As with any insurance product not every person that has medical insurance will be happy with the level of service that they get from their provider. What can be distressing is that when you need support from your health insurance provider the most will normally be when you are actually ill and perhaps do not that the normal strength to cope with a serious complaint. But what happens if you are not happy with your health insurance? What can you do about it? What are your rights?
1) Read the small print
The first step is pre-emptive. The most important things you can do before you agree to sign a health insurance contract is to make yourself aware of what is and is not included under the terms of your cover. As with any insurance product, you don’t want any surprises when you do fall ill and are expecting to be treated under the terms of your policy.
2) 14 day ‘cool off’ period
As with all financial products you have a 14 day cool off period within which you can cancel your health insurance premium and not incur any penalties. If you are unhappy with any contract that you have signed it is your right to withdraw you business.
3) Familiarise yourself with your health insurance contract
What is included in your policy, what is not? What do you have to do should you become ill? Under most policies, for example, you cannot just go ahead and have treatment and expect it to be paid for. You have to have authorisation from your health insurer. They can refuse to pay for treatment that they have not authorised. Reading the small print ensures that you keep within the parameters of your contract. If you do this you have much better grounds for complaint should there be a serious problem.
4) Communicate
If you are not happy with something, tell your private health insurance company. Sometimes problems arise from misunderstandings which can easily be corrected by good communication.
5) Official complaint
If you are not happy with how your problem is resolved then you can go through an official complaints procedure with the health insurance company. Every company will have one because they are legally obliged to do so. Tell your insurer that you want to make an official complaint and they should start proceedings in order to help you do that. They are legally obliged to acknowledge your complaint within five days and they have to respond in full within 28 days.
6) Keep notes
If you have a complaint, keep track of who you spoke to about it, what they said and when any conversations took place. This will help you to keep things clear in your mind but will also help if you are not happy and need to take the matter further.
7) The Financial Ombusdsman
If you are not happy with the way the company have dealt with your complaint and you feel that all avenues have been covered you have the right to take your complaint further. The Financial Ombudsman Service is a free and neutral organisation which helps to resolve complaints. They will look at all the evidence and make decisions based upon its findings. However you will need to show that you have followed the official complaints procedure with the company in question.