Sneaky private medical insurance costs customers
The small print on many private medical insurance policies means it can take up to four years before customers are able to get money for treatment, PruHealth reveals.
The insurer points out that many policies have clauses that allow insurers to avoid paying-up for two years, with many policyholders forced to endure another two-year wait if they do try and claim on a number of conditions.
And PruHealth thinks such "sneaky" practices are unjustified and lead to customers being short changed.
This is because many health insurance policies are sold without customers having to go through a medical, or declare anything about their medical history.
To prevent people discovering a condition, and then signing up for insurance, most insurers put a two-year block claims for treatment of any injuries or maladies which already existed in the five years before the customer signed up for insurance.
"The principle is a reasonable one," said Shaun Matisonn, chief executive of PruHealth. "It discourages people from taking out insurance in the certain knowledge that they need to make an immediate and sizeable claim.
"But what most people don't realise is that if they do need to see a doctor about a pre-existing problem during this two-year period the insurer will start the two-year exclusion all over again."
This means that if someone suffers a knee injury four years before signing-up for medical insurance - and it flares up again 22 months after signing up for private medical insurance - not only will the insurer not pay for the treatment then, but they will often also bar any payments on the injury for the next two years.
"We think this practice is inequitable and unjustified," said Mr Matisonn.
"It's a sneaky way of reducing the insurer's risk and penalises people unfairly at a time of acute need."
He added: "Imagine you were just a few weeks or even a few days away from reaching the two year deadline when an old condition flares up.
"You check to see if you're covered only to discover that not only is the answer no, but you've now got a further two years to wait before you can claim for any treatment for that condition.
"We're calling on the industry to follow our lead, abandon this practice and switch to a more equitable fixed two-year exclusion."
And the changes should not stop there, Mr Matisonn adds.
"We think there are many other aspects of private medical insurance which need to be reformed and reviewed. First and foremost we need to treat the customer fairly.
"If insurers offered more value for people who make efforts to look after their health they would have to rely less on other techniques to reduce their costs."
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