Bupa has been slapped with a $35 million fine after misleading its customers, hospitals, and medical providers regarding the benefits of its private health insurance plans.

The company was found to have incorrectly informed members that they could not claim benefits for mixed coverage and uncategorised items from May 2018 to August 2023, even though they were indeed eligible for those benefits.

This misrepresentation affected over 4,100 claims, leading the federal court to label Bupa’s conduct as false, deceptive, and unconscionable.

ACCC Deputy Chair Catriona Lowe described Bupa’s actions as “extremely serious,” noting the financial harm, distress, and suffering experienced by thousands of customers.

“Many Bupa members opted to cancel, postpone, or completely avoid necessary medical treatments after being wrongly informed that they were ineligible for insurance benefits,” Lowe stated, highlighting the potential health risks and complications that ensued.

“Private health insurance represents a major financial commitment for consumers, and they have every right to expect the coverage they pay for,” she emphasized.

Bupa accepted the court decision and apologised to its customers.

“We remain deeply sorry for these errors and have apologised to our affected customers for the impact this has had on them and their families and have taken actions to ensure this doesn’t occur again,” the provider said in a statement.