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Medical Insurance - The Whole Truth
Health insurance is available in three basic guises - although there are a great many policies out there under various names. They range from simple cash plans, where you receive a cash pay out when you receive certain types of health care, plus a set amount per night if you're hospitalized, right through to fully comprehensive policies.
One thing is important; whatever sort of cover you take out. If you're asked to fill in a form relating your previous health history, it's vitally important that you're completely open and honest and include absolutely everything. Even things that are not relevant to the condition for which you have to claim can come back to cause problems if you fail to disclose them.
What happens when you make a claim under your health insurance policy is that your records will be checked and if there are any discrepancies between what you've told them and what your GP's note say, then the claim will be in dispute. Even if the condition which has been omitted appears to have nothing whatsoever to do with the condition for which you're making the claim.
Insurers frequently issue policies taking your word for the medical facts and it's rare that they ask to see any notes. They say that this would be too costly, but when they may have to pay out, it's a very different matter. What if a condition that doctors had been suspicious about, but not discussed with the patient, had not been disclosed? The patient obviously had no way of knowing the doctors suspicions and the insurers didn't ask for any medical notes - so where would that leave any claim?
There's a case of a man who had attended his GP, on and off, for a number of years. For the past ten years or so, his doctor was suspicious that he had the symptoms of multiple sclerosis. They were only suspicions and the patient was not told, although they were mentioned in his medical notes. Had he tried to take out health insurance obviously no mention of multiple sclerosis could have been made. Multiple sclerosis is a serious condition and there's no doubt that there could have been an interesting case if a subsequent claim was made.
When eventually the diagnosis was made and the patient discovered that the doctor had recognised the symptoms well enough to make notes for a number of years he made a complaint, saying he should have been made aware of the possibilities in order that he could make plans, there followed a legal battle with his local NHS trust. They admitted that the doctor's actions had been wrong and the patient was awarded compensation. This just goes to show that the way that these insurances are sold needs some changes. With the best will in the world, people can't possibly remember every single illness and it also makes the point that there are things which they don't even know about!
There is the suggestion that the law in the UK should be altered. This would be by introducing something known as "non-contestability". A contract containing a clause like this would put a time limit on the insurer's ability to examine previous medical notes when arranging cover.
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