Bupa HI Pty Ltd (BUP)

Performance

The Private Health Insurance Ombudsman prepares an annual report on the service delivery and performance of Australian health insurers. The following is a selection of statistics about this health insurer - the full report and an explanation of these figures is available from the Ombudsman's website. Please note information is not provided for some insurers in some states, as there are insufficient numbers reported to APRA for states in which the insurer does not have a large membership.

Performance Insurer Industry
Benefits as a % of contributions 86.2% 86%
Management expenses (% cont) 7.8% 9.1%
Management expenses (average policy) $293 $350
Surplus 6.1% 4.9%
Member retention (%) 83% 82%
Coverage ACT NSW VIC QLD SA WA TAS NT
Hospital Related Charges Covered 83.6% 89.6% 93.3% 91.4% 95.3% 89.1% 94.3% 90.7%
Industry Result 83.8% 90.4% 92.2% 90.8% 94.6% 93.0% 93.9% 90.2%
Medical Services with No Gaps 81.3% 87% 86.1% 87.9% 86.1% 83.1% 86.7% 84%
Industry Result 78.5% 88.9% 85.6% 88.4% 87.3% 85.0% 88.6% 84.2%
Medical Services with No or Known Gaps 90.2% 91.9% 91.6% 91.6% 91.7% 90.1% 92.3% 91.1%
Industry Result 91.0% 95.5% 94.7% 94.5% 95.1% 96.4% 96.0% 94.0%
General Treatment (extras) Covered 46.8% 50.7% 49.7% 53.7% 56% 59.4% 51.8% 59.9%
Industry Result 48.1% 50.7% 52.4% 54.3% 57.4% 57.5% 54.3% 59.1%
Private Hospital Agreements 4 88 75 50 25 20 8 1
Industry Maximum 9 110 83 61 33 31 8 2
Day Hospital Agreements 5 75 62 45 27 18 6 1
Industry Maximum 6 98 78 57 29 23 5 2
Share of PHIO complaints compared to insurer market share
Benefit Complaints 19.2%
Service Complaints 16.5%
All Complaints 24%
Investigations 33.1%
Market share 25.8%