PHI Prudential Standards (APRA)
Private health insurers must meet capital + governance standards.
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Who must comply
Registered private health insurers.
What triggers it
PHI registration.
When due
Ongoing.
Evidence required
Annual returns + capital filings + board attestations.
Max penalty
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Summary
Private Health Insurance (Prudential Supervision) Act 2015. APRA prudential standards covering capital, risk management, governance + outsourcing for private health insurers.
Enforced by
Topics
insurancehealth
Related obligations
- CWLTHComply with claims handling + settling as a financial service (s 766A)From 1 January 2022, insurance claims handling is a financial service requiring AFSL authorisation.
- CWLTHTherapeutic Goods Advertising CodeAdvertising of therapeutic goods to AU consumers must comply with TGA Advertising Code.
- CWLTHComply with Private Health Insurance Act 2007 + APRA rulesPrivate health insurers regulated by APRA + PHIO; community rating, complaints + claims rules apply.
- CWLTHComply with General Insurance Code of Practice (ICA)ICA Code binds member insurers on conduct + claims + complaints.
- CWLTHManage business interruption claim definitions (post-pandemic precedent)BI insurance policies must clearly define pandemic exclusions per Federal Court guidance.
- CWLTHGeneral Insurance Code of Practice 2020ICA member insurers bound by service standards + claims handling timeframes.
Frequently asked questions
- Who must comply with PHI Prudential Standards (APRA)?
- Registered private health insurers.
- What triggers PHI Prudential Standards (APRA)?
- PHI registration.
- When is PHI Prudential Standards (APRA) due?
- Ongoing.
- What evidence is required for PHI Prudential Standards (APRA)?
- Annual returns + capital filings + board attestations.
Source: https://apra.gov.au/private-health-insurance. Rules Mate is not a law firm. Always verify against the live regulator source before acting.