Z
zen
Guest
Folks this is a bit of a read but I would appreciate some feedback.
Do you think I have grounds for legal action?
As some of you may know there is a waiting period of 52 weeks before a woman can avail of maternity benefits. Aswith all companies the authority to change policy is an arbitrary one.
I am with my insurer 10 years and seldom make a claim. My partner was with them 48 weeks and was told no she was not covered. I argued that it was irrelavent who was having the baby, I had 10 years service with them and wanted my child to be delivered in a private capacity. They said but you are not having the baby, I argued so what?! Whats the difference, if I could I would but I cant, does this deny my right to have my child to be born in private care? We both created the child!? Long story short we went public and sat on average 4hrs in waiting areas to be seen and the experience could have been better (mildly put)
One of their agents came into our company and gave a presentation on what was covered under our policy and he said we were coverd for everything. I said "you missed something there, you never told anyone about the watining period of 1 year", to which he replied thats waved for your company as there are over 200 members... I almost fell off my chair. I contacted the girl (via email) to explain to me why she didn't know this. She wrote back to say, "sorry you should have been covered it wont happen again, I trust this to your satisfaction...".
I went through their complaints procedure and they denied compensation. They initially told us no we were not covered, then verbally we were, followed by confirmation in writing we were only to be told verbally again that we were not, followed by a mail to say we were not! They said the waiting period was only waved for the policy holder! Which litereally translate to
FEMALE:- If she joins the company and is the policy holder, the waiting period is waved for this benefit if she becomes pregnant.
MALE:- If he joins the company and is the policy holder, the waiting period is not waved for your partner even though she is also listed on the policy (before she was even pregnant).
This is written now where by the way.
I recieved what is referred to as the "final notice" from our insurer with a copy of the terms and conditions of the contract which in all fairness does state the waiting period. However, this issue surrounding the waving of the wating period is written nowhere.
I have since submitted a complaint to the ombudsman who advised mediation which I have declined.
Should I stop this David and Goliath battle.
Zen
Do you think I have grounds for legal action?
As some of you may know there is a waiting period of 52 weeks before a woman can avail of maternity benefits. Aswith all companies the authority to change policy is an arbitrary one.
I am with my insurer 10 years and seldom make a claim. My partner was with them 48 weeks and was told no she was not covered. I argued that it was irrelavent who was having the baby, I had 10 years service with them and wanted my child to be delivered in a private capacity. They said but you are not having the baby, I argued so what?! Whats the difference, if I could I would but I cant, does this deny my right to have my child to be born in private care? We both created the child!? Long story short we went public and sat on average 4hrs in waiting areas to be seen and the experience could have been better (mildly put)
One of their agents came into our company and gave a presentation on what was covered under our policy and he said we were coverd for everything. I said "you missed something there, you never told anyone about the watining period of 1 year", to which he replied thats waved for your company as there are over 200 members... I almost fell off my chair. I contacted the girl (via email) to explain to me why she didn't know this. She wrote back to say, "sorry you should have been covered it wont happen again, I trust this to your satisfaction...".
I went through their complaints procedure and they denied compensation. They initially told us no we were not covered, then verbally we were, followed by confirmation in writing we were only to be told verbally again that we were not, followed by a mail to say we were not! They said the waiting period was only waved for the policy holder! Which litereally translate to
FEMALE:- If she joins the company and is the policy holder, the waiting period is waved for this benefit if she becomes pregnant.
MALE:- If he joins the company and is the policy holder, the waiting period is not waved for your partner even though she is also listed on the policy (before she was even pregnant).
This is written now where by the way.
I recieved what is referred to as the "final notice" from our insurer with a copy of the terms and conditions of the contract which in all fairness does state the waiting period. However, this issue surrounding the waving of the wating period is written nowhere.
I have since submitted a complaint to the ombudsman who advised mediation which I have declined.
Should I stop this David and Goliath battle.
Zen