Case Studies

In 2013, Centrelink granted a complainant’s claim for the Age Pension. In 2017, the complainant’s financial advisers identified they were incorrectly receiving a reduced rate of Age Pension because Centrelink believed they were a homeowner.

The complainant sought compensation from Centrelink under the Compensation for Detriment caused by Defective Administration (CDDA) Scheme on the basis that their claim had been incorrectly assessed and they had been underpaid for four years. Centrelink assessed the CDDA claim and decided that compensation was not payable.

The complainant made a complaint to the Office of the Commonwealth Ombudsman (the Office). Following our investigation, Centrelink offered compensation in the form of an amount in excess of $25,000, equal to the additional Age Pension that they should have been paid over the 4 year period.

For more information on what the Office does click here.

For more information about how the Immigration Ombudsman can help you click here.

For more information about how the Law Enforcement Ombudsman can help you with the AFP click here.

Case Study 1

A complainant requested a review of the NDIA's decision to decline the request for specialist funding for a wheelchair (in their child's plan). The NDIA undertook the review and confirmed its original decision. Although the NDIA verbally informed the complainant of the decision, it did not send them or their child a written decision. Without a written decision, they were unable to seek merits review of the NDIA's decision by the Administrative Appeals Tribunal (AAT).

They complained to the Office. We contacted the NDIA, and it sent a decision letter to their child. They were then able to exercise their right to review the NDIA's decision.

Case Study 2

A complainant contacted the Office due to delays in receiving assistive technology in their NDIS plan. They told us they were in hospital and were waiting for the NDIA to approve funds so they could obtain customised mobility equipment, and have modifications made to their home. Once the modifications were made, they could leave hospital and go home. They told us that they had followed all the steps including providing quotes and assessments. They called the NDIA multiple times and waited five months for a decision before approaching the Office.

We investigated their complaint. We noted the request had been handled by various teams and there had been lengthy delays in processing the request and responding to the participant's attempts to follow up the NDIA's decision.

During the investigation, the NDIA acknowledged the complexity of the participant's circumstances. It took action to provide a support coordinator to assist the participant to engage with the hospital, obtain the mobility equipment and make the required home modifications ­ so that the participant could leave hospital and return home.

For more information about how the Office of the Commonwealth Ombudsman can help you with the NDIS click here.

Case study 1

An international student asked the Office for help to get a refund from their education provider. The student’s provider told the Office they had no record of receiving any money from the student.

The student thought they could prove they had paid the provider because they had money transfer receipts. The provider had also given them a Confirmation of Enrolment (CoE).

The provider insisted they had no record of receiving a payment. They said they had issued the student’s CoE based on the transfer receipt, without confirming that they had received the funds.

The student gave the Office the receipts showing the international transfers. The Office showed them to the provider, who told the Office their bank details were incorrect, and the funds were sent to the wrong bank.

The student’s bank confirmed that although they initially sent the funds to the wrong bank, they had fixed the error and sent it to the provider’s account.

The Office compared the student’s transfer receipt with the provider’s bank records, and found a payment with the student’s reference number. The amount was slightly different to what the provider expected because of the routing error.

Once the Office gave this information to the provider they decided to refund the student.

Case study 2

An international student contacted the Office to complain that their provider wouldn’t release them to study another course.

The student was worried their Bachelor course was not well respected and they would struggle to find a job after finishing. Instead, they wanted to do a Certificate III level course at another provider.

The provider told the student that they wouldn’t release them because:

• they couldn’t transfer to a lower-level course under his visa conditions, and
• they had not demonstrated compelling or compassionate grounds for a transfer.

The student appealed the provider’s decision internally, but was unsuccessful, so they complained to the Office.

The provider showed us information that confirmed the student had done a lot of research before choosing the provider’s course. It was evident the student would be in breach of their visa conditions if they transferred to a Certificate III level course. Also, the student had not provided any evidence of compassionate or compelling circumstances.

The provider had good policies and procedures in place and had followed them correctly.

The Office decided to close the investigation because the provider had:

• followed all the required laws, policies and procedures, and
• been fair and reasonable.

Case study 3

The Office received a complaint from a law firm on behalf of the estate of an international student who had died while studying in Australia. The law firm was seeking a refund of fees from the student’s provider, but the provider was not responding.

The provider explained to the Office that it had not been responding because it was getting legal advice about its obligations.

We assessed the complaint and decided the provider should refund the student’s estate. They would have needed to refund the student if they had withdrawn from studies. Following some discussion with the provider about the calculation of the refund amount, they paid the refund.

Case Study: Australian Securities and Investments Commission (ASIC)

The Office received a complaint that the Australian Securities and Investments Commission (ASIC) had deregistered their company because they had not paid the annual review fees. The complainant advised that even though they had advised ASIC of a change to the address for their company, the annual company review fee invoices were sent to the old address and as a result, they had not paid the annual fee. Once they became aware of the error, the complainant paid the annual review fee. They complained it was not fair to have to pay fees for late payment of the annual review fee.

