Southern Cross Healthcare Avis 18

I had an extremely stressful experience with Southern Cross. Despite having no pre‑existing conditions when I joined, my surgery was declined less than 24 hours before the procedure after weeks of delays, repeated document requests, and poor communication.
They later added multiple exclusions that I never had before joining. This experience has completely broken my trust. I will be cancelling my policy and do not recommend them.

Spare yourself the hassle and stress – avoid Southern Cross Medical Insurance.

In my experience, when submitting a dispute or complaint, you are treated as though you are wrong from the outset. There appears to be little genuine investigation or consideration of all the information available to them.

On two separate occasions during my complaint process, Southern Cross Medical Insurance issued negative outcomes without conducting what I would consider a thorough review. Decisions were communicated before all relevant information had been reviewed or even accessed.

A complaints process should be fair, impartial, and comprehensive. Unfortunately, that has not been my experience. Based on how my dispute was handled, I cannot recommend this insurer.

Not a good experience unfortunately.

Went through all the correct avenues of appointment's with the GP to get an ENT specialist referral for a needed tonsillectomy for our son.

SX denied funding the procedure privately as they don’t recognise snoring and sleep apnea as a relevant symptom for the procedure. Despite the specialists referral letters and urgent recommendations that the tonsillectomy happen due to severely enlarged and obstructive tonsils and adenoids.

Apparently children have to suffer with extensive ear infections and tonsillitis before SX will consider approving surgery. Even then I imagine they will probably think of a reason why they won’t cover it.

Looks like we will join the waitlist in hopes we can get this done through the public system, while still forking out for supposed private health insurance.

We used to have a comprehensive policy and while we had that everything was fine - 5 stars. Due to the ever increasing premiums we had to scale down to 'surgery only' (Wellbeing One). I had one claim in 2011 under the comprehensive policy and no additional claim until last November. I needed several scans (ultrasound, x-ray, CT) in the lead-up to surgery and, although it was clear after the 1st ultrasound that I will need surgery, we had to pay for the scans up front. That wasn't the worst. Once we had proof of surgery we asked for reimbursement for what we had already paid - and those morons paid it to the provider! One provider (one of the specialists) immediately refunded us. However, we are still waiting for reimbursement from the other provider and one of the bills is 'on hold'. It's not all sorted yet. Zero stars for the Wellbeing One policy. When you have surgery etc you don't need the extra hassle of having to follow up each and every bill. Also their website for submitting claims is VERY difficult to navigate.

Have been with Southern Cross for about 5 years now, on the 80% cover plan.

I recently had a couple of surgeries and found it easy to get pre-approval and get Southern Cross to pay my surgery bills.

Deceptive and misleading billing practices and poor customer service. My family and I joined only a month ago and have set fortnightly payments on our premiums through direct debit. Four fortnights worth of premium were suddenly deducted without any warning and without any invoice sent to my email. Called their customer service and they told me some BS about their billing cycles and notifications sent through their mysoutherncross portal which you wouldn’t really check everyday. No resolution offered by Southern Cross. We decided to switch health insurance providers and will tell friends to stay away from Southern Cross like the plague!

Category: Health Insurance

I have been a loyal Southern Cross member for over 10 years, always paying for UltraCare (their highest level of cover). But after my recent experience, I’ve completely lost trust in this company.

In April 2025, I spoke to a Southern Cross representative to place my policy on overseas suspension, as I had just relocated to Australia. I was clearly told it would be suspended from December 2024 for two years, covering both me and my partner.

Relying on this, I made financial decisions and didn't budget for any premiums. Months later, Southern Cross claimed the suspension was never applied and that I owed them $5,710.50 in arrears — despite not using the policy, aside from two automatic GP-submitted claims totalling $94 that I wasn’t even aware of.

Their reasoning? They said I gave “incorrect information” — which is untrue. I disclosed our plans transparently and was told by their own staff that it would be handled. Southern Cross has since refused to acknowledge responsibility for giving me false reassurance, even though they admit their communication was unclear and that their staff failed to follow proper process.

