I recently received an email from Mandy, upset and distressed over the $8,000 she had been slugged with that was not going to be covered by her health insurer to pay for her cancer treatment.
“I’m 59 years old and I’ve been with these mongrels for 30 years blindly paying for what they told me was ‘top’ hospital and extras cover. Now I’ve been forced to go to my super just to pay for all the gaps that this stupid policy doesn’t cover”.
It makes me wonder about whether health insurers understand the expressions “good will” and “a duty of care”. When you’re sick and believe you have the best health cover you just shouldn’t have to face being brushed off by your insurer. You also shouldn’t cop the additional pressure of finding the money to pay for your recovery. 

However, the sad thing is Mandy is far from alone.
A recent national study by the Consumers Health Forum found many patients were forgoing medical treatment because of unexpected costs, with others dipping into their savings and superannuation to cover the ‘surprise’ medical bills. Mandy noted in her email that there were extra costs for the anaesthetist and bills for scans that were not going to be covered because they were post op. “I received one bill for an MRI. I found I wasn’t covered by Medicare and I was told by my private health insurer ‘you should have read the fine print of your policy’.

Many patients are also not aware that private health insurance does not cover medical services that are provided out of hospital and which are covered by Medicare. These services include GP visits and consultations with specialists, in their rooms, and diagnostic imaging and tests. Unfortunately the low medicare rebates generally don’t even come close to covering half of the cost leaving patients strapped.

As Alan Kirkland from Choice recently stated, “It can be completely perplexing and sometimes impossible for patients in need of surgery to work out how much they will be out of pocket”. Kirkland also noted that average prices for procedures such as knee replacements and colonoscopies should be publicly available and easy to access which at present they’re not. Talk about poor disclosure from the funds!

However when it comes to some things, the health funds are not entirely to blame. Present legislation in Australia prevents health funds from covering the gap for outpatient consultations. Until this is addressed by the Government the problem is with the Medicare Benefits Schedule and what doctors charge, rather than the funds.
And don’t some doctors always charge a hell of a lot more than the MBS designated fee.

What can you do if you have a problem with your fund?

Established in 1996, the Private Health Insurance Ombudsman is a nationwide service that assists health fund members to resolve disputes through an independent complaints handling service. Your complaint must be about your health insurance arrangement, meaning its got to be about the policy failing to do something or an area where you feel you were covered but are being told a different story. AMA President Michael Gannon recently commented that patients were not getting value for money and were being left confused by unnecessarily complex policies that often did not provide an acceptable level of cover.
This sort of scenario is where the Ombudsman can help.

Speak to your fund first

The Ombudsman will not, and in some cases cannot, investigate complaints until they have been raised with the agency. Most health funds have internal complaint handling procedures that may be able to sort out the problem to your satisfaction. However it’s often at this point that customers may feel they’re getting the runaround but persist and advise them that you will not be fobbed off, and that the problem will not go away unless it is properly resolved.
Here’s some simple tips when dealing with the your health fund.

Get your communication with the fund in writing

As a lawyer, I can’t state how important it is to get your communication with the fund in writing. Send emails after any initial phone communication detailing what has been discussed and request that they reply and keep you updated about your matter via email, or at worst SMS.
Reliance on phone contact could mean you end up speaking with multiple people all of whom may mean well but information and results always end of getting scrambled. Try and get a case manager or one person to communicate with you on phone but still keep up the written stuff.

What to include in your complaint
Whether you write or telephone, set out your complaint as clearly and briefly as possible. Be specific rather than general. Stick to the main facts, and don’t go into excessive detail. If detail is necessary, it is useful to set it out in a logical order including your name and contact details; relevant dates and times; a description of the incident or decision; details of telephone conversations, meetings and any steps you may have taken to sort out the problem already; and any explanations you think are important. Attach copies of relevant documents to your covering letter, and sign and date it.
It’s important to be organised!

And don’t forget, if you are unable to sort out the matter after making all reasonable efforts to do so, you should then contact the Ombudsman and make a complaint.
They also have a range of tools for consumers, including the consumer website PrivateHealth.gov.au

If you are looking at changing funds I recommend you check out the reviews by verified customers on productreview.com.au 
There’s one fund that surprisingly stands head and shoulders above all the others when it comes to customer service and performance.

Corynne Cirilli from Town and Country magazine recently asked some high profile New York divorce lawyers what the First Lady would be entitled to if their relationship ended. Trump is famous for demanding pre-nups from his former wives but Melania may be in the box seat when it comes to challenging hers.

Eavesdrop on a steakhouse lunch between divorce attorneys and you’re likely to hear them engaging in their current favorite sport: speculating on the marital arrangement between Donald and Melania Trump. “We love talking about it,” one recently told me. “What’s in the pre-nup? Did it get renegotiated during the campaign, or after he won? How would a split play out?… It’s irresistible conversational fodder.”

