Great 'How to ensure your insurer pays claims' Hunt: How to assure a payout

LadyIndecisive

Re the last line, with little/no investment income from premiums the situation is very much a-changing.

pedro123456

Looks like the ABI have moved the joint guidelines.

Lets show you them from the BMA site

http://www.bma.org.uk/images/MedicalInfoInsurance_tcm41-173470.pdf

Only relevant information should be provided and it is ethically unacceptable to provide extraneous information. Doctors must not send originals, photocopies or printouts of full medical records in lieu of medical reports and ABI members should not accept them. The full records are not necessary

cogito

pedro123456 wrote: »

Looks like the ABI have moved the joint guidelines.

Lets show you them from the BMA site

http://www.bma.org.uk/images/MedicalInfoInsurance_tcm41-173470.pdf

Only relevant information should be provided and it is ethically unacceptable to provide extraneous information. Doctors must not send originals, photocopies or printouts of full medical records in lieu of medical reports and ABI members should not accept them. The full records are not necessary

You seem to have missed the sections on Consent. Have you read them?

pedro123456

What are you bleeting on about cogito, if you have something to say say it.

If not just do one

Katie-Kat-Kins

Pedro I think what cogito means is that you can authorise you GP to disclose your entire medical records to anyone you like. If the poster signed a release then the GP is not at fault.

In any event if I was looking at a Fibromyalgia case I would consider any psychiatric history to be very relevant.

cogito

KatP wrote: »

Pedro I think what cogito means is that you can authorise you GP to disclose your entire medical records to anyone you like. If the poster signed a release then the GP is not at fault.

In any event if I was looking at a Fibromyalgia case I would consider any psychiatric history to be very relevant.

Exactly. Perhaps I should have realised that pedro needs things spelling out in full.

pedro123456

Katp.

I am perfectly aware that you can authorise anyone seeing your FMH, however as set down by the joint BMA- ABI guidelines they shouldn’t be requested or excepted.

A claimant puts in a claim for whatever reason, the IC ask him/her to sign a consent form for the GP to divulge medical information, this information should be relevant and pertinent to his/her claim. It is the GP’s role to answer the questions asked, referring to the patient notes.

The Insurance Company pay the GP (as again set down in BMA-ABI guidelines) and the GP should do what he is paid for, and not just ask the Surgery Secretary to photocopy notes and forward these to the IC as the guidelines are in place to prevent this.

The problem is IMO, GP’s have no idea these guidelines exist, and the IC have no intention of highlighting them to the GP’s.

The BMA will inform GP’s of the fees.

Go into your GP surgery and ask to see a copy of these joint guidelines, you should have your own copy have you?

The only way to bring them to the surface is to report GP’s for not following these guidelines, they would soon get the message if their registration was put under threat. IC just ride over the guidelines and the ABI turn a blind eye.

In any event if I was looking at a Fibromyalgia case I would consider any psychiatric history to be very relevant.

As per guidelines you shouldn’t have been aware of it unless his GP thought otherwise.

In any case what psychiatric history has to do with Fibromyalgia is a mystery to me, they are (IMO) totally unrelated, but again I am not junevillis GP

As for what cogito has to say, it won’t mean much and it really don’t matter to me.Hes not on this planet.

pedro123456

Great 'How to ensure your insurer pays claims' Hunt: How to assure a payout

Print off a copy of this and take it to your GP surgery.

http://www.bma.org.uk/images/Medical...m41-173470.pdf

pipk62

I came here to find more information on insurances.

And indeed there is some good advice here.

Like reading the small print on an insurance document you need to read through this carefully, then you begin to realise that the advice is based on two prominent factors.
1) Many of the comments are from within the industry, not that that is a completely bad thing, the advice given is relevant, but it does give an insight into the industry; and declares that if you aren't completely literate (insurers term ="stupid") then either get independant advice (such as CAB) or don't bother with insurance.
2) Some people have been wronged and some people have been caught out, to insurers they are always the same, no matter what happened they're "stupid" (this has been said or implied several times in this thread), either because they were trying to get something for nothing, or didn't fully understand the policy, even if you had sought advice from the insurance company itself (and acted on that advice) and regardless of any mitigating circumstances; as a result some people now have an attitude to insurers in general
3) Insurers, like any company, want to make a profit, which is fine, but there is a fine line between profit and greed, (although with some the line is very broad indeed) and some insurance companies will try their utmost to avoid paying whatsover(I say some as I don't believe all act unethically, maybe not even most?)


A great insight, Thanks

pedro123456

It’s not just a case of reading the small print though, and the constant inference that “if you haven’t read the T&C, or policy wording” then you the policy holder only have yourself to blame if things don’t work out.

The fundamental problem is that the T&C, are bias in favour of the IC, in order for a claim to be successful you have to meet the IC’s definition, and these Insurance definitions (especially medical definitions) will be more stringent than the medical definitions, making them bias in favour of the IC.

I think the IC’s have their own definition of definition