Principle rules and by-laws

You can't have the same type of health cover with more than one health fund (e.g. you can't have a Hospital and Extras package with 2 health funds). But you can have hospital only cover with one health fund and Extras only cover with another

Benefits will only be paid for claims which meet nib criteria

nib reserves the right to recover any money paid in error or obtained fraudulently, or by any other means contrary to nib's rules

Your customer number needs to be quoted on all claims - you'll find it on the front of your nib card

Benefits are only paid if the claim is made within 2 years of when the service was provided. This means claims are paid by the date of service so if your limits have been reached in the year you were treated, or you weren't covered for that service then, the claim cannot be paid.

Customers will not be paid any benefits if they are not financial. nib policies are unfinancial if premiums are in arrears. nib may cancel policies that are more than 2 months in arrears

We believe it's important you and your family have the right cover. So, if you change your mind, just call us within 30 days of starting your cover. We will transfer you to another cover of your choice, or refund your premiums at your request, provided you have not made any claims.

Benefits are not payable for:

  • Policy applications or claims where false or inaccurate information is supplied
  • Services by providers not registered with nib
  • Services where a customer is eligible to receive benefits from a liable third party, including: Worker's Compensation, Third Party e.g. car accidents; Medical Negligence; Public Liability e.g. fall at a public place.
  • Services given to customers of a provider's family, or to a provider's business partner and family. This also applies to people not independent from the provider's practice (e.g. employees)
  • Services like examinations for life insurance, health certificates, mass immunisation, health screens and other expenses incurred for services required by employers.