Case Studies

The following case summaries highlight common issues and consumer tips. Cases can be filtered by subject below and names have been changed to protect confidentiality. Access to the full case study database is available for IFSO Scheme Participants in the Participant Area.

Showing all Health Insurance case studies

Show all cases

Husband makes claim for obstetrics care for his wife’s pregnancy

The man said that it was “archaic” to view obstetrics care as limited to the person actually having the baby.
Health Insurance

See the case summary

Health pack for depression not reasonable

Ms B had health insurance while she was studying in New Zealand. She was diagnosed with a significan...
Health Insurance mental health

See the case summary

Man with Indian hospital bill argues “Australasia” must include “Asia”

A man complained to the IFSO Scheme when his claim for medical expenses in India were declined. He s...
Health Insurance Travel Travel Insurance medical Covid

See the case summary

Skin surgery benefit changed

Check your policy to see if your insurer can change your policy cover.

Kaia’s health insurer wrote to inform her it was changing the limits for skin surgery under her policy.
Health Insurance

See the case summary

Bad knee, no cover

Health insurance won’t pay claims for pre-existing conditions, unless the insurer has agreed.

Kate needed a knee replacement but her insurer wouldn’t pay, as she'd had knee pain 16 years earlier.
Health Insurance

See the case summary

Leaving out medical details is a problem

Tell your insurer your full medical history, even if you don’t think it's relevant.

Yasmin didn’t mention her two spinal injuries when she applied for insurance. Her claim for a spinal cyst was declined.
Health Insurance Non-disclosure

See the case summary