Unacceptable member behaviour policy

At Southern Cross Medical Care Society (Southern Cross) we are committed to being helpful, accessible, and responsive to our members. We want to ensure that interactions with members are positive, creating and maintaining relationships of mutual respect and understanding. We seek to do so in the most effective and efficient way.

Southern Cross also has a duty to protect and support its staff and ensure the health, safety and security of our employees. We are committed to ensure as far as practicable that the workplace is safe and free from bullying and bad behaviour, which may negatively impact our staff.

This includes taking steps to prevent or manage unreasonable or unacceptable behaviour by members.

Likewise, we expect and require our staff to be professional in all interactions with members. If a member experiences unacceptable or unprofessional behaviour by a Southern Cross representative, we encourage them to submit a complaint. See our full complaints process here.

Objectives of policy

This policy has been developed to help both members and Southern Cross employees clearly understand and identify what behaviour by members and their representatives is not acceptable. And to ensure that members and our employees are clear about how such behaviour will be dealt with by Southern Cross.

Southern Cross does not accept any harm, abuse or threats directed at its staff. Any behaviour of this kind or any of the other unacceptable behaviour described below or reasonably deemed by Southern Cross to be unacceptable behaviour by a member will be investigated and action taken in accordance with this policy.

What is ‘Unacceptable Member Behaviour’?

Most members who contact us act reasonably and responsibly, even if they are upset or frustrated by what has happened. However, in a small number of cases some members behave in ways that are inappropriate and unacceptable.

This behaviour can consist of a member making inappropriate or unreasonable demands on our resources through high volumes of communication. On some occasions, they can be aggressive and verbally abusive towards our staff, or threaten harm or violence.

When members behave in these ways, we consider their conduct to be unacceptable. We’ve set out some types of unacceptable member behaviour below.

Unreasonable persistence and demands

• This may include continued unreasonable demands that have an unreasonable or disproportionate impact on Southern Cross resources; and/or
• Excessive contact and communication with Southern Cross; and/or • Persistent demands to review a decision that’s been fully considered by the appropriate people within Southern Cross

Unwillingness to co-operate with Southern Cross

• This may include an unwillingness to co-operate with Southern Cross to resolve a matter; and/or
• Withholding information, providing dishonest information, presenting false and/or incomprehensible arguments; and/or
• Refusing to accept reasonable explanations or final decisions

Behaviour that compromises Southern Cross staff or other member health safety and security

• This may include aggressive behaviour, bullying, verbal and/or physical abuse, threatening verbal and/or physical abuse, discriminatory and/or derogatory comments or actions
• Threats of harm to themselves or other people, and/or Southern Cross property.

How Southern Cross determines whether behaviour is unacceptable

We deem a member’s behaviour to be unacceptable when it negatively impacts:

• the health, safety and security of our staff; and/ or
• our ability to do our work and perform our functions in the most effective and efficient ways possible.

We’ll review the appropriate correspondence and communication, including recorded phone calls and notes about an interaction with the member. A senior manager will decide what (if any) action should be taken.

We’ll investigate what has happened carefully. We’ll treat the member fairly and consistently and provide an opportunity to explain. Southern Cross will keep an open mind, act without prejudice and with transparency. Southern Cross will consider all relevant evidence presented by the member.

What happens if the behaviour does comprise unacceptable member behaviour?

If we deem a member’s behaviour to be unacceptable, Southern Cross may take one or more of the following actions:

• Communicate our decision to the member setting out the behaviour that was not acceptable.
• Remind the member, that we require any communications to be undertaken in a clear, courteous and reasonable manner.
• We may decide at this point to place restrictions on how a member may contact us and how we will communicate with them going forward. This may include requiring the member to only contact us through a representative, only accepting communications in writing and referring them to other agencies if we are not able to assist them with their issue or concern.
• Provide a written warning about the member’s unacceptable behaviour, referring to this policy and outlining potential consequences should the unacceptable behaviour continue.

If the unacceptable member behaviour continues, we may consider further action, including termination of the member’s policy.

Southern Cross Medical Care Society (trading as Southern Cross Health Society) is a licensed insurer and a licensed financial advice provider. For more information about the financial advice service we provide and a copy of our public disclosure statement please visit southerncross.co.nz/disclosure-statement.

Southern Cross Medical Care Society (trading as Southern Cross Health Society) has an A+ (Strong) financial strength rating given by Standard & Poor’s (Australia) Pty Limited. The rating scale is: AAA (Extremely Strong), AA (Very Strong), A (Strong), BBB (Good), BB (Marginal), B (Weak), CCC (Very Weak), CC (Extremely Weak), SD or D (Selective Default or Default). Ratings from ‘AA’ to ‘CCC’ may be modified by the addition of a plus (+) or minus (-) sign to show relative standing within the major rating categories. Full details of the rating scale are available at www.spglobal.com/ratings/en/about/intro-to-credit-ratings. Standard & Poor’s is an approved rating agency under the Insurance (Prudential Supervision) Act 2010.