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Bupa out-patients claim.


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Need help regarding bupa, had a valve replacement operation and a pre op under the same auth code.

Now bupa are sayiny the pre op is a out patients benefit and comes out of that pot as we have a limit on out patients treatment of £1000 and the cost for the blood test were £899 were are now knackered they said they mention this in a conversation with my wife on the phone but the letter i recieved does not state anything bout the pre op or that they are coming out of out patients ben.

Page 3 of letter states:

out pateint treatment-

where we have confirmed eligibility for consulations we will also cover diagnostic services such as pathology in connection with the treatment.

Bupa said they told wife in telephone conversation as the letter is address to me ive said that it does not state anywhere in the letter about this benefit.

Help as this is driving me up the wall.

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Guest Gertie100

Can't really offer specific advise - however I would say that they surely must prove that they have informed you of the situation in writing.

In exactly the same way that if the shoe was on the other foot would they accept your word? Doubt it...

Ask them (in writing) how they would prove in court that you were aware of the situation...

 

Sorry I can't be of more help and hope you had a successful op!

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Guest Gertie100

Phone records? Recording of conversation with wife? Call their bluff and ask for a copy of it to be sent to you...

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Guest Gertie100

The question must be asked of whether they should have discussed this with your wife, hopefully someone else will be along to help!

 

In the meantime if you have asked for a copy of the recording, or of the transcript of the call, then all you can really do is wait...

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Well the account is in my wifes name and is supplied by her work scheme.

Just been passed on to there customer relations team as the manager could not auth this, as he says reads the letter bupas way and i read it in my favour, its a complete mess and now have to pay for visits to consulants now as no benefit left.

They dont give a s*** it will take as long as it takes is what i have been told as they have 5 days to reply and 15 working days to investigate but i have no records of anything other than this letter and its getting on my nerves.

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  • 2 years later...

I have a similar issue with BUPA, and intend to address the matter with their senior management. To this end, does anyone have an email address for the following BUPA personnel:

 

Alistair How ~ managing director of Bupa International

 

Thanks.

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