This code was developed by HFANZ to inform customers of their reasonable expectations with health insurance. It is in addition to a customers statutory rights and the terms and conditions of their policies. Click here to read the code

The Human Rights Act lists the prohibited grounds for discrimination, although there is an exemption for insurance in certain circumstances. This allows for the effective operation of the insurance market. New Zealand's health insurance is a risk based system, meaning those with higher risks will pay higher premiums. The most noticeable impact of the exemption in operation is the higher premiums for older age groups.

Because premiums are based on claims costs for specific age bands, they increase with age. Another example of the effect of the exemption would be the application of an insurance premium loading at the time of acceptance to take account of increased risk due to a specific condition or disability. Strict rules apply requiring this to be actuarially or medically based.

Guidance note:
Prepared by HFANZ for members, this Guidance Note explains the different approaches that health insurers adopt when pricing premiums, and the complex issues facing the industry. It makes recommendations on premium pricing, disclosure requirements, and the meaning of "other factors" in terms of the Human Rights Act 1993. View Guidance Note

The Human Rights Commission has recently reviewed its guidelines relating to health insurance, in consultation with the industry. Further information, including their guide, is available from the HRC website.

Health insurance is affected by many of the reforms contained in the Government’s review of financial products and providers (RFPP).  While some of the changes have already resulted in legislation being passed, other aspects are less advanced and legislation may be some time away.  HFANZ has had input into the development of legislation and the regulations being made under the Acts.

A brief snapshot of some of the key components of the RFPP process of relevance to health insurance is provided here.

 Financial Advisers Act 2008 and Financial Service Providers (Registration and Dispute Resolution) Act 2008

These were the first parts of the RFPP process to be enacted.  The Acts provide for registration of all financial service providers, together with a mandatory requirement to be part of an approved dispute resolution scheme.  A Government-backed reserve scheme is provided for as a default option.  Financial advisers will also face a suite of competency testing appropriate to the advice they are giving.  The legislation distinguishes between complex advice and more routine advice, allowing organisations to apply to cover staff involved in the latter without the need for individual registration.

More information on the implementation of these Acts is available on Government websites.

Ministry of Economic Development: med.govt.nz

Ministry of Consumer Affairs: mca.govt.nz  

Insurance (Prudential Supervision) Act 2010

This Act establishes a licensing regime for insurers and provides for prudential regulation and supervision by the Reserve Bank of New Zealand.  Key objectives are to promote confidence among policyholders and the general public.  In order to achieve this, the Act requires insurers to comply with a range of measures, including financial strength ratings, solvency standards, risk management and other policies.

More information on the implementation of this Act and the regulations made under it can be found on the Reserve Bank's website.

Reserve Bank: RBNZ.govt.nz

Other policy areas

The Ministry of Economic Development continues to progress policy work on other aspects of the review, including market conduct and operations and mutuals governance.  For more up to date information, visit the Government website. 

Ministry of Economic Development: med.govt.nz

The Human Rights Commission has developed guidelines relating to health insurance in consultation with HFANZ, Age Concern and Grey Power.

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