INTITIATING MINISTERIAL INTERVENTION

(Approaching Your Local Federal Member of Parliament)

 

“Our deepest fear is not that we are inadequate.   Our deepest fear is that we are powerful beyond measure.   It is our light not our darkness that most frightens us.   We are born to manifest the glory...that is with-in us.   Its' not just within some of us: It’s in everyone.   And when we let our own light shine, we unconsciously give other people permission to do the same.   As we're liberated from our own fear, our presence automatically liberate others.”

-- Nelson Mandela 1994 --

 

This paper is a short outline of how to mount our battle against the Insurance Companies and their persistent refusal to pay legitimate ME/CFS claims to the innocent victims of an illness that they never chose to get.   The only way to make progress is to make our individual voices heard – to combine our individual cases and keep making the Federal Government aware of our plight via our individual members.

 

It is easy to believe that we cannot, as an individual, make a difference here.   I do not believe that to be the case.   We can act individually towards a common purpose.  If we all act, then there is a genuine opportunity to succeed.   Our task is to act unselfishly for the benefit of others and take our case to our Member.

 

Please do not ignore this opportunity.   Every voice counts.

1.     Approaching You Local Member

The first step in this task is approaching your local member.   Your local member is detailed in the white pages of the telephone directory under P for Parliament of the Commonwealth.   Be careful that you do not chose the wrong one – make sure you confirm with the Office that you are in their electorate.   An MP is unlikely to argue your case if you are not their constituent.

 

My preference is for you to see your member in person – in part to show them what an ME/CFS person looks like in the flesh, and in part to show the face behind the pain.   Personal attendances build relationships and empathy with the sufferer.   This personal interaction makes it hard for your case to be ignored – for you to be dismissed.   It establishes credibility and believability.  

 

ME/CFS people are not liars.   They are not malingerers.    They are not whingers.   They are not hypochondriacs.

 

The face-to-face interview is a powerful tool in combating these misnomers in the most effective way possible – eye contact and body language.

 

HOWEVER – a face-to-face interview may not be possible.   Indeed with many who suffer this illness, it will not be physically and/or cognitively possible to attend an interview.   For these people, I can only encourage you to try and ring your local member for a telephone conference.   This may be achieved by arranging with the staff to make a time for this call, or, perhaps writing to them first, then calling.   If you entertain the latter, I suggest you send a picture of yourself – humanize and personalize yourself.   You are a person, not a faceless voice at the end of the phone.   Make sure they know this.

 

Once you have the appointment, you will have the opportunity to voice yourself.   This is the interview.

2.     Preparation for the Meeting

Before you attend the meeting, I suggest you take a bit of time to organize yourself.   It is essential to have a clear idea of what you want to tell the MP about your case, and to define what you need to achieve an appropriate outcome.

 

Each and every case will be different.   The companies will be different.   The type of policy will be different.   The Doctors used will be different.   The medical evidence you have will be different.   You need to summarise what your case is in brief.   Try and highlight where the Insurance Company has attacked you, where it has failed in its obligations under the contract, and in assessing your claim.

 

Be brief in these notes – they are to prompt you on what you want to discuss, and perhaps to act a paper for the MP to refer to in the future.   I would encourage you to supply the MP with a summary.

3.     The Interview

The interview is your opportunity to state your case – to tell them what you’ve gone through and what you need from them.   I would suggest that you take some one along with you, who can take notes, who can assist you to state your case, and to take you to and from the meeting.

 

ME/CFS is as much about human hardship and emotion as it is about contractual entitlements.   Be open, be honest and don’t hold back.

 

I encourage you to do the following:

 

  1. Explain what policy/ies you have with what companies;

 

  1. Explain the excuse that the Insurance Company gave for canceling/refusing the claim;

 

  1. Explain any methods that the Insurance Company may have used to avoid the claim – eg use of the same Doctors that other ME/CFS claimants have had used to refuse their claims; highlight if the Doctor said things like “I don’t believe in CFS”; the use of Psychiatrist’s where you have been shown to have a biological illness; refusal to grant access to Insurance Company medical reports (hence acting contrary to the principle of fairness and right of reply guaranteed under Beverley v Tyndall Life Insurance Co Ltd (1999) 10 ANZ Insurance Cases 61-453); failure to acknowledge certain medical evidence (such as research evidence or non-medical practitioner evidence like psychiatrists or physiotherapists); breaches of AMA regulations and the like.

