Aviva Medios Healthcare - are we being treated fairly?

02Jim

Thank you davidstone; my letter has been sent.

Has anyone seen this in The Telegraph 22 Dec 2000 by Alison Steed:

Norwich Union Healthcare has been accused of changing cover for around 25,000 policyholders switching from OHRA private medical insurance (PMI) policies, without informing them.
Healthcare intermediaries claim the policy terms have changed because of changes to the policy wording, making them less advantageous. The insurer denied this.
Letters sent out by NUH to policy holders about the January 1 switch, a result of OHRA's merger with NUH earlier this year, stated there would be "no changes to your policy benefits or premium structure, although Norwich Union has simplified some of the policy wording"
however intermediaries argue that the changes to the policy wording will have a detrimental impact on the benefits available, even though on paper they appear the same. PennyO'Nions, a specialist healthcare intermediary at The Onion Group said: 'You can leave the benefits as they are, but change the terms & conditions that are available, and that to me constitutes a change. If they don't see it as that, that is their prerogative, but it will have an impact on clients."
One criticism related to a change in the claims process. NUH operates under its own specialist fee guidelines, setting down what it will pay for certain procedures. If the specialist you are referred to charges more than this, you must see a "cheaper" specialist, see the same specialist and pay the difference, or convince your specialist to charge less. OHRA met full claims in full, said Dr O'Nions.
Policyholders will now need to renew their PMI policy each year, whereas with OHRA it was automatically renewed, and guaranteed for life once policyholders had signed up. NUH claims this clause still exists, as cover 'can be continued for life", but health specialists disagree.
Zig Malendewicz, principal at a specialist intermediary, NIMIS, said: "It doesn't say it will continue for life. Our clients joined the OHRA policy on the basis that they would have cover guaranteed for life and suddenly, without prior warning, this major benefit has been taken away from them. They are extremely angry about these changes".
Tim Baker, commercial director of NUH, said:"It is just not true. OHRA policy holders are not up in arms, and a significant proportion of direct debits are already back with us. There are one or two intermediaries that are ubhappy, but they don't represent the majority."

Barry_Man

I've been a Medios Exec Plus policyholder since mid 1999. Unfortunately I do not have any policy documentation back past the last 2 or 3 years. I would urgently like to get to see older policy documentation (ideally from 1999 thru 2006). Is anyone able to supply copies of such (ideally scanned). What I'm really after are the parts that cover all the relevant topics under discussion in this thread.

Also, is there any more recent news (as it has been quite a while since anyone posted here)?

mwng

"Is anyone able to supply copies of such (ideally scanned). What I'm really after are the parts that cover all the relevant topics under discussion in this thread".

I have one supplied by Aviva recently - they claim it is the 2001 wording - unlikely they would lie as when I requested it I cc.d the Adjudicator - but you never know!

We are heading for the Ombudsman now - am submitting arguments over the next 2 weeks.

mwng

Actually not sure it is Medios Exec - I think it's a normal Medios policy.

Guardog

mwng, you need to look at the 2012 Terms and Conditions that accompanied your latest premium review notice to work out whether you have a Medios Healthcare policy or Medios Exec policy; the policy type is printed in large print on front cover of those Terms and Conditions.

If it is the 2001 Medios Healthcare policy, you can check whether Aviva supplied a full copy of the original as:

- page 2’s last section stated the following
“We guarantee that whatever your age when you took out the Medios Healthcare Policy, you will never have more than one age-related premium increase during the lifetime of the policy. For example, if you join at age 29, when you reach 30 your premium will rise to the 30-39 age band – no further. So you will never pay more than a new entrant aged 30 – even when you are 70! In our eyes you grow no older.
Once accepted, you may renew your policy annually at prevailing rates and subject to the terms in force (with any exclusions applying to each Insured). This cover can be continued for life.
And remember – unlike no claims bonuses, you cannot lose your Guaranteed Loyalty Bonus.”

- page 13’s Article 7 stated the following
“The policy shall be for one year and is continuable subject to the terms in force at the time of each renewal date. We may alter the standard terms of the policy at any renewal date by notifying the Policyholder.”

