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Employer Private Health - £350 for 10 minutes

13

Comments

  • ValiantSon
    ValiantSon Posts: 2,586 Forumite
    edited 9 February 2018 at 11:49PM
    mschris wrote: »
    No, I think you are. People design process. You would design process to stop this happening. It's simple user experience. This process doesn't help anyone! You design a process that either stops this happening or creates a layer so the customer is aware of the cost and had to actively agree to it.

    Do you think unexpected crazy roaming charges were fair even if they were in the T&Cs? No, it's about common sense and stopping companies like this using this type of pitfall like a revenue stream. You don't realise as well, the doctor charged £140 - there are like 4 companies in the middle that increased this to £353 - essentially for admin.

    Once again your analogy is deeply flawed. You are comparing apples and pears.
    mschris wrote: »
    Do you think this is proportionate? Fair?

    It is the cost. Get over it.
    mschris wrote: »
    I just made up a partial responsibly percentage that felt right

    Which is exactly how such decisions aren't made. "I plucked a number from the air, your honour."
    mschris wrote: »
    Of course, but I didn't think it was valid in the same way. I thought the appointment that was authorised two months before was already paid.

    Well then you were wrong, but having been familiar with the terms of your policy would have avoided that.
    mschris wrote: »
    I actually had the thought if I missed it i would be charged.

    If you had phoned the insurer to check then you would have found otherwise and been able to avoid this whole debacle.
    mschris wrote: »
    No, of course I wouldn't, and didn't. This is why I called up after I attended a "chat" prior to treatment to find out what would happen. This was a consultation that I thought was already paid for.

    That is exactly what you did do!
    mschris wrote: »
    I didn't say I forgot. I said that when it was authorised I thought it was done on the date I called! Not the date I attended.

    You were wrong about that, but it is nobody's fault but your own. If you had familiarised yourself with your policy documents then you would have known better. Here's an important life lesson for you.
    mschris wrote: »
    If my phone gets stolen, the claim is authorised / covered on the day I claim / the day of the actual incident. Not the day I receive the new phone

    What? Again, not the same thing at all, but I'll indulge you for a moment. You are covered in this instance because you are insured on the date the loss occurred. You were not covered when you attended the appointment, which is when the insurer incurred costs.

    mschris wrote: »
    Really? I don't accept this. Your expectations are far far too low. This is the legacy pitfalls of this type of company. Something setup in the 80s and hasn't gone through disruption. There is no way in hell a new modern, maybe app based, progressive health insurance company would allow this (and that's just the surface, there's no way in 10 years time all of the discriminatory conditions wouldn't be covered as well)

    Wild speculation about possible future private health insurance policies based on zero facts and lots of wishful thinking. I very much doubt that any insurer would do as you believe they all will in the future.
    mschris wrote: »
    OMG. Seriously? We have quantum computing in it's infancy and you're saying that the date I handed in my notice a "date box" couldn't have been updated and an automated notification sent? If you sincerely believe this is outside the realm of software then I don't know where to start...

    Nobody said it was theoretically impossible, but that it isn't a practical reality in the present time.
    mschris wrote: »
    ?...Only my HR department, the payroll team, finance team, my manager, the company..no where in that process "update vitality" couldn't have been done. Even Vitality could have had a button on their site or app that says "handed in my notice" - this doesn't exist.

    The terms were provided to you and those terms were very clear (as has been demonstrated to you). Your failure to familiarise yourself with those terms is your own fault. Stop trying to blame others for your own mistakes.
    mschris wrote: »
    Ok I'll make it clear what I want: solutions.

    Here's a solution for you: pay the money and accept that you made a mistake, then move on.
    mschris wrote: »
    I believe, this isn't fair, this isn't right - I don' believe I should pay £353 for this. I want solutions to resolve this. If you don't agree with me - thank you for taking the time to read this. I know i made a mistake but I don't need your reply.

    You believe it isn't fair, but the law says otherwise.

    This is a public forum and people, like me, have replied to try and explain to you why you are wrong, so as to help you move on from this situation. You don't like what they have said because it doesn't fit your world view, but nonetheless what they have said is correct.

    You don't get to say who can and can't reply to a thread.
    mschris wrote: »
    I don't want this. I was willing to accept and pay maybe £70 for my mistake and move on. £353 is something I cannot afford! That is a serious amount of money.

    Unfortunately it is a debt that you have and you will have to find the money to pay it or face serious consequences.
    mschris wrote: »
    I'm surprised at the responses on this forum actually. In real life everyone I speak to responds along the lines of "that's ridiculous / how can they allow it? Can you fight it / I hate private insurance, be glad you're not in the states"

    However on here....the entire sentiment, I don't know it's more blaming me than offering a solution or even challenging the company. Which is really surprising to me.

