Icon Collections chasing 'debt' to a Nuffield hospital following operation under BUPA - Am I liable

[Sausage1971]

Hi,

 

I had an operation at a BUPA hospital in Novemebr 2011.

 

I was covered under a company scheme which(as advised by my employers) covered all costs including any excess.

 

I am now receiving emails from Icon Collections representing the hospital asking for £220 plus £18 (their costs).

 

I have referred them back to the company but the company is no longer trading.

 

The policy was in the company name and I was covered as an employee.

 

I have asked Icon to confirm the policy was in the company name and they cannot as they have no contact with BUPA

 

Am I liable as the patient for the outstanding amount? I have seen no documentation apart from an invoice from the hospital produced in April 2013.

[citizenB]

If there was a company policy then I cant see they can claim from you.

 

I will try and find someone who might know

 

You might need to obtain terms and conditions of the policy and I am not sure that BuPa would provide that as it would be covered by Data Protection.

 

Either way, IMHO, I don't think you are responsible for the payment. But wait until the person I have alerted looks in.

[Sausage1971]

Thanks for the reply. That's what I thought.

 

I can't see BUPA providing me with Ts & Cs.

 

Icon are saying that the contract was between myself and the hospital. I received the treatment, therefore I am liable for the bill.

 

I provided the hospital with payment details (credit card) when I was checked in as per their procedure but no charge was made against it.

[Sausage1971]

Replies from Icon when I questioned liability.

 

Bupa Healthcare have only part paid a claim in relation to your cover with them.

Any shortfall becomes a patient liability.

 

 

The hospital provided a service to yourself & you would be held liable for any unpaid balance, as per the hospital terms & conditions.

 

 

We recommend you settle the balance to avoid any further action, incurring additional charges, & attempt to reclaim the funds from any third party if you feel you have a dispute with any third party.

 

Healthcare policy details are confidential between the insurer & their member.

Regardless of the primary name on the policy the hospital provided the service to yourself.

 

 

If you have any dispute regarding your cover or benefit payable, by your insurer, it is a matter you will have to resolve with them.

 

 

At this stage, the hospital provided the service to you & funds are overdue & require settlement.

[dx100uk]

trying to spoof you.

 

dx

[Sausage1971]

Thanks. Thought so.

 

I would really like to stop them in their tracks but can't think how to compose a response.

 

Any help is appreciated.

[ericsbrother]

You were not provided with a service, your employer was and that has gone so tough luck to BUPA.

 

 

Unfortunately, that isnt the end of the matter as they have your name and addy and will continue to pursue you for the money they know is not forthcoming.

 

 

The reason they wont give you the details of the agreement is because they know that their contract is with your employer and they arent going to get their money from there so they are hoping that you are scared enough to pay up.

 

 

Your problem is that their T&C's probably state the words " the customer" rather than defining who the customer is so they will stretch the meaning of the wording to suit the occasion.

They may start court proceedings against you,

 

 

there was a case similar to yours where some poor sod had a default judgement against him from a tool hire company because he collected an item from them and signed for it on behalf of his employer.

 

 

They claimed that he had entered a contract that he hadnt

 

 

when he asked for set-aside of the judgement they cancelled the debt.

 

 

keep an eye on any further written demands but dont pay up.

[Sausage1971]

It doesn't scare me in any way but I just want rid of them.

 

When you say I wasn't provided with a service, I was as I received treatment??

 

BUPA was the provider of cover and the hospital was part of the Nuffield group.

 

So, essentially my response is that the contract wwas between BUPa and the hospital to pay the hospital bill and any shortfall then transfers to the holder of the policy which is my ex-employer.

 

Would Icon have to prove any contract between myself and the hospital or myself and BUPA?? If so, wht would they need to provide?

[Sausage1971]

So they would need to prove a contract exists between me and the hospital or me and BUPA?

 

If that is the case what paperwork would need to be produced and how do I respond??

[BRIGADIER2JCS]

Hi did you sign any paperwork on admission to the hospital?

 

BUPA cannot provide data specifically on your ex-employers policy, but you can ask a 'generic' question e.g. ' Do company HCI policies normally cover an employee for any excess charges levied by a hospital?''

 

I have seen case where the employer has genuinely believed the policy covered all contingencies but very often the opposite is the case.

[Sausage1971]

Hi,

 

I recall signing paperwork on admission and giving my credit card details. No payment was taken.

 

This paperwork has not been provided, just an invoice produced this year.

 

Icon are acting for the hospital NOT BUPA, this is why they cannot produce any BUPA paperwork.

