Westfund Limited (WFD)

Westfund Health Insurance has been built on solid community values and a foundation of trust, located in the heart of regional Australia. We are proudly not-for-profit and are honoured to be trusted with looking after our members’ health.
Our history can be traced back more than six decades to the official registration of the Western District Mine Workers Medical Benefits Fund in Lithgow in 1953. The seeds of today’s Westfund were, however, sown long before this date and illustrate a potent connection to mutualism and of a community drawing strength by uniting together for collective purpose and benefit.
Today at Westfund, we still believe the member is the priority. We treat our members as people, not numbers.
While our care centres are located throughout regional communities, we have health providers located across Australia, providing support to our members nation-wide.
We empower our members to select the cover that best suits their needs with our Your Cover, Your Choice suite of products – linking individual Hospital and Extras covers together to provide greater flexibility.

This information is provided by the insurer

Westfund Limited provide further information regarding:

Agreement Hospitals

This fund has agreements with some private hospitals or day surgeries to provide services at low or no out-of-pocket costs. You can see Agreement Hospitals for this insurer and further details are available from the insurer.

Business Structure

This insurer is a mutual organisation that operates on a not-for-profit basis.

Westfund Limited operates in all states and territories.

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.

Ombudsman complaints compared to market share
All complaints 0.6% 0.9% market share
Investigated complaints 1.4%
Health Insurer Retention and Finances Industry result
Member retention (hospital cover) 89% 86%
Benefits as % of contributions 88% 85.4%
Management expenses % of contribution income 13.3% 9.5%
Management expenses per average policy $540 $358
Coverage ACT NSW VIC QLD SA WA TAS NT Australia
Hospital Related Charges Covered 85.1% 93.3% 91.0% 91.2% 93.6% 90.4% 91.5% 72.4% 92.3%
Industry Result 83.1% 89.7% 91.9% 90.3% 93.9% 93.0% 93.4% 90.0% 91.0%
Medical Services with No Gaps 80.5% 93.1% 87.0% 89.6% 90.3% 86.6% 90.7% 86.8% 91.3%
Industry Result 78.1% 89.8% 88.8% 89.7% 90.7% 87.6% 91.6% 88.5% 89.3%
Medical Services with No or Known Gaps 94.0% 98.0% 97.6% 98.1% 98.5% 97.9% 97.7% 92.1% 98.0%
Industry Result 92.7% 96.5% 97.6% 96.8% 99.1% 97.0% 98.2% 96.2% 97.1%
General Treatment (extras) Covered 41.3% 47.3% 42.6% 48.7% 44.7% 45.2% 41.9% 42.2% 47.5%
Industry Result 47.7% 50.1% 51.7% 53.4% 56.7% 56.6% 54.1% 58.8% 52.6%
Private Hospital Agreements 5 96 76 51 20 21 8 2 -
Industry Maximum 6 99 84 61 27 28 9 2 -
Day Hospital Agreements 8 89 72 48 26 22 4 1 -
Industry Maximum 11 108 94 64 35 39 9 2 -