 

  1. Explain what you can and can’t do in daily life – the nature of the illness.

 

  1. Explain what your occupation was and how you are affected;

 

  1. Explain how you and your family have been affected physically, psychologically, and financially by their refusal to pay;

 

  1. Explain what legal or other action you have taken;

 

  1. Explain that Section 55A of the Insurance Contracts Act 1984 allows ASIC to take up cases where a breach of the Act occurs, and it would be in the public interest to take action.   Section 13 of the Act imposes a duty of utmost good faith.   Breaches of the policy, breaches of case law, and breaches of other Acts (eg Trade Practices Act 1974) are a breach a utmost good faith.   ASIC is not currently enforcing their right under this Section because they assert that “ASIC’s consumer protection mandate focuses on apparent systemic issues within an insurance company and/or issues that raise broader industry concerns”.   They will only act if ASIC can “identify issues that appear to be systemic or widespread”.  

 

  1. Explain that ASIC has had many such problems placed before them and that they are not acting.   Ask the MP to write to the Minister on your behalf, to ask him to allow ASIC to take up your case.   You want your MP to make the Minister (which is the Treasurer – he is in charge of ASIC) aware of the abuse that is occurring in your case.   The MP also needs to ask the Minister why ASIC are not acting on these cases when the Insurance Contracts Act 1984 makes it clear that our rights are to be protected.

 

  1. Ask the MP what he wants in the letter to him.   The letter that must follow this interview is important to allowing the MP to follow-up with the Minister, everything that you have discussed.

 

Obviously this is not an exhaustive list.   I am open to suggestions from the experience of others and welcome suggestions for inclusion into this information site.

 

The whole point of the interview is to inspire your MP into action.   Get him thinking about your plight, your problems, your pain and heartache.   It is this that he/she needs to witness, understand and identify with.   It is this image and experience that he/she will carry to the Minister.

 

4.     Drafting Your Letter

The letter that you draft to your MP is basically what he/she will rely upon when making representations to the Minister on your behalf.   It has been suggested to me that the letter be between 2 and 3 pages long.   It is more of a summary.   It needs to be easy to read.   It needs to be succinct.   The reader will have only a limited time to read it; hence he/she wants to get the gist quickly and easily.


Quite obviously, we can’t all write this ourselves.   I would suggest using someone else to assist you.   If you cannot, do you best.

 

When writing the letter, try to include the following:

 

  1. Refer to your meeting/conversation, it time, and date;

 

  1. State what your illness is and when you were affected, and when you were diagnosed.   State your cognitive and physical limitations, and any impact it may have upon your ability to write the letter;

 

  1. Briefly list your policy/ies, when you got sick, when you claimed, the outcome of the claim, how long it ran for, the Doctors you’ve seen on your side, on their side, and what reason they gave for canceling/denying the claim;

 

  1. Demonstrate briefly how their cancellation/denial breaches the policy;

 

  1. Outline the biological/psychological tests and reports that you’ve had, and who they were with, and their outcome;

 

  1. Outline where the insurance company sent you, who they were, and, if applicable, highlight how they carry out no testing, and seek out a Doctor that supports the case of the company that sent them.   Maybe highlight how many hours you’ve spent with your Doctors versus how many with theirs;

 

  1. If they have been paying, detail how long they paid, and on what evidence.   Highlight their change in view if evidence is not different or stronger, but the opinion changes when an opposing view is paid for;

 

  1. If they send you to a Psychiatrist, highlight how they pre-diagnose what is wrong with you, and do not look at the facts of the case;

 

  1. Highlight any denial of natural justice that may occur via the company’s refusal to provide access to the file, and/or Insurance Medical Reports (in accordance with Beverley above and the Financial Industry Complaints Service’s rules);

 

  1. Assert that the Insurance Company has not discharged its contractual responsibility, not its duty under Section13 of the Insurance Contracts Act 1984 (utmost good faith – or breaches of Trade Practices Act 1974);

 

  1. Ask that the MP to ask the Minister to have the case be investigated by ASIC under its powers in Section 55A of the Insurance Contracts Act 1984.

 

Don’t get into detail or evidentiary information.   Make reference to the fact that you have evidence.   If they want it they will ask for it later.

 

Keep copies of the letter.

 

5.     Following Up The Complaint

The submission of the complaint is not the end of it.   You need to follow up your complaint with the MP.   Ask him how long he/she expects it to be before your hear back.   Take note of the date and follow it up.   Don’t assume it will get done.   MP’s are busy and have many constituents and business groups all pushing their own needs, hence it can be overlooked.   Make sure your MP writes back to you to advise what he/she has done and what will be done.

 

Good Hunting.   Feel free to lodge your case with my database so that I am aware of the number of people making these submissions.   I will guarantee confidentiality, and only utilize this information for statistical purposes.   If I would like to use your case, I will ask for permission.   Anonymity is assured if desired.