The Office conducted preliminary inquiries and asked ASIC for information on how it processed the request to change the company address. After receiving our preliminary inquiry, ASIC realised it had not properly processed the change of address for the company. It reassessed its handling of the matter and agreed to reinstate the company's registration and waive the fees relating to the late payment of the annual company review fee.

Case Study: Fair Work Ombudsman (FWO)

A complainant was a participant in the jobactive program and was referred to a position as a labourer by an employment service provider. They found out they were being underpaid, and their provider referred them to the Fair Work Ombudsman (FWO) who advised they had a right to leave the position and assisted them in doing so.

The complainant told their provider they had left, but the provider lodged a non-compliance report to Centrelink, resulting in their Newstart Allowance being suspended. When they complained to the National Customer Service Line (NCSL), they were told to contact the Fair Work Ombudsman.

They then made a complaint to the Office. The investigation identified errors on the part of the provider and found that on the basis of the information that was provided in the complaint to the NCSL, it would have been appropriate for the NCSL to refer the complaint to the provider for further investigation. The complainant's payment was restored, with back pay, and their record corrected

Case Study 1

A complainant sent a parcel of sentimental items back to Australia while on holiday overseas. Before they went on holidays they had placed their mail on hold. The mail hold failed, and a collection card was left by Australia Post. The card advised that the parcel was awaiting collection at their local Post Office.

When the complainant returned from overseas they went to the Post Office to collect their parcel. The complainant was advised that the parcel had been returned to sender as no one had collected it.

They complained to Australia Post, were unhappy with their response so they they contacted the Office.  Enquiries were made with Australia Post who reviewed their records and agreed the mail hold had failed. Australia Post contacted the overseas postal operator who located the parcel and sent it back it to the complainant. Unfortunately, it was lost on the way to Australia this time.

Australia Post agreed the parcel would not have been lost if the mail hold had not failed. Australia Post agreed to pay compensation for the loss of the parcel and a postage refund.

For more information about how the Postal Industry Ombudsman can help you click here.

Case Study 1

A medical specialist told a complainant their child needed surgery. They had purchased hospital cover from a health insurer less than 12 months earlier. The complainant called the insurer to check whether the costs of the surgery would be covered. The insurer told them over the phone it would be covered so they booked the surgery for their child.

The complainant used savings to pay for the surgery. They then lodged a claim for reimbursement with their insurer. Two weeks later, the insurer told them the claim would not be paid. The insurer said an independent medical adviser assessed their child's condition and decided it was a pre-existing condition. Insurers can impose a 12-month waiting period for payment of benefits if a medical practitioner appointed by the insurer assesses the condition is pre-existing.

The complainant came to the Office for help. The Office contacted the insurer and asked for copies of all communication with the complainant, including call recordings.

In one of the calls between the complainant and the insurer, the complainant was told the pre-existing conditions waiting period didn’t apply. This was incorrect, as they still had 3 months to wait before the end of the waiting period for the procedure their child needed.  If the insurer had told the complainant the correct information, they could have delayed the surgery until the waiting period was over.

The Office told the insurer it did not provide correct information to their complainant so it should pay for the surgery. The insurer agreed to pay for the hospital costs.

Case Study 2

A complainant started a health insurance policy in June. A government rebate was automatically applied to their policy, reducing the premium. The insurer asked the complainant to complete a rebate form to confirm the reduced premium. They thought they had returned the form and did not hear anything more about it.

In late October, the insurer contacted the complainant to let them know they hadn’t received the form.  The insurer warned the complainant they would increase the premium, backdated to the start date in June, if it wasn’t received. The insurer wrote to the complainant 6 days later to tell them the premium had increased. The letter also explained they were now behind in their payments.

The complainant could not afford to pay the extra amount so they cancelled their direct debit payments. They started a new policy in late December with a different insurer. The second insurer applied new waiting periods because the first policy had ended more than 2 months earlier.

The complainant was not in good health and was receiving medical treatment. They contacted the Office and asked us to help. The first insurer provided its records of communication. The insurer admitted they should not have allowed 5 months to pass before following up on the rebate form. The first insurer offered to reduce the amount the complainant owed it by half. They also issued a new end date certificate so the second insurer could remove the waiting periods on the new policy.

For more information about how the Private health Insurance Ombudsman (PHIO) can help you click here.

Case Study 1

A complainant was doing their tax return when they saw they had a VET FEE-HELP debt on their tax office record. The complainant had enrolled in the course in 2015 but did not complete it. They were surprised to see the debt because the provider told them the course is government funded and they would only pay for the units they completed.

The complainant contacted the Office to get help.  The Office looked at the information they gave us. We decided it was likely the complainant was misled or deceived by the provider when they enrolled in the course. The Office recommended the debt should be cancelled. The complainant did not have to pay the debt.