Bupa HI Pty Ltd v Chang [2019] FCAFC 180 (17 October 2019) (Gleeson, O’Callaghan and Jackson JJ)


Catchwords:


HEALTH LAW – proper interpretation and application of Medicare Benefits Schedule – claim by private health insurer under the Australian Consumer Law against ophthalmologist and his service company in respect of allegedly overpaid amounts – primary judge dismissed insurer’s claim – appeal dismissed

CONTRACT – whether insurer formed a “reasonable opinion” that conduct of ophthalmologist “may adversely impact” insurer’s “goodwill, reputation or business” thus entitling it to “deregister” him from its “Gap Scheme” – primary judge made declaration that insurer had breached its contract with the ophthalmologist – appeal dismissed