Private Medical Insurance

markwalker69 · 6 April 2020 at 11:14AM

I currently have private healthcare that costs just under £80 per month with AXA and my policy is a health on line inspire policy so I can only use Spire Hospitals. My question to the forum is what happens to my policy? I know that the NHS has taken over Spire healthcare and I know from a consultant that works private sessions at Spire that they are not doing any private work for the next 3 months, so what I ask myself is why am I paying for a service that I’m clearly not getting. I fully understand that these are tragic times and people are in financial hardship and uncertainty but policy’s are still being offered to people at this present time for which cannot be fulfilled.

I have spoken to AXA and they are adamant that they are still giving a service for which I totally disagree.
I feel that AXA and other companies should be doing more and if policy’s are for hospitals that have been taken over by the NHS then they should be frozen until this horrid virus is over.

Christina_1982 · 14 May 2020 at 10:55PM

Did you get anywhere with this?

I pay for private dental care - obviously not able to get the full service during this period, I’ve not yet contacted my provider

gettingtheresometime · 15 May 2020 at 12:32AM

markwalker69 said:

I currently have private healthcare that costs just under £80 per month with AXA and my policy is a health on line inspire policy so I can only use Spire Hospitals. My question to the forum is what happens to my policy? I know that the NHS has taken over Spire healthcare and I know from a consultant that works private sessions at Spire that they are not doing any private work for the next 3 months, so what I ask myself is why am I paying for a service that I’m clearly not getting. I fully understand that these are tragic times and people are in financial hardship and uncertainty but policy’s are still being offered to people at this present time for which cannot be fulfilled.
I have spoken to AXA and they are adamant that they are still giving a service for which I totally disagree.
I feel that AXA and other companies should be doing more and if policy’s are for hospitals that have been taken over by the NHS then they should be frozen until this horrid virus is over.

well I guess the first question is do you need to utilise your policy now? Or is this a hypothetical question?

Semple · 15 May 2020 at 9:35AM

You may well find that they temporarily arrange for you to be seen elsewhere (i.e. not at a Spire hospital), which would mean that they're fulfilling their duties in providing the cover, even if it means they have to subcontract the work to another private healthcare provider.
The only way you'd know for sure (and have grounds for refund/discount etc) is if you were to make a claim on the policy now.

Dr_Crypto · 15 May 2020 at 10:24AM

BUPA sent me an email the other day saying they are seeing private patients. I don't think they ever stopped as such but of course the same principles that apply to the NHS (avoiding face to face where possible, no elective procedures to be performed, etc).

marilynt · 21 May 2020 at 7:24PM

We have Denplan dental insurance. I have to say I did not understand how this insurance works!
My husband lost a filling last week. Rang the practice, they are closed for patients, told him to get a temporary filling from Boots, as we are over 70 they dropped a packet of two temp fillings on to our door step. He applied the filling and it fell out 12 hours later!. Feeling moderately fed up at spending around £50 a month for this I contacted Denplan and asked about a refund as they are not providing us with a dental service. Their reply was interesting and absolutely washes their hands of it, 'your contract is with the dentist"
If you have had your appointments cancelled, you can speak to your registered practice who can advise you on the procedures in place for patients. When the practice are running the payments made will cover the cost of the treatment when you next go in and so any refunds would mean treatment would need to be paid privately.

Yes these appointments, and in our case an emergency appointment, would have taken place and been paid for, the point is that they haven't taken place, and because they have been 'pushed down the line' will be paid for in the months payment taken in the month they happen. It would be more honest of Denplan to say we are paying for the dentist to be furloughed.

That's fine, but I wonder what Denplan actually do. Their letter was patronising and vaguely threatening.

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stelatham · 1 July 2020 at 4:59PM

I have a PMI policy with Aviva and they are refusing to refund or extend the policy for the 3 months that all private hospitals were taken over by NHS. this resulted in my appointments being cancelled.
I am escalating my complaint with the financial ombudsman as how can they charge for a policy they cant insure? they are clearly in breach of their terms & conditions of the premium.
Martyn Lewis what is your advise?

Dr_Crypto · 1 July 2020 at 7:45PM

What would you have done if your doctor was off sick for the 3 months?

It’s not the insurers’ fault the government severely limited what activity hospitals could undertake.

Hope9 · 2 July 2020 at 4:44AM

Hi Mark,
I agree. I think I can answer your question. I have had diagnosis in the last month which requires urgent treatment. We have a AXA PPP family healthcare policy as an employment benefit. Still costs us £250 a month.

I approached Axa PPP for help in find treatment , was passed around their never-ending office teams for hours or left on hold for long periods. I now have recieved a very formal, legally worded letter to say they're treating my talking to them as a complaint & that they as AXA are only under contract to reimburse their member's claims & they are able to do this step even if the service providers are as they term it are providing a very limited service provision.
No empathy shown just defence to a complaint I've not made simply tried to use a healthcare policy.
There is also a definite undercurrent to their letter of we (AXA) is helping the NHS & government keep everyone safe so you can move along!
I agree charging (alot) for scotch mist right now. They also offeres when I was trying to find a hospital consultant that they had a mindfulness hub & a new extended online GP service to "help". Not sure that's quite what I need.
Leaves a really poor taste for what is our third most expensive direct debit as a family.

Dr_Crypto · 2 July 2020 at 10:14AM

They are probably right. The doctor doesn't work for the PMI. They are (generally) self-employed and then bill the insurer who pays them. There is no employment relationship between the independent contractor (Dr or hospital) and the PMI.
It wasn't AXA that caused the doctor to suspend their private practice. That was either the decision of the government or the doctor themselves. That's why I asked what someone would do if the Dr was off sick for 3 months.
AXA had no way of making the doctor reopen their practice. If the Dr had been open (and some limited services were still open) then the claim would have been met.