The Federal Court has ordered Bupa to pay A$35 million in penalties for unconscionable conduct and making misleading representations to members regarding their health coverage entitlements. The insurer admitted that between May 2018 and August 2023, it engaged in conduct that resulted in thousands of Australians being wrongly denied benefits for medical treatments. The Australian Competition & Consumer Commission (ACCC) brought the action, establishing that Bupa misled members, hospitals, and medical providers. The company incorrectly advised that members were not entitled to benefits for any part of a claim when, in fact, they were covered for portions of the treatment.The breakdownThe core of the issue centred on "Mixed Coverage Claims" - situations where a patient received hospital treatment involving multiple procedures, some covered by their policy and others not. Instead of paying out for the covered segment, Bupa rejected the entire claim. The "all-or-nothing" approach meant that members paying premiums for specific coverage were told they had none, often leaving them with out-of-pocket expenses. Key rulings:Admission: Bupa cooperated with the ACCC, admitting it engaged in misleading or deceptive conduct and, in