Commonwealth Consolidated Acts

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PRIVATE HEALTH INSURANCE ACT 2007 - SECT 121.1

Meaning of health insurance business

  (1)   Health insurance business is:

  (a)   the business of undertaking liability, by way of insurance; or

  (b)   an * employee health benefits scheme;

that relates, in a way referred to in subsection   (2), to * hospital treatment or * general treatment.

Note:   The following kinds of insurance business are not health insurance business:

(a)   accident and sickness insurance business (see section   121 - 20);

(b)   liability insurance business (see section   121 - 25);

(c)   insurance business excluded by the Private Health Insurance (Health Insurance Business) Rules (see section   121 - 30).

  (2)   The liability by way of insurance, or the arrangement to make payments under the * employee health benefits scheme, must relate to:

  (a)   loss arising out of a liability to pay fees or charges relating to provision in Australia of such treatment; or

  (b)   provision in Australia of such treatment; or

  (c)   the happening of an occurrence connected with the provision in Australia of such treatment; or

  (d)   the happening of an occurrence in Australia that ordinarily requires the provision of such treatment.

  (3)   It does not matter for the purposes of paragraph   (2)(d) whether payment of benefits to the insured is dependent upon one or more of the following:

  (a)   such treatment or benefit being provided to the insured;

  (b)   the insured requiring such treatment or benefit;

  (c)   fees or charges being payable by the insured in relation to the provision of such treatment or benefit.



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