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ahm
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Edited by:
Ajust Content Team
Last updated:
August 27, 2025
AI-sourced. Human-edited. Made clear for you.

How to submit a complaint with
ahm
 

 If you’re an ahm member with a complaint, you’ve got multiple fast paths:

  • Phone (fastest during business hours): Call 134 246 (Mon–Fri, 9am–6pm AEST). Ask the agent to log a formal complaint and request a case reference.

  • Email (written record): feedback@ahm.com.au — include your policy number, full name, best contact, dates, who you spoke to, what went wrong, and what outcome you want (refund, fix, policy change, explanation).

  • Secure message (portal/app): Log in at ahm.com.au or the app → “Message us”. Provide the same details as above if you prefer not to use personal email.

  • Post (if sending documents): Address your letter to ahm (a Medibank division) via the postal details on ahm’s Contact us page and mark it Complaint. Email/phone is usually faster.

  • Accessibility & support: Ask for interpreter services, accessibility assistance, or nominate an authorised representative to act for you.

What to include: Policy number, dates, names of staff, a clear description, supporting docs (no card numbers), and your requested resolution. ahm typically acknowledges immediately by phone or within 1 business day via email.

What happens after you submit a complaint to ahm?

  • First-contact resolution: Front-line teams try to fix simple issues on the spot (e.g., claim miscalculation, benefit explanation).

  • Escalation to Customer Advocacy Team: If it’s complex or can’t be fixed immediately, it’s assigned to a case manager who investigates with claims, policy and tech teams. You’ll get an acknowledgement and a case ID.

  • Timeframes & updates: Target resolution within 10 working days. If delays occur (e.g., waiting on hospital/insurer info), they’ll explain why and give a revised timeline.

  • How they communicate: You can nominate phone or email. Urgent cases (imminent treatment, hardship) are prioritised.

  • Outcomes: Clear explanation + remedy when upheld. Typically a apology, error correction, expedited claim, refund of overpayments, policy adjustment, or compensation where appropriate.

  • No disadvantage: Complaints are free and won’t impact your cover. If you’re unhappy with the outcome, internal independent review is available before you go external.

Common complaints against
ahm

  • Claim & benefit disputes: Lower-than-expected payouts for surgery/dental. (Tip: Call ahm before procedures to confirm benefits and waiting periods; get key advice in writing.)

  • Customer service experience: Difficulty escalating; occasional poor interactions.

  • Coverage/policy confusion: Waiting periods, upgrades, extras. (Tip: Keep product fact sheets; ask reps to note your file and send follow-up email confirmation.)

  • Cancellations/changes: Long holds, occasional post-cancellation debits. (Tip: Get written cancellation confirmation, cancel direct debit, and monitor statements - ahm will refund mistaken charges.)

  • Premium increases/value concerns: If cover feels poor value, ask for plan options aligned to your usage.

  • Communication issues: Wrong addresses, phone-only preferences.

Complaints submitted through Ajust

How other consumers
ahm
 complaints got resolved

ATO dependent coverage fixed: A member flagged an ATO denial; an ahm rep coordinated documentation and proactive follow-ups. ATO reversed the decision and confirmed coverage.

Difficult cancellation → refund processed: After cancellation, a further premium was debited in error. ahm apologised and refunded it, albeit delayed.

How to escalate a complaint with ahm

  1. Back to your case manager: If 10 business days pass or you’re unhappy, reference your case ID and request a re-review.

  2. Senior review: Ask for escalation to a senior manager/Customer Resolutions Manager; restate the remedy you seek and why.

  3. External option (free): If unresolved, lodge with the Private Health Insurance Ombudsman (PHIO). Mentioning PHIO often prompts a final internal look.

  4. Stay organised: Keep emails, call dates, names, and documents (PHIO will request evidence).

  5. Urgent health needs: Flag urgency at every step; ask your provider/doctor for supporting letters to prioritise the case.

Regulatory & Ombudsman Information for ahm

  • Private Health Insurance Ombudsman (via Commonwealth Ombudsman): 1300 362 072 · ombudsman.gov.au (Private Health Insurance). Free, independent dispute resolution; generally after you’ve tried ahm first.

  • PrivateHealth.gov.au: Official info on private health insurance and consumer rights; useful for policy comparisons and complaint stats.

  • ACCC / State Consumer Affairs: For potential misleading conduct or broader consumer law issues; they may still direct health-insurance disputes to PHIO.

  • AFCA: Not usually applicable to private health insurance (banking/general insurance focus).

  • Legal advice: Rarely needed. PHIO resolves most cases faster and free.

Official ahm Complaint Resources & Links

ahm
Complaints FAQs

You’ve done your part, now it’s time to hold
ahm
accountable.

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