private medical at work allianz have advise that treatment is per policy and not per

stolt

hi there i wasnt sure where to best put this question we have private medical insurance at work and ive paid in for year snever needed to use it, this year i've used it for physiotherapy. I checked the policy and it states




Prescribed physiotherapy (initially limited to 12 sessions per condition; limit also applies to prescribed and non-prescribed physiotherapy sessions, where combined): £ 650


- Non-prescribed physiotherapy (visits) Max. 5






however allianz have said to me that


Unfortunately I must inform you that your below Physiotherapy benefit has a benefit limit of £650 per policy year, so as you had reached that benefit limit for claims received for treatment from the 2 practices, our claims team were required to perform deductions on your claim.


For your information, this benefit limit would not be per condition, but for the overall claims we have received for Physiotherapy Treatment during the policy year.




i read the policy it was per condition and as the physio ive been having is for two different parts of my bosy which it clearly states on the invoices (i actually went to two separate physios so not to confuse anyone when the invoices were sent in)


am i reading the small print wrong, ie per condition incorrectly i dont want to go back and make a full of myself.

Fosterdog

I’m reading it a maximum of 12 sessions per condition but a maximum of £650 per year regardless of whether that’s for one, two, or ten conditions. It doesn’t sound like you’ve gone over the session limit but the monetary limit.

pmduk

I've worked in this field, albeit more than 20 yrs ago and that's how I read it. It's Prescribed Physiotherapy: £650, with an explanatory clause.

BorisThomson

(i actually went to two separate physios so not to confuse anyone when the invoices were sent in)

A physio will treat you holistically, you should stick with the same person for both conditions.

boo_star

It sounds to me like they’ll only pay for £650 worth of “prescribed visits,” whatever that means.

You exceeded it so they won’t pay out anymore money.

peachyprice

A limit of 12 sessions per condition, up to £650 per year in total. It's important to read the clause taking the brackets into account.