Most of the above was not repeated in attached Terms and Conditions , nor was it included in subsequent Terms and Conditions. However, those representations were the cornerstone of the agreement between Policyholder and Insurer. In fact existing Terms and Conditions cannot operate without the given 2001 age-band detail, which is not supplied anywhere else.

Obviously, since 2001 Aviva has:
- inappropriately granted itself the power to change all policy terms as opposed to restricting that power to standard terms;
- taken away lifetime cover availability by limiting cover availability to when the “product is still offered by us”,
- removed New Entrants in breach of Guaranteed Loyalty Bonus obligations but misrepresented their continued existence in ongoing Terms and Conditions.
The above does not include all complaint matters.

It is important to emphasise that the Medios policy is not a one year policy but a continuable policy; hence the term of yours will be many years – detailed in your annual premium review notice. That’s also easy to work out from the latest Terms and Conditions, which stipulate the Policy’s Commencement/Inception Date and states the Policy Schedule to give details of premium etc (ie premium review notice is not a contract but solely a Schedule to the Policy). Please note that It is important to use the terminology of Review Date (see Condition 3 of 2012’s Terms and Conditions) or premium review notice rather than to refer to an annual renewable policy (which can be misconstrued as being a new policy).

If you still want a copy of original 2001 policy then supply address details and one will be sent. Apparently, you can message me direct on this system.

mwng

[EMAIL="mwngraham@gmail.com"]mwngraham@gmail.com[/EMAIL]
Thanks Guardog - very useful. My email above.

Lawton

Considerable progress has been made with the FSA.
It now understands policyholders’ Guaranty loss
and, equally importantly, the policy’s structure.
This will assist focus on Aviva’s wrongdoings.
None of this might have been possible without the involvement of my MP.

As occurred previously, the FSA insists on its investigations being private and policyholders need to wait and see what it concludes, together with any consequential actions.

Far less understanding was achieved with FOS’s adjudicator prior to her silly decision on 2012’s premium increase, taken without awareness of the Guaranty’s relevance.
The adjudicator’s refusal to change her mind did enable her to avoid looking foolish, at the time.
That decision was manoeuvred through by limiting the evidential base to Aviva supplied information.
Worst still, the adjudicator took sides by ignoring complainants’ key claim on their lost Guaranty.

To an extent, the above-mentioned FOS events benefitted policyholders as they were forced to work harder to communicate Aviva’s wrongdoings.
Also, the views of a relatively inexperienced adjudicator were never going to be significant for a case that was always going to be decided by an ombudsman, due to the large amounts of money involved.
As cases are worked through and complainants pick-up on the adjudicator’s shortcomings, problems will increasingly befall FOS and unfortunately slow down its process.

In the last week of August FOS informed the first complainant that “it is likely to be several months before it (the case) is considered (by the Ombudsman)”.
Consequentially, policyholders might need to consider payment of the Review Date premium for 2013.
If they intend to pay that premium, they might want to inform FOS that it needs to be included in their claim.

The reason given for FOS’s delay is “a large volume of cases the ombudsman has to consider”. However, case volume was known some 2 months earlier than that late August missive (when the first complainant’s case was placed in the queue).

Interesting times are ahead, albeit over months rather than weeks.

burtwood

Well what a mess FOS is in.

Apparently, all change as cases reviewed as ready for Ombudsman, with place in queue, have been pulled.

New story is
"Unfortunately, we are dealing with a large volume of cases at moment and have not been able to start this review (preparation for the Ombudsman's review)".

She says she will will write in 3 months [from 2 October] with an update on progress!

Policyholders need to pay attention to Lawton's comment on 2013's premium.

jenssen

An initial post to introduce myself having just found this thread, and interesting posts, during a web-search in reaction to receiving a letter from Aviva last week about administration changes.

In addition to being late arriving to this forum, I am in a similar situation to a couple of forum members here; I am not experienced in legal or financial fields, but I am concerned that the terms of the Medios policy for life that I took out with OHRA in 1996, are under attack, or have already been changed, by Aviva. I now see I have a lot of catching up to do, starting with carefully re-reading this thread and initiating an exchange with Aviva.

Thanks All.

how_2

Word on the streets is that Aviva is unravelling faster than BBC