During his two previous divorces, Trump stuck mostly to the pre-nup; although Ivana Trump contested it, she reportedly got $14 million, a New York apartment, a Connecticut mansion, and Mar-a-Lago once a year, as well as $650,000 annually for alimony and child support.
[Below- Trump and first wife Ivana]

Marla Maples contested hers, too, and is said to have been awarded around $2 million.

But now that the stakes are higher, we asked a few of the country’s top matrimonial lawyers for their take on what could happen if the first couple were to split.

T&C: HOW IS THE TRUMP PRENUPTIAL AGREEMENT MOST LIKELY STRUCTURED?
Thomas Kretchmar, associate, Chemtob Moss & Forman: I can’t speak to them directly, but in a New York high-net-worth marriage, a pre-nup is primarily designed to protect what is already owned prior to the marriage, versus things that may be accumulated moving forward.

Peter Stambleck, partner, Aronson Mayefsky & Sloan: What I would have recommended to them is a title controls pre-nup. It makes it very clear that, in the event of divorce, everything in his name will be his and everything in her name will be hers.
What would his main concerns have been when structuring the pre-nup?

Stambleck: Billionaires have complicated asset structures. They have shell companies, LLCs, investments in other companies, and it’s very, very complicated. One main purpose of a pre-nup is to avoid having to share in that, but also to avoid the headache that goes into producing all the documents and having accountants come in and look at all of it. Theoretically, that’s what could happen in the absence of a pre-nup.

T&C: HOW WOULD THEY DIVIDE ASSETS- REAL ESTATE, ART, OR JEWELLERY?
Jacqueline Newman, managing partner, Berkman Bottger Newman & Rodd: My guess is real estate will be involved. Obviously, he has the apartment in the city that was his before the marriage, and I can pretty much guarantee he’s not giving it to her. But in situations where I’ve dealt with very high-income, high-asset cases, the moneyed spouse will purchase an apartment for the non-moneyed spouse and the children to live in.

Stambleck: And usually any personal property that directly relates to that person stays with him or her. There’s no question, for instance, that her jewellery will be hers, not his.

T&C: WHAT ABOUT THEIR 11-YEAR-OLD SON, BARRON?
Newman: It’s handled by the courts. Given what I’ve read in the tabloids, it doesn’t seem as if there’s going to be much question as to who the primary caretaker is. My guess is that she would get primary custodial rights and he would get access whenever he happens to be in town.

How much money is she likely to get?
Newman: In this situation, if she has $50 million, she can afford to buy something. But $50 million, while it’s definitely a lot of money, in New York City, for what she’s used to, she wouldn’t be able to replicate what she has now. He probably had a good sense of what kind of lifestyle they’d be living, so I would imagine the payout would be fairly generous.

T&C: WOULD HE HAVE AGREED TO MAINTAIN HER LIFESTYLE?
Stambleck: Can he put in a pre-nup that she’ll have access to the Mar-a-Lago residence for a month in December? Yes, you can literally put anything in the pre-nup. He could say that on 72-hour notice she’ll have use of the plane.

T&C: COULD SHE NOW CHALLENGE THE PRENUP TO ANGLE FOR MORE?
Stambleck: It’s unusual. One of the main reasons to enter into a pre-nup is that, in addition to protecting the wealth, you’re also trying to make it clean—and stay out of the press. In the state of New York, it’s a very high hurdle to try to get a prenuptial agreement overturned.

Kretchmar: An interesting issue with prenups in New York City, which is within a jurisdiction where it’s really very difficult to invalidate a properly prepared, properly entered-into prenuptial agreement, is that it is not unusual to see the non-moneyed spouse still getting a little more in the settlement than the pre-nup entitled him or her to. The non-moneyed spouse may believe that just the idea of challenging the agreement will strike enough fear, stress, and overall agitation into the moneyed spouse—in terms of not wanting to be in the courts, not wanting to be in the gossip pages— that he or she may be willing to pay a little more just to make it go away.

T&C: WHEN TRUMP RAN FOR AND THEN BECAME PRESIDENT, MELANIA’S SITUATION CHANGED. DOESN’T SHE HAVE A LOT MORE LEVERAGE NOW THAT IT’S SO IMPORTANT THAT THE MARRIAGE DOESN’T FALL APART? MIGHT SHE HAVE RENEGOTIATED THE PRENUP?
Kretchmar: Without speculating on any particular case, it’s certainly true that spouses can, during their marriage, modify the terms of an existing prenuptial agreement in response to a material event. is is done in a document called a postnuptial agreement. Sometimes post-nups are used as a stopgap to an eventual divorce. Other times they are genuinely just a revision or refinement of existing rights in light of a change in the spouses’ circumstances.

Newman: It’s very hard to overturn a prenup in New York. The only thing that she could possibly try to argue—and I’m not sure it would succeed—is that when she entered into the agreement she didn’t anticipate he would be president (assuming it was not discussed as a possibility at that time). Therefore, in terms of any spousal support waiver, it would not be fair and reasonable for her to waive spousal support at this time, because there are now more anticipated expenses that she will incur being first lady, especially if she divorces him when he is in office.

