are moving to another health insurer and advising others of the problems we've had with NIB.

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  • 1 review
  • 1 helpful vote
Private message

Failure to cover tonsil and adenoids removal surgery for child - CONTRARY to advice given in Februar

1 out of 5, reviewed on Jun 07, 2018

In February 2018, we were advised that our daughter would possibly require tonsil and adenoid surgery. I obtained the item numbers from the ENT and rang NIB who assured me the whole of her surgery (including her private hospital stay) would be covered. Yesterday it was confirmed that she required this surgery. I rang NIB again and was told that they would cover SOME of the surgery but it was also likely that, as two items were not covered (this is contrary to what I had been told), that they now may not cover ALL of the surgery, including the private hospital. Given the wait for this surgery is YEARS on the public waiting list, we are going to have to fork out of our own pocket for surgery that was apparently covered 4 MONTHS AGO. What I have been told is that unless ALL of the item numbers are covered, then they will not cover the WHOLE of the procedure (ie they will cover the tonsil removal but not the turbinate resection so because this is not covered, then they will not cover the theatre time that the hospital will require so they will not cover ANY of the theatre time or hospital admission). I'm not talking about them not paying the gap - they are not going to pay for the ENTIRE PROCEDURE! What a joke. Talk about misleading and deceptive conduct.

1 person found this helpful, do you? Yes

Insurance claim made

Great cover and amazing customer service

5 out of 5, reviewed on Jun 06, 2018

Firstly, the customer service I have received has been amazing. Polite and understanding staff who actually care. Have paid thousands over my lifetime for health insurance but nib has made everything easy and affordable. I was shocked with price.
I have claimed on my extras and because I can see who I want, I get the full 60% back.
Highly recommend them.

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Johns River

  • 3 reviews
  • 1 helpful vote
Private message

Insurance claim made

Steer clear of NIB

1 out of 5, reviewed on Jun 06, 2018

Recently had surgery on my foot, when it came time to pay gap with surgeon was advised that NIB were the worst for coverage of fees and they weren't wrong. $6k a year and I'm out of pocket $1300 for surgeon bill because of NIB, dreadful and I am moving to another fund.

1 person found this helpful, do you? Yes

Comments
NIB Official

Hi Tim,

We're sorry to hear about your experience with us. If you would like to call us on 13 16 42 we would be happy to look into this for you.

Thanks

Moorebank

  • 2 reviews
Private message

Insurance claim made

Would prefer to give no stars - DO NOT GO WITH THEM

1 out of 5, reviewed on May 31, 2018

These guys are useless, even the hospital advised me that NIB are up the top with the ones who try everything not to payout ... why the hell to I have private health cover if nothing is covered,
Im done with NIB and suggest others go elsewhere .... its obvious the only 5 star ratings on this page are from NIB staff members

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Comments
NIB Official

Hi GTR99,

We're sorry to hear about your experience with us. If you would like to call us on 13 16 42 we would be happy to look into this for you.

Thanks

Brisbane

  • 10 reviews
  • 2 answers
  • 8 helpful votes
Private message

Verified Customer Insurance claim made

Never had a problem claiming for hospital, fixed 60% on extras is great, claiming is too easy, custo

5 out of 5, reviewed on May 28, 2018

I had a $5,000 day hospital operation to remove a skin cancer off my face and paid only the $500 excess, pathology included.
For extras, NIB invented simple claiming. Upload the receipt and it's done. Money arrives in my account within 5 days. Knowing you'll always get 60% back on any extras claim is valuable to me. Other providers seem to have to complicate everything with itemised schedules. Being able to call the service desk outside work hours is also important to me. I am surprised at some of the negative reviews as I have always been totally satisfied with my experience.

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  • 1 review
  • 2 helpful votes
Private message

Insurance claim made

Most stressful few weeks of my life

1 out of 5, reviewed on May 23, 2018

As a new member I have been absolutely appalled at the standards and protocols this company have in place. What would have been stress free at my old insurer has been three weeks of constant phone calls and unbelievable requests made by them. As soon as my claim has been settled I will be going straight back to my old insurer, I'd rather pay more and have piece of mind that I will be under no stress after being incredibly sick! Life your game NIB!

2 people found this helpful, do you? Yes

sydney nsw

  • 1 review
  • 1 comment
Private message

Treatment of the disabled

1 out of 5, reviewed on May 23, 2018

Phoned nib to ask a simple question regarding my disabled daughter who cannot read and mentally unable to sign a power of attorney. They kept on insisting they wanted a power of attorney. Could not get it through their thick sculls. What a disgrace. Now cancelled the policy and found another fund who was only too happy to understand the situation. Dont go near nib if you have a disabled child.

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Comments
NIB Official

Hi Tess,

We're sorry to hear about your experience with us. If you would like to call us on 13 16 42 we would be happy to look into this for you.

Thanks

You should get your legal team to look into it before someone sues you.

Insurance claim made

Medigap is a myth

1 out of 5, reviewed on May 22, 2018

Long time customer, first time complainer. You get told of the magical medigap where your long term contributions to private health are finally rewarded, only the providers listed on the website ALL don't participate (bar one for those in extreme financial stress). I asked nib for details of providers in Canberra that actually participate, of course they couldn't provide it. I'm told the payments to doctors haven't been updated in 11 years which is why no one participates, it is a joke.

