Denplan Dentist Advice please

Undervalued

Toothsmith said:

LoubyLoo said:

Thank you to all that have replied.  It has certainly answered my queries.  Looks like our choice now is to either cancel Denplan and go private or try to get another dentist which is not a possibility I think.  Or continue paying Denplan and getting no service as our dentist is still recuperating from his hip replacement.  

I would try a written complaint to the practice first, to confirm what you've been told that you 'can't see the locum because you're on Denplan'. If that is the case - I would get in touch with Denplan to have a word with them about that. It's really not very good!

Short of going to court, does anybody regulate Denplan or arbitrate on disputes? As I said earlier (correct me if I am wrong) it is not insurance so you cannot go to the Financial Ombudsman Service in the way you can with, for example, your boiler service contract.

Can Denplan (whoever they actually are) instruct a participating dentist to see a patient, pay them compensation and / or refund their fees?

Apollonia

Short of going to court, does anybody regulate Denplan or arbitrate on disputes? As I said earlier (correct me if I am wrong) it is not insurance so you cannot go to the Financial Ombudsman Service in the way you can with, for example, your boiler service contract.

From Denplan information leaflet:

Denplan Ltd, trading as Simplyhealth Professionals, is an Appointed Representitive of Simplyhealth Access for arranging and administering dental insurance. Simplyhealth Access is incorporated in England and Wales, registered No. 183035 and is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Denplan Ltd is regulated by the Jersey Financial Services Commission for General Insurance Mediation Business. Denplan Ltd only arranges insurance underwritten by Simplyhealth Access. 

Undervalued

Apollonia said:

Short of going to court, does anybody regulate Denplan or arbitrate on disputes? As I said earlier (correct me if I am wrong) it is not insurance so you cannot go to the Financial Ombudsman Service in the way you can with, for example, your boiler service contract.

From Denplan information leaflet:

Denplan Ltd, trading as Simplyhealth Professionals, is an Appointed Representitive of Simplyhealth Access for arranging and administering dental insurance. Simplyhealth Access is incorporated in England and Wales, registered No. 183035 and is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Denplan Ltd is regulated by the Jersey Financial Services Commission for General Insurance Mediation Business. Denplan Ltd only arranges insurance underwritten by Simplyhealth Access. 

Thanks for that.

So I wonder why it is offshore? I think that confirms that a UK customer (patient) can't use the FOS if they have a dispute?

Which this seems to confirm......

https://www.denplan.co.uk/about/code-of-practice

Toothsmith

Denplan does have a really effective complaints handling team, which is why I suggested writing to the practice to get clarification on just what they are saying, and making sure it's not just a misunderstanding. It really makes no sense to me why a practice would discriminate against someone on a regular payment plan.
I'm pretty sure they don't have any direct powers to deduct money off a dentist and give it back to the patient, or impose any penalties on a dentist. But they are a good team, and generally find a way to solve things in a way that keeps people happy.
There are many other ways a complaint against a dentist can be escalated though, without need for a financial ombudsman. If a complaint is received by a practice, within a few days it should have replied with a copy of it's complaints policy. That should give details of where a complaint could be escalated to if the practice can't solve it satisfactorily. 

Undervalued

Toothsmith said:

Denplan does have a really effective complaints handling team, which is why I suggested writing to the practice to get clarification on just what they are saying, and making sure it's not just a misunderstanding. It really makes no sense to me why a practice would discriminate against someone on a regular payment plan.
I'm pretty sure they don't have any direct powers to deduct money off a dentist and give it back to the patient, or impose any penalties on a dentist. But they are a good team, and generally find a way to solve things in a way that keeps people happy.
There are many other ways a complaint against a dentist can be escalated though, without need for a financial ombudsman. If a complaint is received by a practice, within a few days it should have replied with a copy of it's complaints policy. That should give details of where a complaint could be escalated to if the practice can't solve it satisfactorily. 

I am struggling to see how the two parts I have highlighted are consistent?
I do agree this particular situation sound most likely to be an admin error or misunderstanding.

Toothsmith

Having a good & effective complaints handling system is not all about being able to get money off dentists. It's about finding out what is going on, finding out both sides of the story, and finding a mutually agreeable solution. In many of their cases, after resolution, the patient is still quite happy continuing to see the dentist (and the dentist seeing the patient!) - which has to be a good result.

As in this case - we're both pretty convinced this is some sort of admin slip up where someone probably having a bad day on reception told the patient the wrong thing, or something the patient interpreted the wrong way. Also as in this case, it is quite amazing how many times patients go to the other options without complaining directly to the practice first. Just getting those two sides talking to each other is most often the quickest way to resolution.

If the complaints team really do feel the dentist has done something very wrong, it doesn't really matter that they can't take money off the dentist. By pointing out the other alternative routes the patient has, and how much time and money and stress defending those could cost the dentist - a reasonably bright dentist would realise that a relatively small refund might well turn out to be the best value option. On the other hand - if they do feel a dentist is the victim of a vexatious complaint they will help & support there too.