This story appeared in the February 2018 issue of Town & Country.

For those who can afford it, divorce proceedings can end up being a very expensive game of chess with neither party giving much ground until the bitter end. When it’s the super rich, lawyers often are often powerless in calming clients down as they battle for the multiple mansions, mega yachts and private jets.

I have a sneaking suspicion some lawyers don’t mind these fights as they know their bread will also be healthily buttered at the end of the day. Lets take a look at the all time monster Aussie divorce settlements and the crazy legal costs that were incurred. I’ve taken every amount and put it through our trusty inflation calculator so you get the 2018 worth of the payout. And here we go, let’s start with the ‘lightweight’… if you can pardon the pun.

NUMBER 5 – The Strahan Divorce
With legal fees between the two of $35 million and 12 years in court, the Strahan’s managed to whittle away a sizable part of their fortune in what is now considered the longest running divorce case ever before the Family Court of Australia. Family Court Judge Paul Cronin who presided over the matter decided in December 2017 that ‘After 12 years of waiting, and at huge expense, the husband is entitled to have the matter concluded’. Mrs Strahan, who met her ex-husband in the late 80s and married in 1994, employed the help of lawyers from a congo line of 15 different firms during the lengthy battle over assets.
Initially she asked for spousal maintenance of $278,000 per WEEK of which some $70,000 would be spent on the care of their only child, who was autistic. Judge Cronin decided that because Mr Strahan entered the relationship with established successful businesses, he was entitled to keep a bigger slice of the couples $100 million fortune.
Mr Strahan was awarded $38 million in assets and his Swiss chalet while Mrs Strahan was awarded five properties and cash, valued at $11 million. Prior to that she had previously received $13 million, in an earlier judgement.

NUMBER 4 – The Packer Divorce
Billionaire James Packer has never been lucky in love. And so it was in 2007 when his six-year marriage to his wife Erica ended, just months after moving into their dream $50 million mansion at Vaucluse.
Unlike the Strahans above, the Packers, who at the time had three young children, didn’t have an acrimonious divorce.

Apparently, there was a very healthy pre-nuptial in the tens of millions if things went south. One source at the time also stated that, with a personal fortune of about $5 billion, James had promised to provide generously for Erica and his children.
Without big legal bills for either party, we’ll keep this comfortably at number 4.

NUMBER 3 – The Norman Divorce
Prior to their divorce proceedings in 2007, Greg Norman and his first wife Laura were married for 25 years. That should sound a warning that a big payout to the wife is on the way. There were lots of games played by both parties in court and the legal bills were in the millions.
Settlement took a year to be finalised and Mrs Norman’s lawyers claimed that Greg was trying to delay signing the deal in the hope she would accept a lesser amount.

There was even a claim dismissed by Mr Norman’s lawyers that he had locked her out of the house and stopped her credit cards. Norman’s lawyers countered in a petition to the court which  stated bluntly,”The wife did not teach the husband to swing a golf club”.  Ah, the games that get played.
Finally, with her $103 million dollar settlement (2018: $118 million), there was plenty of money for Laura to buy a new home with new locks far from… the golf greens.

NUMBER 2 – The Gibson Divorce
What’s not to love about Mel Gibson?
After all isn’t he, as the 2001 movie he starred in, “What Women Want” ?
Well, not back in 2009 when his wife of 29 years Robyn filed for divorce, stating ‘irreconcilable differences’. This surprisingly occurred the week after he publicly stepped out with a pregnant Oksana Grigorieva.

When the Gibson’s married in 1980 there was no pre-nup signed, so it was a big time payday for Robyn who under Californian law became automatically entitled to half of the couple’s $850 million dollar fortune. Mel didn’t put up a big legal fight, so it is estimated Robyn walked away with a $425 million dollar settlement (2018: $459 million). Less the estimated $200,000 in pesky lawyer fees.

NUMBER 1 – The Second Murdoch Divorce 
The biggest divorce payout naturally belongs to the biggest whale with the longest marriage. Billionaire media mogul Rupert Murdoch’s second wife, Anna Torv (now Anna Mann), received $1.7 Billion (2018: $2.66 Billion), mostly in News Corp stock, when the couple’s 31-year marriage ended in 1999.

But Rupert also gets an additional special commendation prize thrown in because only weeks after the divorce became final, he married a woman 38 years younger, Wendi Deng. Murdoch and Deng divorced 14 years later, and while she received two luxurious homes in the settlement, the couple’s pre-nup dictated that she wouldn’t get quite the payoff Anna received.

While Murdoch appears to have grasped the wisdom of prenups, he apparently hasn’t given up on the institution of marriage. Just recently, he married Jerry Hall, the former model and mother to four children with her longtime partner, Mick Jagger.

Let’s hope at 87, Rupert finally gets some life long wedded bliss.