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Medical Insurance - Charged more than if direct customer


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I had to get a few tests done and thought it would be better to get them done through the Insurance company. I spoke with them and they authorised the claim and directed me to their approved location. Asked the question from Insurance company as to how much they would cost as I have a £1000 excess and they said they can't disclose contracted rates and its best if I ask the hospital what their direct rates are for paying customers for comparison. 

 

Got the bill through and a scan they charge £400 for has been billed to the insurance company for £650. Basically in total a £500 bill for private customers is £800 for the Insurance company.  That's a bit extreme.Spoke to insurance company and they are saying I need to pay what their set rates are.. 

 

Do I have any rights in this situation? 

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Personally, I would not be surprised at all if a self-funding patient is charged less by a private health provider than they would be if they were a health insurer.

 

Think about it - a private health provider doesn't want to scare away customers who are paying with their own hard-earned money, whereas a health insurer is more or less a captive customer and they can be charged what the provider thinks they can stand.***

 

In the same way, I'm sure that "self-funding" customers of car body-shops etc get a better deal than car insurance companies do.

 

What do the T&Cs of your health insurance say?  If you are concerned that they are fraudulently charging you more for the excess than they have been charged by the provider, I suppose all you can do is ask them - but I doubt they'd admit it.

 

(I'm not sure how far an SAR might get the sort of answer you want.  You could try asking both your insurer and the hospital I suppose.  If you don't get a satisfactory response from your insurer you could try complaining to the FSO - but that might not go down well with your insurer).

 

***  Before you ask, any retailer or provider of services is perfectly entitled to charge different customers different prices - so long as they don't break any equalities legislation.  Although I'm a former NHS manager I'm currently having tests doen privately, and I'm confident I'm paying less as a "self-funder" than if I were insured.

Edited by Manxman in exile
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You could always try asking your insurer.  Tell them you followed their advice to ask the hospital what their rate for self-funding was and tell your insurer that the hospital gave you a significantly lower fee than they (your insurer) is now charging you.

 

Tell them that if you'd known they were going to charge more of your excess you would have reconsidered using the insurer.

 

Don't ask - don't get...

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I asked them that and even politely complained that this was unfair that they wouldn't tell me the insurance company rates before hand. As I knew I would end up paying either way so if I knew would have preferred to pay direct. 

 

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