My customer service agent also gave me incorrect advice on hospital excess, which was a pretty simple answer. Also spoke at me for a good ten minutes and should have listened. Feeling pretty let down overall and questing private health on the whole.

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  • 1 review
  • 2 helpful votes
Private message

Verified Customer

Disgraceful. Avoid. Will not help you when you need it

1 out of 5, reviewed on May 22, 2018

Very similar to the case below, I injured my finger in a tackle playing footy. It swelled but was movable, not that much pain so booked to see my GP Monday morning.
Turns out I broke it and ruptured the tendon, requiring immediate surgery.
My wife is due with our first child in 4 weeks so I couldn’t wait on the public list and risk being unable to assist her during this period, which was a good thing I had private health....or so I thought.

See, turns out NIB is the only provider than mandates all claimants of accidental injury need to seek “emergency hospital” treatment within 24 hours of the injury. They don’t really understand where someone may not live close to a hospital, or that an injury is not life threatening and warranting clogging up the emergency system, nor heaven forbid your injury is not understood to be as serious at the time.
My GP confirmed that even if I had presented to an emergency department, they would have recommended I see my GP as they wouldn’t have been able to do anything for me.

Additional, hospital websites recommend the reasons for attending an emergency department should be for injuries requiring urgent attention only. This wasn’t urgent - the pain wasn’t too bad and it wasn’t life or death.

Upon speaking to surgeons, GPs, anaesthesists, assistants and all the numerous office ladies who take the payments over the last week... they have all resoundingly told me that NIB is the most distrusted and unreliable health provider in the industry. They have reinforced my disbelief that a health fund would find such a trivial loop hole to omit their liability.

My wife and I have cancelled our policy as of this morning, my parents are doing the same as a result of this kind of service being highlighted.

Please - if you are reading this, and you’re weighing up who to take out cover with, don’t choose NIB. You’d be better off putting your monthly premium in another bank account to save for any health mishaps down the road... don’t give them a cent.

2 people found this helpful, do you? Yes

  • 1 review
  • 1 comment
  • 2 helpful votes
Private message

Does not treat members as individuals and have no compassion.

1 out of 5, reviewed on May 16, 2018

Absolutely disgusted by the way I have been treated by NIB and regret joining this fund.

I injured my knee Saturday playing football and was advised to not go to the hospital by health professionals at my club due to the nature of the injury.

Made an appointment to see a doctor first thing Monday morning and upon visiting and receiving scans found out that I needed surgery on my knee. NIB refused to cover my surgery as an accidental injury as I did not visit the emergency room within 24 hours, despite admitting that my injury was that of the accidental type.

I had assumed it was ACL related (which would have been covered by NIB), however there is a fracture needing a bone graft (not covered). I am a young, otherwise healthy female who has the base level cover as I have only just began working full-time and wanted the insurance for peace of mind for accidental injury.

Despite witnesses and being able to provide evidence of the injury occurring on the weekend, this was not good enough as I did not visit the emergency room.

NIB's response was ludicrous, being that you should ALWAYS call an ambulance and visit the emergency room in order to ensure the accidental coverage. So for instance, if you simply roll your ankle make sure you seek emergency treatment 'just incase' you need further cover.

I tried to apply for special consideration with no avail, despite my circumstance, including my partner needing surgery the week before.

My initial though when I did the injury was 'thank goodness I have private health insurance', now it is I wish I did not have the insurance as if I went through the public system initially I would have never face these issues.

NIB were bragging that they even offer the accidental insurance coverage and that not many insurances do. This is a blatant lie as I am now changing my cover and ALL that I have researched cover it - without the 24 hour time frame! For instance AHM will cover the accidental injury regardless of when you seek treatment as they time frame is not what determines whether you accident is accidental or not... The example I was given my AHM was For example - a member has an accident and hurts their foot. They may just think it's sprained/bruised and not seek medical attention/hospital treatment for a week - at which point they discover it's broken and requires surgery. In this instance although medical attention wasn't sought 'immediately', it was required and ahm would pay benefits towards the treatment.

If you want a fund who does not treat you like an individual and will look for ANY loop hole to not cover you, please join NIB. But if you are after cover from a company who genuinely cares about their members - Look anywhere else! I understand that my cover does not cover bone graft surgery, but like I mentioned early I am a young healthy adult and can't believe they wouldn't make an exception for the 24 hour time frame.

The stress caused by trying to get anywhere with NIB has been the last thing I have needed. If you want peace of mind cover this is not the fund for you.

2 people found this helpful, do you? Yes

Comments
NIB Official

Hi Bree,

We're sorry to hear about your experience with us.

If you would like to call us on 13 16 42 we would be happy to get someone to look into this for you.

