Medical Insurance - what exactly does "allowance" mean?

Joelinlancs

I've just got off the phone with AXA and I'm fuming. Hang on.

OK, now I've calmed down.

I've got a medical policy for the family. I pay them a hundred and something pounds a month, have done for a couple of years. Never yet claimed.
In order to keep my premiums down I've taken an excess of £100, and I've agreed that my "outpatient treatment allowance" will be capped at £1,000 per year.
I've just put in for a claim. Doesn't really matter what it is, it's outpatient treatment, I've been through all the processes and had it approved. The total amount is £180, and it's my first claim, so as I expected they've agreed to pay £80, I'll pay the rest, and that's my excess paid for the the year.
Except: they now say I've had £180 of my outpatient allowance. I'm only allowed another £820 outpatient treatment for the year.
Hang on, I say. I've paid £100 of that £180. Surely you can't count the money I've paid towards the allowance?
Yes we can, they say. It's all in the handbook. Page somethingty-something......
Handbook be damned, I say (but more politely). Something like this should be front and centre in bold capitals, because to me it's really disingenuous. It's not a £1000 allowance at all. It's £900, because I'm paying £100 of it.
They're not having any of it. That's our policy, that's the way it works. They don't even seem to understand how sneaky they're being here.

So what precisely does "allowance" mean? It seems to mean money they pay, maybe a bit of money I pay - or does it just mean whatever they want it to mean?
Am I being unreasonable? Or are they? Let me know your thoughts.

Thanks,

Joel

Quentin

If you only pay one excess per year, irrespective of how many different claims you make it sounds quite good.

(It will mean whatever it says on page "something somety"!)

Joelinlancs

Yes, I think the deal I'm on isn't a bad one, all told. Even with this little sting in the tail. I just feel they're being a bit sneaky!

IronWolf

Indeed it is sneaky. I dont think my health insurance has an excess, and my outpatient isn't capped, but I'll look out for this in the future.

As an aside its always best to check with your insurance company before paying for medical treatment just to make sure they are covering it.

Joelinlancs

The cap's just a feature they introduced as an alternative for those of us who thought the premiums were getting a little high!

Agreed re checking in advance, that's what we did, although it meant we had to wait a few weeks longer before finally booking the treatment.