    Then the people you have spoken to in "real life" were either a) being nice to you and trying to calm you down; or b) completely ignorant of how insurance and employment contracts work. Either way they were wrong.
    mschris wrote: »
    I will challenge it under these conditions.

    - This is not treating customers fairly.
    - I've been expected to agree to a mystery cost without consenting to it.
    - The cost is not proportionate and there unnecessarily added cost
    - It was partially my employer's and vitality's responsibility to ensure that at least at some type of exit / leaving process was in place to prevent such an event.
    - The company was collecting my health data (steps etc - used for commercial gain) after I left without my permission as they didn't cancel my account thus breaching my privacy
    - The appointment was 1 hour late which I will be invoicing for my time

    Your challenge will fail dismally.

    Taking each point in turn:

    - It is entirely fair and consistent with both the law and the terms of the policy. There is no case to answer.
    - No you haven't. When you attend an appointment privately you consent to paying any charges that are not covered by your insurance.
    - The cost is proportionate. You are paying for the time of a highly skilled professional. The cost is entirely in line with the market rate.
    - No it wasn't.
    - It is not a breach of your privacy. I suggest you read the Data Protection Act https://www.legislation.gov.uk/ukpga/1998/29/contents
    - You can't invoice the hospital for your time. Sometimes appointments are delayed. This is not something you can invoice them for.
    mschris wrote: »
    If anyone else has any other ideas I'd appreciate it.

    Here's an idea: accept that you made a mistake, pay the bill and move on!

    Your challenge will not be successful, so you are just wasting your time and energy.
  • ValiantSon
    ValiantSon Posts: 2,586 Forumite
    mschris wrote: »
    @ValiantSon I'll ignore - see above

    So I disagree with you and you ignore me. How very mature of you!
  • stator
    stator Posts: 7,441 Forumite
    Part of the Furniture 1,000 Posts Name Dropper Combo Breaker
    You need to understand how this process worked.
    You phoned the insurance company, they authorised the appointment. At this point they may have checked you were employed and covered. They gave you the details of the doctor to contact and you made an appointment with that doctor. The doctor carries out that appointment and sends a bill to the medical insurance company. They check their records and find out you are no longer covered. They send you the bill.
    There are many different companies involved here. They will not all know the details of your employment.
    I'm afraid you misunderstood something, but if you try to take this any further you will get one response from everybody "You should have checked".
    Changing the world, one sarcastic comment at a time.
  • mschris
    mschris Posts: 19 Forumite
    Sixth Anniversary 10 Posts Name Dropper Combo Breaker
    edited 10 February 2018 at 2:00AM
    @ValiantSon
    I understand your viewpoint, thank you for your reply. I disagree with several points but I see no value in addressing each point. I'm not ignoring you to be rude (even if you were condescending) it's just not helpful to me.
    You need to understand how this process worked.

    I do understand what happened, I do. My whole argument is ideological, this should not have been possible. Since it possible i think there should have been a process to at least have something like "this is going to cost £X as this is now self funded, please sign here"

    Imagine if I walked into a MRI or something other than a 10 minute chat, it might have bankrupted me. I just don't believe this should be possible - there are so many ways they could put process in place to prevent this.
    I'm afraid you misunderstood something, but if you try to take this any further you will get one response from everybody "You should have checked".

    OK. taken on board. I'm going to leave this here now. I had hoped for some interesting insight, unorthodox approach or some law that might help. Once the ombudsman replies with a verdict I will update either way.

