How we manage complaints

Complaints Management Framework

Our Complaints Management Framework governs how we manage complaints at Comcare. The information on this page is based on the framework. You can also download the framework:

How to make a complaint

See feeedback and complaints for how to make a complaint. 

We may ask you to put your complaint in writing. You can use these tips for preparing a complaint.

If you need help with making a complaint, let us know. We will give you reasonable assistance if needed.

What is a complaint?

A complaint is a statement of dissatisfaction which requires a response.

You can make a complaint about:  

• a service provided by Comcare, its employee or a contractor  
• an action or decision, including concerns about quality or timeliness  
• how a policy or process has been applied.  

We may also be able to help with resolving complaints about claim management by self-insured licensees or under the Seacare scheme.  

What is not a complaint?

Most contacts we receive are not complaints. The following contacts are not complaints:

• an enquiry or request for information
• a request for a service
• feedback or a suggestion about Comcare’s services
• an application for review of a decision where a right of appeal exists
• comments about Government policy or legislation
• the provision of information (e.g. reporting a workplace health and safety incident).

However, you can complain if we do not address or respond to a request for information or a service in a timely way.

If we assess that your concerns are best managed under a different process, we will advise you and explain our reasons.

Timeframes

We acknowledge email and written complaints within 2 calendar days.  

We aim to resolve complaints within 21 calendar days. If your complaint is likely to take more than 21 days to resolve, we will let you know and contact you at least every 10 days with an update.  

Timeframes may be longer if a weekend or a public holiday falls within those days.

How we manage complaints

Record

We record all complaints on receipt and assess each one to determine if it is in scope for Comcare. We check for urgency and importance and which business area should respond to the concerns. It may be the officer who is managing your matter, their supervisor or another team if appropriate.

Acknowledge

We acknowledge all complaints received, usually by the same method as they are made.  

Assess

We identify the concerns raised and may contact you to ask for more information or to clarify the key issues or concerns. We listen to your perspective and answer any questions you may have. We explain the complaints process and give you an indication of how long it is likely to take. We will ask you about your desired outcome and may also discuss other options. We will keep you updated of progress. 

Resolve

We examine the issues and concerns raised and work with you to find a solution. We may review information and documents, seek input from business areas and identify steps needed to rectify any problems or errors.

As part of the resolution we might:

• apologise
• give you information or advice
• explain what went wrong and how we’ll prevent the issue happening again
• refer you to another agency or organisation
• fix an error  
• change a decision (this doesn’t include where you are appealing a decision)
• confirm that our actions were appropriate and explain the reasons for that decision.

We will look at whether:

• all aspects of your complaint have been properly addressed
• you have been consulted appropriately
• the outcome is consistent with relevant legislation, policies and guidelines.

Communicate

We’ll let you know the outcome of the resolution process and explain the reasons for it. We’ll inform you of other options that may be available to you.

Learn and improve

Where we identify an error or a process issue as the root cause of the complaint, we acknowledge it, learn from it and make improvements.

Review

If you are not satisfied with how we handled your complaint, you can ask for a review. To seek a review, let us know within 21 calendar days of receiving the outcome of your complaint why you believe the outcome or the complaints process was unfair or unreasonable.  

Requests for review made outside of this timeframe, or without clear reasons for seeking a review, may not be considered.  

We may also decide not to review your complaint if:

• we consider another option is more suitable
• we have already reviewed the matter, or
• we assess that a review is not warranted in the circumstances.

Read about internal reviews of complaints.

External review  

You can ask the Commonwealth Ombudsman for an external review at any time if you believe Comcare has treated you unfairly or unreasonably. The Ombudsman generally expects you to raise your complaint with us first. If you have a reason not to do that, you can discuss this with the Ombudsman's office.  

To request a review, go to the Commonwealth Ombudsman website.  

Rights and responsibilities

Your rights

As a Comcare client you have the right to:

• make a complaint
• be heard and be treated with courtesy and respect
• have your complaint managed in line with the Complaints Management Framework
• seek review if you are not satisfied with the complaint response or process
• withdraw a complaint at any time.

Your responsibilities

When making a complaint we expect you to:

• treat Comcare staff with courtesy and respect
• clearly describe the problem and the solution you want
• provide relevant information so that we can consider your complaint
• be willing to engage and cooperate with the complaint process.

Our rights

Comcare has the right to:

• protect our staff from behaviour and content that is aggressive or threatening, or otherwise poses an unacceptable risk to staff safety or wellbeing
• refuse to consider complaints that are vexatious or outside of our scope
• continue to investigate a complaint after it has been withdrawn, if it raises serious issues.

Our responsibilities

Comcare has a responsibility to:

• support your right to lodge a complaint, including by providing reasonable assistance if needed
• protect your privacy and, if requested, your anonymity
• manage complaints in line with our Complaints Management Framework and relevant procedures
• provide regular updates and a timely response
• provide information about the complaints process, including your right to review.

Values and principles

Values

Comcare values complaints and is committed to delivering a high-quality service. Our Complaints Management Framework describes how we will grow a culture that encourages feedback and is aligned to our values of:

• earning and strengthening trust with our stakeholders
• acting with integrity and respect
• collaborating and innovating
• striving to have a positive impact.

Principles

Our complaints management process demonstrates these values by applying 5 guiding principles. We will manage complaints in a way that is:

• Fair: We assess and manage complaints fairly, impartially and with integrity.
• Accessible: Our complaints process is easy to access and simple to follow. If you need help to make a complaint we will assist you.
• Responsive: We listen and respond promptly. We communicate openly and honestly. We aim to resolve complaints at the earliest opportunity and monitor resolution timeframes.
• Accountable: We welcome feedback and seek to improve and learn from complaints. We explain our assessments, actions and decisions. If you are unhappy with how we managed your complaint, you can seek a review.
• Transparent: We are open and clear about how complaints are handled. We explain the resolution process and what you can expect.

Recordkeeping  

We record the details of your complaint and the outcome in our complaints management system. This helps us manage your complaint effectively and ensure a clear record of the steps taken.

We also record information that helps us identify trends and opportunities to improve our services, including:

• your name and contact details
• what your complaint is about and how it can be categorised
• relevant details such as claim numbers or the specific issue raised
• the outcome of your complaint and any actions taken.

A complaint is closed in our system once we have advised you of the outcome.

Privacy

Your privacy is important to us. Comcare may use the information you provide as well as other information we hold that is reasonably necessary for us to consider your complaint. Any personal information you provide will be handled in accordance with the Privacy Act 1988 (Cth). For more information about how Comcare handles personal information and to view our Privacy Policy visit Privacy.