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Health Insurance No man's land....help please

722

Posts

EW GURU

Latest post on 08 February 2011 - 11:14

Hi - I changed insurance companies on 1st Feb, and the problem I now have is that following a Well Woman Check that I had on the prior insurance, I now need to have further tests (pelvic CT scan) which the new insurance company is refusing to cover as they are classifying it as a pre-existing condition. So it seems as though no-one will cover me for this - has anyone experienced this? Where would I go to do a CT scan via a gment hospital? So frustrated...i want to get to the bottom of the problem, not have to fight out a way to pay for it!! Thanks.

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722

Posts

EW GURU

Latest post on 08 February 2011 - 12:08

thanks, i am going to go back and argue with them, as i have pointed out to them repeatedly, there is no condition yet! and hopefully there wont be! let's see how that goes. am also trying to find out about going down the government route and am not yet getting any joy over the phone as to whether a clinic or a hospital would be the people to do it...

309

Posts

EW EXPLORER

Latest post on 08 February 2011 - 11:36

I would check the details of the policy but if it is worded as a new medical concern and the Dr is prepared to back this up then I can't see that they are allowed to refuse it. Also if the scan is to check something, how can they say it is an existing "condition"? I would be arguing it is an examination at this stage and no proven condition yet - that of course depends on your situation. Whilst our insurance covers "everything" and is considered a excellent expat insurance, I have often had to argue with the assessors and normally when you question them and show them that you are not prepared to be denied medical attention then they normally back down and pay it. I was even told one time that they have a certain percentage of claims that they have to deny to keep payout at a certain rate.

722

Posts

EW GURU

Latest post on 08 February 2011 - 11:25

Yes was wondering about doing that. I don't know though whether the new company would still deny it based on the fact they have seen a request already for a CT scan of the pelvis. Just checked the price of paying for it myself privately and its nearly AED2500!!!!!!!!

309

Posts

EW EXPLORER

Latest post on 08 February 2011 - 11:20

Without obviously knowing the medical details, I would suggest that you find a nice doctor that you haven't seen before - if the insurance company have details of the one you used before to claim-, explain the situation to the Doctor that it is not being covered with your regular doctor due to "pre-existing" and that the health issue is improtant and see if the Dr is able to word the claim (while still being legal) to cover a possible "new" medical concern that requires a Pelvic CT. Have had to do this before too.

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