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  • FIRST POST
    • mschris
    • By mschris 30th Jan 18, 8:25 PM
    • 15Posts
    • 0Thanks
    mschris
    Employer Private Health - 350 for 10 minutes
    • #1
    • 30th Jan 18, 8:25 PM
    Employer Private Health - 350 for 10 minutes 30th Jan 18 at 8:25 PM
    Hey all,

    Can someone please help me with this I don't know what to do. I had Vitality - private medical - through my employer

    I basically attended an appointment / consultation with a Doctor AFTER I left my job. This appointment was 10 minutes however as a result I'm being invoiced 350.

    I'll explain as a timeline as I think it's clearer:

    November - first time using private medical, I called the claim line, I explained my health issue and the claim authorised, appointment booked for 14th January (i assumed it was paid for then)

    December - handed in notice
    late December - left company

    January - attended appointment

    Now, I thought that since the claim was approved and booked that everything was sorted. However the problem is that they're saying as I left my job I have no cover. It's not paid / authorised the date I call, it's done on the actual date I attend.

    My entire problem why does Vitality have no responsibility to tell me? why would I get not get an e-mail when I leave. Why would it not be cancelled? Like how is this possible? How is this down to me?

    I know,everyone is going to say read the small print. I read SO much of it, I spent like a good 3 days commuting reading all this documentation so I could understand was covered and wasn't. However I don't remember reading any of this.

    What can I do?
Page 2
    • mschris
    • By mschris 9th Feb 18, 10:37 PM
    • 15 Posts
    • 0 Thanks
    mschris
    @ValiantSon I'll ignore - see above
    • ValiantSon
    • By ValiantSon 9th Feb 18, 10:44 PM
    • 1,846 Posts
    • 1,713 Thanks
    ValiantSon
    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.
    Originally posted by mschris
    Once again your analogy is deeply flawed. You are comparing apples and pears.

    Do you think this is proportionate? Fair?
    Originally posted by mschris
    It is the cost. Get over it.

    I just made up a partial responsibly percentage that felt right
    Originally posted by mschris
    Which is exactly how such decisions aren't made. "I plucked a number from the air, your honour."

    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.
    Originally posted by mschris
    Well then you were wrong, but having been familiar with the terms of your policy would have avoided that.

    I actually had the thought if I missed it i would be charged.
    Originally posted by mschris
    If you had phoned the insurer to check then you would have found otherwise and been able to avoid this whole debacle.

    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.
    Originally posted by mschris
    That is exactly what you did do!

    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.
    Originally posted by mschris
    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.

    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
    Originally posted by mschris
    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.


    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)
    Originally posted by mschris
    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.

    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...
    Originally posted by mschris
    Nobody said it was theoretically impossible, but that it isn't a practical reality in the present time.

    ?...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.
    Originally posted by mschris
    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.

    Ok I'll make it clear what I want: solutions.
    Originally posted by mschris
    Here's a solution for you: pay the money and accept that you made a mistake, then move on.

    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.
    Originally posted by mschris
    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.

    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.
    Originally posted by mschris
    Unfortunately it is a debt that you have and you will have to find the money to pay it or face serious consequences.

    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.
    Originally posted by mschris
    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.

    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
    Originally posted by mschris
    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.

    If anyone else has any other ideas I'd appreciate it.
    Originally posted by mschris
    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.
    Last edited by ValiantSon; 09-02-2018 at 10:49 PM. Reason: Typo
    • ValiantSon
    • By ValiantSon 9th Feb 18, 10:45 PM
    • 1,846 Posts
    • 1,713 Thanks
    ValiantSon
    @ValiantSon I'll ignore - see above
    Originally posted by mschris
    So I disagree with you and you ignore me. How very mature of you!
    • stator
    • By stator 10th Feb 18, 12:39 AM
    • 6,224 Posts
    • 4,109 Thanks
    stator
    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
    • By mschris 10th Feb 18, 12:56 AM
    • 15 Posts
    • 0 Thanks
    mschris
    @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.
    Last edited by mschris; 10-02-2018 at 1:00 AM.
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