VHI Health Insurance - Bad Advice

Charles1412

Hi

I took out a health policy 14 months ago with VHI having asked friends and family for advice. I haven't had health insurance for the last 5 years but I transferred my wife's cover from her family policy where she has been a member since she was a child - on Plan B. When I called the VHI for advice and explained that we had no children but were intending starting a family they pointed me in the direction of their newer plans specifically their Life Stage Choices Family Plan. They pushed the fact that you receive money back for your day to day outgoings and having assertained from me that access to Blackrock & the Mater private weren't essential they recommended family plan level 2. I stated at the time that as long as we had access to private consultants that would be sufficient. Fast forward 2 months ago and my wife has been attending a consultant for depression and she was admitted to a private hospital for treatment. When I called the VHI to let them know that she was been admitted to hospital they informed me that we only had 50% cover and would have to make up the shortfall. I feel they have mis-sold the policy to me and as per their brochure it states "cover for up to 100 days in-patient psychiatric treatment. I spoke to a lady in admissions who agreed that the VHI try to newer customers towards these new programs which although giving back for day to day medical expenses - they also hugely limit their liability for treatment. My question is can anyone advise do I have a leg to stand on if I try to take things further regarding been mis-sold this product. For what is essentially a difference in premium of less than E200 I am looking at a shortfall in costs of E12000.

Barname

M P S O B

Mountjoy Mugger

Barname wrote: »

M P S O B

What on earth is that supposed to mean?

Cabaal

OP, you state VHI says "cover for up to 100 days in-patient psychiatric treatment", you'll notice it says up to this doesn't mean the actually provide 100% cover in all circumstances

Accordingly you should have checked before hand to see what percentage of cover you would have, VHI would have provided you with all the documentation to say what is covered and where when you signed up.

whippet

going back a few years ago I was talked in to changing over to one of these life stage choices policies from plan b option as part of the work group scheme.

I quite clearly remember the sales rep saying that it was a rebranding of their policies and that my cover wouldn't change and that the original plans would be phased out.. mind you I didn't get that in writing.

At the time I was already attending a consultant who worked out of the mater private.

When I had to spend a few nights in the Mater Private for tests it all came to light, I got a letter from the VHI the morning of my appointment telling me they were not covering me for the Mater Private as per the new policy.

I checked the documentation and yes they were right, I was stupid not to check but it was sold to me as being the replacement product for what I was currently subscribed to.

I had to prospone my treatment while I wrote very detailed letters to the CEO of VHI (in a civil manner might I add) .. my case wasn't helped by the fact that the sales rep in question wasn't working with the VHI any more.

Through the jigs and the reels it was agreed that I could backdate my premiums for the plan b options and avail of the cover, but this was done as a matter of courtsey rather than them admitting any wrong doing.

I was lucky in that I could show that recieving this treatment now would avoid much worse medical problems later on in my life, so in effect limiting the VHI's liability in the future.

My advise to the OP is to contact someone in VHI as high up as possible and explain that you were not fully aware of the changes in your cover when the new policy was sold to you.

best of luck !

dudara

Moved to Banking & Insurance & Pensions

dudara

broker2008

One of the problems when one contacts a call centre is that there tends to be scripts that are followed.They ask a couple of questions and they arrive at the "most suitable" option for your circumstances.The script changes depending on the answers provided.So if one were to say that money back on GP visits was the most important feature,cover towards consultants visits, no excess,low premium, good maternity benefit they could arrive at a number of plans eg family plan, family plan plus & forward plan and different level might fit the bill.The key question is did they ask what % of cover for a private hospital would you like ? Is is that 100% of the treatment is covered but only 50% of the accommodation costs ?

Perhaps they recorded the conversation ?

Hope it works out for you and your wife.

PS- this should be a warning to others who are thinking of reducing their level of cover. Know what benefits are important to you.All 3 insurers have their plan details on their websites except some of VHI's company plans

Charles1412

Hi Guys thanks for the replies.

With regards to broker - As far as I can recollect their main question in deciding on the cover following on from asking if we were looking to start a family was - do you require cover for the Mater private or Blackrock. They never mentioned the old plans as in B,C,D etc. From the other contributor input it seems to be that their sales approach is to advise any new customers into the life stage plans and as mentioned the women working in the admission dept told me this was also her personnel experience. As her daughter had been taken off the families insurance plan due to spending a year overseas in college and when she returned and they tried to put her daughter back onto the families cover which was plan B - VHI informed her that they were no longer offering this plan.
As regards your other 2 questions I am not sure if they recorded the conversation - should I ask for a copy of it?

&
as as per the table of benefits -Family Plan Level 2

Section 1 - Hospital charges in participating hospital in section B ( Private hospitals and treatment centres it says :
Benefit Limit(% of hospital charges)
Day car & side room 60%
semi Private Room 50%

but it does not mention the other costs ( as obviously the close on E500 a day isn't just for accomadation).

I also have a brochure dated Nov 07 Lifestage Choices - & in the section hospital cover it says Cover for up to 100 days in patient psychiatric treatment.

FINALLY ONE OTHER POINT - ON THE VHI WEBSITE ON THE FRONT THERE IS A SECTION WHERE IT SAYS CHOOSE A PLAN IT IS IMPOSSIBLE TO CHOOSE ANYTHING OTHER THAN THE LIFE STAGE CHOICES AS IT DOES NOT ALLOW YOU TO CHOOSE THE OLD PLANS.

broker2008

I would say the difficulty is that you were a new customer as opposed to a customer switching plans. Had you switched plans because of the renewal letter suggesting it, the letter would have told you what you were gaining and what you were losing in cover ie the cover for blackrock etc.

Not sure of the price of accommodation in the particular hospital that the stay was in but it is steep enough per night in any semi private room in any hospital.

VHI have to sell Plan B if requested but not necessarily on their website, by phone. Call them and look for a copy of the call and then put it in writing requesting to her the call.