Thanks

Myself and other family members have already spent HOURS on the phone trying to resolve this issue with no avail. I was told I might qualify for special consideration only to have this rejected by ... read more »

Insurance claim made

Poor Customer Service

1 out of 5, reviewed on May 08, 2018

Customer service is absolutely appalling, Even the case manager was just as bad, been waiting 2 months to complete my claim and receive my money, having to keep chasing them up, will be definitely going to another health insurer, would definitely not recommend NIB to anyone, absolutely disgusting service!!!!!!!

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Sydney

  • 4 reviews
  • 1 comment
  • 6 helpful votes
Private message

Customer service appalling

1 out of 5, reviewed on May 08, 2018

NIB Customer service is probably the worst I have ever encountered.About a year ago I queued for nearly an hour in the CBD office to update some details.When I was finally attended to I was told that there was no-one in the office who could help both staff were trainees and the manager was not in the office that day.I could if I wanted go to their Paramatta office.I left my paperwork ,after many calls told it was processed.It was not.It took about 60 minutes to cancel this policy and 15minutes to get a better one from HCF

1 person found this helpful, do you? Yes

Comments

I just read the last 6 months of reviews and thought that consumers might be helped by knowing that there is an Ombudsman whose job it is to assist people who have issues with private health insure... read more »

  • 15 reviews
  • 1 comment
  • 2 answers
  • 6 helpful votes
Private message

Was wrongly advised

1 out of 5, reviewed on May 03, 2018

Was given bad and wrong advise when first moved here and never had private health insurance..so for years I was paying double to what I really needed to pay, now I moved to Medibank and pay half, sadly I was ripped off for many years by NIB.

1 person found this helpful, do you? Yes

  • 1 review
  • 2 helpful votes
Private message

Insurance claim made

Liars! Dishonest! Worst!

1 out of 5, reviewed on May 02, 2018

They don't even deserve 1 star. If there was a minus rating, I would give that.
This is the worst insurance one can have. Every time I called I got different answers. They told me my whole doctor's checkup was covered and I got back $72 out of $220.
Once I asked about a surgery cover, they told me to ask my doctor to call nib. Like yeah, are you kidding me? My doctor has nothing better to do with his life that he would waste 30 mins waiting for your stupid confused answers! WORST service! WORST customer care which gives all the wrong information!

2 people found this helpful, do you? Yes

Adelaide

  • 1 review
  • 4 helpful votes
Private message

Worst insurance company ever, they just want your money and didn't care about your health

1 out of 5, reviewed on Apr 30, 2018

NIB insurance company definitely the worse insurance company I have ever met. I have been a member with this health insurance company for years, and never claimed anything. Until last month, my son need to do a small paediatric surgery, I called them, first their customer service told me everything is covered. I went ahead organized the surgeon and hospital. All of the sudden, they called me again last week and told me it is not covered because it is not in their policy including list. After questioned by me about "it is not included in your excluding list either", they insist that they will only cover whatever is listed in their including list. How on earth can they write all the names of the surgeries in their list???? Even my son's surgery is covered by medicare, NIB wont cover it. I have to pay everything out of my own pocket. NIB told me to use medicare for my son's surgery. From what I understand is NIB just want our money and not happy to cover anything for your hospitalization, they are worth than thieves or mugs. Health insurance company suppose to help you when you need them after paying them for years, but not with NIB. I would suggest everyone "Do not go with NIB HEALTH INSURANCE", because they will rip you off and leave you to die when you need them.

4 people found this helpful, do you? Yes

  • 1 review
  • 1 helpful vote
Private message

Insurance claim made

Not Good

2 out of 5, reviewed on Apr 24, 2018

Went in for back surgery called and they said everything was covered, I ended up paying $19,000 My flights to Sydney and a hotel for my husband. Looking in to changing to a more honest Private Health.

1 person found this helpful, do you? Yes

Comments
NIB Official

Hi Sandie,

We're sorry to hear about your experience. If you would like to contact us on 13 16 42 we would be happy to discuss this further with you.

Thanks

  • 1 review
  • 3 helpful votes
Private message

Dishonest

1 out of 5, reviewed on Apr 22, 2018

Poor customer care. Every time I rang I was given a different answer. Finally got through to a manager who tried to belittle me ....fortunately I have a medical qualification....the information she gave me ...totally wrong

3 people found this helpful, do you? Yes

1 of 18 pages


Questions & Answers

How do I access a claim form?

Bethany asked on Jun 14, 2018

Answer this

Hi Bethany,

You can find out about our claim options, including how to access a claim form here : https://www.nib.com.au/health-information/account-assistance/claiming

If you require any further assistance, please contact us 13 16 42.

Thanks

Hye.im Elsi,I am a oversea student.and im pregnant for 22 week.if I delivered here at the private hospital.do NIB will cover the hospital cost?i have been using NIB for 2 years.

Elsi asked on Apr 21, 2018

Answer this

Hi Elsi,

Thank you for your enquiry. So we can assist you further can you please call us on 13 16 42.

Thanks

Can I know what is actually covered in NIB OSHC?

Vivian N asked on Mar 08, 2018

Answer this

Hi Vivian,

We would be happy to get a member of our customer support team to assist with your enquiry.

Please contact us on 13 16 42 or email nib@nib.com.au.

Thanks

See all 28 questions about NIB Health Insurance