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@BUPA will not reimburse me for 2 overlapping policies, which were incorrectly set up following miscommunications


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TLDR:

My wife and child were on a private BUPA policy and I “transfered” them to my corporate policy to save money. This went wrong and as a result they had 2 overlapping policies for months which I both paid without noticing. I don't think BUPA were clear with us. Can I claim?


 

I.    Summary of facts

  • Prior to May 2021 I was on the corporate account on my sole name, while my wife and child were on a private policy with BUPA which I paid for

  • In May 2021, I asked for my 2 dependants on the private policy to be transferred to the corporate policy so that I would pay (a lot) less each month

  • The company organized the transfer and added my dependants to the corporate account, and notified me that I would get a call from BUPA regarding closing the private account

  • It is currently unclear whether the call with BUPA ever took place as there is conflicting information from 3 different sources (see below)

  • In June 2021, I received confirmation in writing that my dependants had been added to the corporate policy

  • In September 2021, the dependants were removed from the corporate policy via an administrative/computer error which is unrelated to the main issue at hand

  • In February 2022 I noticed that payment for the private policy had kept going out of my account despite our belief that the private policy had ceased to exist

  • HR attempted to intercede in my favour to have the corporate policy reinstated as of October (they can do this) and BUPA refund the private policy. BUPA firmly refused on the grounds it is my wife's fault for not cancelling the private policy

  • My wife then formally cancelled the private policy and was reinstated on the corporate policy on Feb 16th 2022

 

  • As a combined result of the events above:

  • Between June 2021 and September 2021, my dependants were covered on two insurance policies, instead of the intended one policy (corporate)

  • Between September 2021 and the 15th of Feb 2022, the dependants were only covered on the private policy, instead of the intended corporate policy

  • From the 16th Feb 2022, everything was settled to work as intended. (As it had been intended from the start)

 

The private policy cost roughly £380 per month whilst the corporate policy costs roughly £50 for a similar level of cover

 

 

II.      Points of contention
 

  • Regarding the call that was allegedly supposed to happen to allow the private policy to be cancelled, there are 3 conflicting sources of information.

  • 1) My company's HR department were told by BUPA that my wife was called, but that there were language barrier issues (she is not a fluent English speaker) and the call resulted in hanging up. This is firmly disputed by my wife. HR do not want to get involved further with my dispute with BUPA and will not provide evidence of this.

  • 2) I called BUPA to ask them for recordings of that call, but they insisted that in fact they never spoke to my wife on the phone so there was no phone call. I have recorded this call.

  • 3) My wife and I remember speaking to BUPA about the policy and her giving vocal consent to agreeing to something.

  • BUPA suggested that we may have spoken to our corporate dept instead of the private dept. that these 2 are separate and that we needed to call both. This was not made clear to us by BUPA at the time.

  • [TODO] I will need to go through all my telephone records to see if we can find evidence of a call to BUPA around that point in time to see if we can confirm whether a call did indeed take place or not.

 

  • I would like to note that at no point in time neither my wife nor myself ever received a confirmation in writing that the private policy had not been cancelled as we intended. Although we did received some missed calls and an email to ask us to speak to them about our account, no details were ever provided and no follow-up was ever performed from BUPA.

 

 

 

III.     Establishing responsibility

  • I admit that there was a longer than reasonable delay for me to notice that the intended actions had not been performed correctly, that I should have double checked earlier, and that I should have noticed earlier that funds were still going out of my bank. I also would like to point out the following mitigating factors:

  1. At the time we believed that this would be a transfer of an account from a policy to another. I did not understand that it would be cancelling one policy and starting a new one.
  2. I had especially arranged with HR that my wife's existing conditions would continue to be covered, which was confirmed, leading us to further believe that it was a transfer, not a new policy.
  3. In June we received a refund of £300 from BUPA. We assumed that it was a refund from the private policy being cancelled. Unfortunately this was a one time insurance rebate that was completely unrelated.
  4. At the same time we also received papers by post confirming that my wife and child were now under my corporate policy. However we never received information pertaining that she was still under the private policy (policy renews in Spring, so no renewal docs).
  5. All of the above led us to believe that everything went as intended so that we can drop it and focus on our main concern at the time which is:
  6. In June we were in the middle of a failed house deal and dispute with seller which took up all our time and energy. The deal fell through and between June and December we had been in a frantic search for a new house, with lots of money going in and out of the accounts for contractors/solicitors etc... so that I didn't pay attention to the regular bills until early this year when I finally noticed the mistake...

 

 

  • In the interest of not deteriorating the relationship with my employer. I'd like to avoid involving HR if possible, and also to be frank I don't suppose they did anything wrong here aside from the clerical error which was not related to the case, (but may impact my final compensation). I do appreciate that they have tried to help.

 

 

  • I do believe that it is fundamentally wrong from BUPA's part to

    • Allow a customer to be covered by overlapping policies without any written notification or warning, and without a customer's consent.

    • Rely on telephone calls only when they have functional email and postal addresses for us. My wife is not a native English speaker and I am generally very busy during the day, making it difficult for us to pick up calls.

    • Give conflicting information as to whether a call happened or not. Imply that a language barrier would cause them to give up on one hand (which is not acceptable in any way) whilst claiming on the other hand that no call every happened.

 

 

IV.               What I would like to achieve, with your help

 

 

  • Best outcome: a full refund of the private policy fees between June and February 2022.
  • Alternative outcome A: a full refund of the private policy fees between June and September, at the time my dependants were double covered.
  • Alternative outcome B: a partial refund based on my admission to have failed to notice the mistake for an unnecessary long amount of time.
  • Consolation outcome: a full refund of the corporate policy and associated taxes between June and September – if I cannot get compensation for the private policy.
  • Worst outcome: give up entirely and move on.

 

 

Note that the private policy cost an extortionate amount of approx £380 per month, so around £3000 for the full duration.

 

 

 

V.               What I would appreciate to know

 

 

  • Am I right to believe that this is not solely my wife and my responsibility here, but that BUPA has a lot of bad practices to answer for?
  • If yes, do you recommend I start the normal route? So complaint, then letter of claims, then SCC?
  • What's the best outcome that I can expect?
  • Any threads you can point me to for me to do some reading?

 

I beg you, please no pieces of advice about going through your statements each month and triple checking everything. I am already fully aware of this and angry enough with myself so as to not need extra chastising.

 

Thank you so much for your time.

K

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Start off by sending BUPA an SAR.

If there were two policies running at the same time then you may well be able to recover money paid under a mistake.

Begin with an SAR

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Thank you. I will get the SAR underway. May I submit a SAR in the name of both my wife and myself? Or does it need to be 2 separate requests?

 

 

A couple of details of note as regards to the overlapping policy.

 

- On the phone (i have it recorded). BUPA have stated that it is not unusual for clients to deliberately have 2 overlapping policies "just in case something goes wrong with one of them". II find that highly questionable to say it politely.

 

-BUPA are also very adamant that their corporate and private departments are two completely separate things, but I suppose the SAR should cover everything as it's the same parent company.

 

 

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Hi @BankFodder Sorry to bother know you're busy.

 

I have the S.A.R ready to send would be good to get confirmation whether it's okay to send it in both my name and my wife's (signed by both) or if I need to do 2 separate ones. A quick google didn't help much.

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