Can I charge back if I didn't consent to the sum?

vladlondon

Hi,

A medical clinic charged my card with several hundred pounds because apparently the procedure was not covered by my medical insurance (exemption was buried in the small print). 
At the clinic I signed some document, agreeing to pay something if there's an issue with the insurance. I don't have a copy of that document yet. 

However, at no point I was advised of the cost of the procedure which happened to be unaffordably large. Am I allowed to make a chargeback based on the fact that I never consented to the amount of the charge? 

I feel the situation when someone can charge a consumer's card for absolutely any amount without consumer's authorisation as fundamentally unfair.

I am investigating what can be done through the insurance company, but that's a separate topic - I am kindly requesting that you only answer about the chargeback component if you know the answer. Thank you in advance!

Ebe_Scrooge

vladlondon said:

Hi,

A medical clinic charged my card with several hundred pounds because apparently the procedure was not covered by my medical insurance (exemption was buried in the small print). 
At the clinic I signed some document, which presumably said I agreeing to pay something if there's an issue with the insurance. I don't have a copy of that document yet. 

However, at no point I was advised of the cost of the procedure which happened to be unaffordably large. Am I allowed to make a chargeback based on the fact that I never consented to the amount of the charge?

You need to confirm the contract you signed first.  If you did sign to say that you agreed to being charged for anything not covered by insurance (albeit in the small print) then I suspect you'll be on a hiding to nothing unfortunately.  You'd need to prove breach of contract in order to have any chance of a chargeback.

k3lvc

(Very) unlikely that you'll get a refund - surely you knew before the procedure took place whether it was covered or not. I only speak from experience but I can't even get an appointment, let alone a procedure, without an approval number from my insurer.

In reality you signed to underwrite the amount and they've taken it - your chance to question this was before you signed

vladlondon

Thank you very much for quick replies. I see your point. 

It looks like using any medical services on a private insurance is essentially a gamble - you have to underwrite the amount and then see if the insurer is able to apply any exemption clause from their tons of small print. An uphill battle, and not very consumer friendly. 

Ebe_Scrooge

vladlondon said:

not very consumer friendly. 

Since when has any insurance been consumer-friendly ?

It's no different from car insurance, house insurance, pet insurance - the insurance company is a commercial business whose sole aim is to make money, end of story.  Pet insurance, actually, is another classic one whereby there always seems to be more things excluded, or have a payout limit, than things that are actually fully covered

DullGreyGuy

There is always a risk, your insurer could go bust and the FSCS scheme only covers non-compulsory insurance up to 90% and so you could end up having to pay the remaining 10% yourself.

In real terms, and ignoring pre-existing conditions the process tends to be very low risk. You get an initial referral and your insurers authorise an initial consultation with a named doctor and normal some basic investigations. After than the doctor submits a treatment plan to the insurer who approve or decline it. As its all pre-approved there is little risks unless the Dr goes off plan or you demand they go off plan.

A chargeback is an almost certain failure because the T&Cs will be such that the private hospital/doctor isnt, to use your words, underwriting the process if the insurer refuses to pay. There may other grounds for complaint/action but that really depends on what has happened and where the process has fallen down. 

k3lvc

vladlondon said:

Thank you very much for quick replies. I see your point. 

It looks like using any medical services on a private insurance is essentially a gamble - you have to underwrite the amount and then see if the insurer is able to apply any exemption clause from their tons of small print. An uphill battle, and not very consumer friendly. 

My (limited) knowledge of private insurers/hospitals (AXA/Bupa) says otherwise - in all cases hospital/clinic has not offered to go ahead with any treatment until approval given from insurer. Did you jump the gun or is your insurer/hospital different ?

vladlondon

WPA has a "premium hospitals" option which was not included in my policy. Based on an approved claim that included diagnostic scans I was referred to a scan by a doctor. I was given a choice of locations where I could make the scan, and the one I chose happened to be on the WPA list of premium hospitals - and I only learned about it after the hospital chased me for a charge.