Health Insurance

Leading health insurance clients come to Mallesons because our specialists understand the particular issues and challenges faced by the health insurance industry including significant pressures flowing from the domino effect of increasing cost of care, increasing premiums and a flight from cover, particularly by younger consumers. We continue to work closely with these clients as Australians look for ways to cut their budgets in the face of COVID-19-driven economic challenges.

We maintain a successful track record advising some of the leading Australian and international industry participants on some of the sector’s largest and most challenging transactions and are able to safely guide clients through the full life cycle of any strategic decision.

We also help health insurance clients navigate the complex regulatory environment and across the full breadth of day to day issues as health insurers look to evolve their business model to address changing consumer needs for an expanded offering including alternative therapies and preventative services focusing on lifestyle and wellness.

Our legal advice for health insurance clients covers:

• Regulation issues, including the structuring of corporate partnering arrangements
• General corporate and commercial advice in relation to taxation, procurement, IT and sponsorship arrangements
• Social media agreements and policies
• IP and branding advice
• Compliance with bribery regulation
• Commercial dispute resolution
• Competition investigations
• Mergers, acquisitions, joint ventures and major capital investment projects
• Employment and pensions.

Our experience

• HBF Health Limited: advising HBF on its proposed merger with HCF to create the largest not-for-profit insurer in Australia.
• Australian Unity: advising on the strategic divestment of its corporate health insurance business, GU Health, to private health insurer nib; also advising on home services joint venture with Ramsay Hospitals.
• Various private health insurers: acting in relation to numerous disputes including Supreme Court litigation arising out of termination of a marketing contract, misleading advertising, IT transformation project disputes and ACCC investigations.
• Confidential PHI client: advising on a range of strategic IT and BPO outsourcing transactions including a core private health insurance platform replacement project: including negotiating its underpinning SAP licensing and support arrangements.
• nib Health Fund: advising on establishment of Whitecoat (data acquisition and initial joint venture) and on the expansion of the joint venture arrangement to include Bupa and HBF.
• nib Health Fund: advising on the acquisition of IMAN (overseas worker and student health insurer), including PHI advice on the (non) application of community rating principles to the provision of such insurance.
• Brookfield: advising on health regulatory (private hospital accreditation and licensing) and PHI issues relevant to the acquisition of Healthscope.