Questions Of Cash: Prevaricating Pru was giving me the needle
Saturday 11 December 2010
Q. I made a claim for acupuncture from my PruHealth Personal Health Fund. Prudential has repeatedly promised to meet the claim, but it has instead rejected or ignored them. They have also continually changed the criteria on eligibility. I have spent many, many hours trying to sort this out with Prudential and I don't believe that this can be resolved without third-party assistance.
A. You contacted us in May – and we hope that this matter is now resolved in a satisfactory way. But it is frustrating that it has been necessary to engage in a substantial, time-consuming and long-lasting correspondence with Prudential to reach what appears to be a solution.
Shortly after we initially raised the problem with Prudential you received a cheque for £292, settling the claims outstanding when you contacted us. However, by this time other claims had been submitted and these were also not immediately paid. Prudential has now agreed to pay you £200 in compensation for its failure to deal with your claims promptly. Prudential also confirms that your policy entitles you to 10 further acupuncture sessions before the end of January without additional authorisation and providing you do not go above the £600 cap on such treatments in any one policy year.
Should you need additional treatment, you will need to get prior authorisation from Prudential before you book the sessions. In a statement, Prudential said: "We have concluded that [the reader] did not receive service of the highest standard from the customer support team. We would like to apologise that this has persisted throughout her claim." It said that some of the problems were made worse by you not being available to discuss these by phone. Another complication was that you had a second health insurance policy with the company.
Prudential explains: "The main issues revolved around initially declined payments as a practitioner did not have the appropriate registration followed by a declined payment due to the customer being unaware that payment for the same treatment episode cannot be split between the PHF and normal insurance benefit. The issues could have been avoided had we been more complete in describing all the information we needed to process a claim after the customer initially contacted us." It has also agreed to pay for one claim that was previously rejected. It will not make a deduction for the element of this claim that was separately paid for by the second health insurance policy.
Q. I am unhappy that when I gave my details to a price comparison website to buy an insurance policy, this was followed up by both a phone call and a letter. This puts a potential purchaser under pressure. AB, Nottingham.
A. The phone call you received was from an insurance broker, who was providing more detail on the limitations to the cover available, which enabled you to decide not to proceed with the policy purchase. The letter you received was from Churchill, and was unconnected with your online enquiry. Churchill, which is part of RBS, says it does not have a commercial relationship with the price comparison website you used.
Q. A few weeks ago you referred to three specialist health insurers who provide cover for people with impaired health histories. Could you provide me with web addresses of these insurers? JS, by email.
A. We quoted three specialist travel insurers, whose names were provided by the Association of British Insurers. The three are AllClearPlus, whose web address is www.allcleartravel.co.uk (0845 250 5200); Free Spirit, www.free-spirit.com (0845 230 5000); and It's So Easy Travel Insurance, www.itssoeasytravelinsurance.com (0845 222 4205). A more comprehensive list of insurance brokers who offer travel policies for people with impaired health histories can be obtained through the website of the British Insurance Brokers' Association: www.biba.org.uk.
Q. I recently returned from a holiday in Tunisia with my daughter, flying with Tunisair from Heathrow. I booked the last flights home for my return from Heathrow to Belfast. But the flight back from Tunisia was delayed by almost three hours and we missed our connecting flight home. We had to buy new flights the following day and get overnight accommodation. This cost us an extra £200. Neither my insurance company nor the airline will meet our costs. What should we do? CM, Belfast.
A. You will have to bear the loss yourself. Your insurer says that your policy does not cover losses caused by travel delays: it is important to ensure that you take out a travel policy that meets your specific needs. Airlines are not required to pay compensation for flight delays of less than three hours: the situation regarding compensation for delays of more than three hours is currently subject to legal review.
In December, we published a letter from DW of Kirby, complaining that he had received a letter from Digital Satellite Warranty Cover asking for payment. As he was expecting a renewal of his Sky Repair Plan, he paid the requested £95.99. When he separately received a bill from Sky, DW realised that he had inadvertently paid the wrong company. We were unable to make contact with Digital Satellite Warranty, but obtained a goodwill refund through your credit card issuer, Barclaycard. Sky told us that it had received several complains about Digital Satellite Warranty. We are pleased to report that the Financial Services Authority has now obtained a High Court ruling appointing provisional liquidators over Digital Satellite Warranty Cover Limited and two other businesses – Satellite Services and Nationwide Digital Satellite Warranty Services Limited – that offered a form of extended warranty. All three businesses were operated by Bernard Freeman and Michael Sullivan. DSWC made a profit of around £10m in one year, with a customer base of up to 200,000 people. Satellite had a turnover of £2.1m this year. The FSA successfully argued that the warranties constituted insurance policies and that the firms had not been authorised by the FSA to operate insurance businesses. Sky has agreed to provide free support to all customers of the three businesses during the remaining contract periods.
Questions of Cash cannot give individual advice. But if you have a financial dilemma, we'll do our best to help. Please email us at: questionsofcash@ independent.co.uk.
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