Now, they’re demanding I pay thousands of dollars because of their mistake. They’ve left me with no choice but to lodge a complaint with the Insurance & Financial Services Ombudsman (IFSO).

No customer should be financially punished for relying on verbal advice from a provider’s own team. Southern Cross has failed in their duty of care — and their treatment of long-term members is shameful.

Have been with Southern Cross since 1979 (46 years), firstly through my employment, and then personally. Had chemotherapy in 1994-95, and they paid. Since then, have barely claimed, and when I have, it's been relatively minor check-ups. Have just received my annual increase - $102, 18.24% -all based solely on my age. Have had numerous email replies to my query as to why, and the morons they employ come back with the same PR claptrap. If you have minimal claims, the increase should be based off that, NOT solely your age. At 71, I realistically can't move companies, and they know that. Very poor service provider.

Terrible excuse to get out of paying. Need surgery on ulner nerve in elbow and reconnect in hand but because I've had carpal tunnel surgery before claim declined. Would waste you money try another insurance company. Very disappointing as southern cross use to be good..

We are about to massively downgrade our policy or change companies due hopelessly ineffective customer service, constant price hikes, and a massive list of unnecessary exclusions they keep adding to our policies.
The website never works after hours if you need to check anything. We get past the login page only to get a 403 error and a message that says there is a problem, try some other time or use some other method of contacting us. This happens all the time. Of course, there is no phone service after hours so you can't do anything.
Dental policy is an absolute joke for anything more than fillings, even with the overpriced Vison and Dental extension.
Policies are deliberately convoluted so adding one thing that you need means losing another, and making any minor change requires a major restructure and a re-quote.
We recently tried to add pet insurance, but it was impossible to work out what you were getting and what was excluded. Thankfully someone recommended PD Pet Insurance and they have been absolutely fantastic and at a far better price. Southern Cross still keep spamming us to join their crappy, overpriced and deceptive pet policy, no thanks.

I just canceled my membership after 17 years of no claims and asking just last month to pay for plantar faciitis treatment which was one of $600 injection. They said no!
Absolute scammers!

Be prepared to face 20% increase each year. Does not look like they are there for people, but rather money

We had 1 good experience claiming for surgery and a hellish experience claiming for a consultation with a specialist. First we applied for a pre-approval for the consultation that we received back positive. Consultation fee was paid upfront by us $1050. After submitting the claim and not hearing anything back after the advertised "7 days" i was told they are behind with processing and not processing yet for the day i submitted. After a couple of days, i logged in again and see my claim was placed "on-hold". I called again and was told they mailed the specialist to confirm the consultation did take place and that it was paid.
I submitted the invoice, and the receipt of payment and still feel like i was treated like a criminal by the Souther Cross agent. It has been 14 days now with no payment yet. Fast to deduct membership fees, slow to refund hard earned money. Poor experience.

Have been with Southern Cross for 48years.This year they put our yearly fee up 20% nearly a 1000 extra
I have not personally ever had a claim

They take a long and unreasonable time to review anything you send through them. You can't do much through the app and they don't make communication easy at all. Honestly, it's the worst health insurance I've ever had. I'll look for alternatives.

Hospital and doctors negligence
My 6 year old nephew is no more in this world
A normal tonsil procedure gone wrong
We need answers
Close the bloody hospital until the investigation is done

Waited over a week for acknowledgement of claim and still nothing.
Until you contact them asking for an update, they will not start processing the claim.
My partner is with NIB and his claims get processed in less than a day and money received within 24 hours.
Southern Cross being such a big company should do better.

Was a member for 35 years (including my family) Hardly made a claim. I needed a hip operation and paid my share of $9,000. Received an infection at the North Shore Southern Cfoss hospital. SC refused to remedy the situation and sent me to the public hospital for 4 further hip operations. Lodged a complaint which was not taken seriously? No longer a member. Southern cross decision has personally affected my health. The loss of both my adult children by suicide affects my mental health. Southern Cross has no compassion or empathy.