 

They say the hospital provided a service to me and therefore a contract exists.

 

The real crux of the question is who is liable for the shortfall, me, my ex-employers or possibly BUPA??

[BRIGADIER2JCS]

You need to ask the hospital for a copy of the document you signed on admission, it is worth asking BUPA the 'generic' question too.

BUPA I think will say they have discharged their liability under the policy if the employer is now out of business you may well be liable.

[Sausage1971]

I understand that the BUPA policy has ceased and they would discharge liability.

 

With the policy holder out of business why would the liability rest with me as I have no contract with the hospital or BUPA?

[BRIGADIER2JCS]

I understand that the BUPA policy has ceased and they would discharge liability.

 

With the policy holder out of business why would the liability rest with me as I have no contract with the hospital or BUPA?

This is why you need to find out what you signed on admission.

[Staraker]

It doesn't scare me in any way but I just want rid of them.

 

When you say I wasn't provided with a service, I was as I received treatment??

 

BUPA was the provider of cover and the hospital was part of the Nuffield group.

 

Right, so not actually a ''BUPA hospital'' as you said in your first post, then?

 

 

So, essentially my response is that the contract wwas between BUPa and the hospital to pay the hospital bill and any shortfall then transfers to the holder of the policy which is my ex-employer.

 

Would Icon have to prove any contract between myself and the hospital or myself and BUPA?? If so, wht would they need to provide?

 

I was under the impression that this sort of private hospital treatment would be either pre-approved by BUPA, or else the patient would pay, and then be reimbursed by BUPA. Don't you have any paperwork from your defunct company about the exact benefits you were covered for, and how making use of them would be arranged? Presumably your treatment took place while the company still existed, but how longer after it did they fold?

[Sausage1971]

Ok, will ask Icon for paperwork.

 

I have a feeling they will refuse/make an excuse.

 

Thinking of wording a response as follows "I dispute any outstanding debt that you may believe exists and am requesting that you provide any paperwork that proves my liability for any such debt"

 

How does that sound? Or is there a better way of wording it?

Edited May 14, 2013 by Sausage1971

[Sausage1971]

The treatment was pre-approved by BUPA and the hospital took my credit card details on admission. I don't have (and never had any) paperwork relating to the company scheme. The company folded this year.

[BRIGADIER2JCS]

Personally I would ask the hospital directly!

[brokebutnotbeatn]

My other half is currently undergoing private treatment against a company policy. The hospital has to obtain a reference number BEFORE carrying out work; this is provided by the insurer. In his case the insurer wrote to my other half with the reference number. If the hospital checked with your insurer then they will have a record of this. As Brigs said, check with the hospital. If you were not told the work would not be covered, or would only be covered to a certain amount then you would need to have entered into some kind of arrangement to pay before the work was carried out. Talk with the hospital and try and unravel exactly what the issue is/was. Then you can talk to Bupa and try and do the same.

[citizenB]

Ok, will ask Icon for paperwork.

 

I have a feeling they will refuse/make an excuse.

 

Thinking of wording a response as follows "I dispute any outstanding debt that you may believe exists and am requesting that you provide any paperwork that proves my liability for any such debt"

 

How does that sound? Or is there a better way of wording it?

 

 

The fact is if they were to consider litigation, then they would have to provide information that proves your liability ?

 

What also bothers me is that you had this operation in 2011. We are nearly 18 months down the line.. surely the hospital would already have been paid? So you need to see the invoices etc that prove your liability. Why has it taken them this long to ask for some money.

 

When did your company cease trading ?

[BRIGADIER2JCS]

The hospitals invoice has been paid but with a shortfall plus an £18 charge from Icon.

[Sausage1971]

So,essentially I am asking why there was a shortfall and if so ask them to prove my liability for that shortfall by producing paperwork?

[citizenB]

Yes, I think this is what you need to establish. Also, why have they taken so long to make contact and even then by way of a 3rd party !

[Sausage1971]

Ok will do and update when I receive a reply. Thanks all.

[Sausage1971]

Hi all

 

Just received a reply, assuming they have no paperwork to prove liabilty. Would like suggestions for a response. Thanks.

 

 

 

The collector of Nuffield Health accounts confirmed that should you dispute your liability with any third party, i.e. Bupa Healthcare, you must discuss the charges with them direct. They are a third party acting on your behalf. Copy invoices relating to this overdue balance have been provided to you previously, for your referral.

 

Please update this department regarding settlement of balance due. It would be recommended that you settle then reclaim should your dispute with your insurers be resolved. The hospital provided a service to you & we attempt to avoid further action, incurring additional charges.

 

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