    It's a long shot but it's all I have. Thanks all.
  • mschris
    mschris Posts: 19 Forumite
    Sixth Anniversary 10 Posts Name Dropper Combo Breaker
    Really? I don't accept this. Your expectations are far far too low. This is the legacy pitfalls of this type of company. Something setup in the 80s and hasn't gone through disruption. There is no way in hell a new modern, maybe app based, progressive health insurance company would allow this (and that's just the surface, there's no way in 10 years time all of the discriminatory conditions wouldn't be covered as well)
    @ValiantSon
    Wild speculation about possible future private health insurance policies based on zero facts and lots of wishful thinking. I very much doubt that any insurer would do as you believe they all will in the future.
    https://www.lemonade.com/de/en/
    Oh look -  here's a new insurance company that just IPOed stateside, totally different mindset, taking a fee per policy left over money going to non-profits, claims paid out in seconds.  Your expectations about how this industry should work are just too low.  Will this company succeed, no-idea - but there are other people thinking, insurance is awful, we can do better.
    ----
    This is still on-going, no final outcome.
  • Weighty1
    Weighty1 Posts: 1,213 Forumite
    Tenth Anniversary 1,000 Posts Name Dropper
    mschris said:
    Really? I don't accept this. Your expectations are far far too low. This is the legacy pitfalls of this type of company. Something setup in the 80s and hasn't gone through disruption. There is no way in hell a new modern, maybe app based, progressive health insurance company would allow this (and that's just the surface, there's no way in 10 years time all of the discriminatory conditions wouldn't be covered as well)
    @ValiantSon
    Wild speculation about possible future private health insurance policies based on zero facts and lots of wishful thinking. I very much doubt that any insurer would do as you believe they all will in the future.
    https://www.lemonade.com/de/en/
    Oh look -  here's a new insurance company that just IPOed stateside, totally different mindset, taking a fee per policy left over money going to non-profits, claims paid out in seconds.  Your expectations about how this industry should work are just too low.  Will this company succeed, no-idea - but there are other people thinking, insurance is awful, we can do better.
    ----
    This is still on-going, no final outcome.
    I'm struggling to believe you have bothered to come back and post on this.  The link you have provided is nothing to do with private medical insurance and therefore the way in which cover is provided is completely different.  Even comparing personal PMI plans and group schemes will be nonsensical as they are administered in different ways.  I'm sorry, but you really seem quite bitter about this when, as has been pointed out numerous times, it could have been completely avoided if you'd have read the policy documents.  I'm literally sat here shaking my head in disbelief.
  • davidmcn
    davidmcn Posts: 23,596 Forumite
    Part of the Furniture 10,000 Posts Name Dropper
    mschris said:
    Once the ombudsman replies with a verdict I will update either way.
    So what happened?
  • Jumblebumble
    Jumblebumble Posts: 2,015 Forumite
    Sixth Anniversary 1,000 Posts Name Dropper
    mschris said:

    Imagine if I walked into a MRI or something other than a 10 minute chat, it might have bankrupted me. I just don't believe this should be possible - there are so many ways they could put process in place to prevent this.

    .
    And you could put a process in place where next time you think someone else is paying you  ask the question "Who is paying for this?"

    ABC of Life again
    Ask questions
    Believe no one
    Check everything
  • Sandtree
    Sandtree Posts: 10,628 Forumite
    10,000 Posts Fourth Anniversary Name Dropper
    Oh look -  here's a new insurance company that just IPOed stateside, totally different mindset, taking a fee per policy left over money going to non-profits, claims paid out in seconds.  Your expectations about how this industry should work are just too low.  Will this company succeed, no-idea - but there are other people thinking, insurance is awful, we can do better.
    ----
    This is still on-going, no final outcome.
    But haven't you noted how their 25% of the money from the sales is guaranteed whereas the charities is only 1% and only more in good years? However does make it an "ethical" investment which is why despite all their warnings about being not sure if they'll ever make money etc in their prospectus still got a doubling of the initial offer price.  InsurTech etc are good at making PR noises but also good at knowing how to turn that into value (even if its an unsustainable business).

    As to the original issue, I possibly have slightly more sympathy on the basis that you say you thought the insurers pay up front and therefore the appointment itself was effectively a formality. The reality is cash is king and almost no one pays in advance in B2B arrangements. Depending on the billing structure it can also be hard to know the exact price at the time of booking.

    Having done some work with PMI insurer there are some employers that will go the extra mile - they ask the insurer to pay claims that go beyond cover limits etc and reimburse the insurer the extra costs but as an ex-employee I'd be surprised of any such goodwill and even as an employee it tends to be reserved for fairly senior or "rising stars" types. At the end of they day if you don't ask you don't get but wouldn't pin too much hope on your employers wanting to put their hand in their pocket.

    Your best hope is to speak to the consultant and see about having the bill represented on their private rates, this is often notably less than their insurer rates.

    Outside that its probably one to chalk up to experience... the day your employment ends is when all benefits stop. If you think there are grey areas like pre-approved treatments or discount vouchers etc then ask rather than assume.
  • TELLIT01
    TELLIT01 Posts: 18,130 Forumite
    Part of the Furniture 10,000 Posts Name Dropper PPI Party Pooper
    I was in a very similar situation.  I had major knee surgery booked to take place in November of a year and was then told we would be made redundant at the end of December.  I checked to see what my situation would be for any treatment e.g. physio, from the start of January.  I was told I would not be covered unless I took on the PHI myself, which was being offered at a heavily discounted cost in the first year, so that's what I did.
    I did not assume that the insurance, provided by the company, would continue once I'd left the company.
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