Changing from VHI to ???

S

SCA911

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As a family of four (2 adults and 2 kids, ages 3 and 1) we have had VHI cover all our lives, currently on Family Plan Plus Level 1.

I want to change to a different company as a result of VHI refusing to pay out on a claim which I consider perfectly legitimate. I am trying to compare policies with Aviva and Quinn but wondering if anyone has any suggestions. Day to day cover, such as GP visits, would be important to us and also additional therapies such as Occupational Therapy and Speech and Language therapy. Also good hospital cover is important to us.

Has anyone had any experience with making claims with Aviva and Quinn and how have the found the whole procedure. Obviously cost of premiums is a factor, in this climate. So we are also trying to get as much value for money as possible.

Any suggestions welcomed.

Thanks
 
When shopping around try the HIA website anyway http://www.hia.ie/

At the risk of diverting this thread off into a separate debate ... are your sure that you really need cover for all (or any) of the family - e.g. especially the kids who (like everybody) are entitled to "free" public care and, as far as I know, there are no private children's hospitals in Ireland anyway?

How come there is any confusion about your declined claim? Usually the policy terms & conditions are clear.
 
On your first Q I take your point and it is relevant when it comes to hospital care, however when a child needs to see a consultant privately for any reason, at least approx 50% of cost of consultant visit is covered plus the tax relief with health insurance. the waiting lists for a public consultants visit which we required recently was 12 months long and a previous visit we looked for was 18 months long. The health insurance in these instances was essential for us.

With regard to claim declined, child was referred to hospital and subsequently admittted to peadiatric ward for consult but did not stay overnight. Insurer claimed afterwards that hospital could have carried out tests in out patients dept. Even if they are correct we of course followed the procedure the hospital suggested as our child was ill. I'm not fully aware of why this would result in the insurer not paying but it appears to be applying the benefit of hindsight for the insurer which obviously was not available to us at the time as the condition could have been serious.
 
I presume that there is some complaints/mediation/ombudsman process for disputed/refused claims?
 
Yes, I presume there is and must follow it up. If anyone knows how to go about this I'd appreciate advice on where to look.
 

On a general note, health insurers will only pay for an overnight stay if there's a clinical reason that such a stay is necessary. It helps keep their costs down because the temptation exists for hospitals and doctors to admit patients that don't require admission, just so they can claim off a health insurer. For most procedures, it's evident why an overnight stay is needed, but when its something that's usually done as a day-case or an out-patient, the insurer will need to know why the person stayed overnight.

In your circumstances, it may be the case that the claim form didn't specify the reason that an overnight stay was required for what would normally be done on an out-patient basis. Ask the VHI for a copy of the claim form so that you can see what the doctor said, if anything. If there is a reason, then you can follow up with VHI as to why it's not acceptable.

If there isn't a reason, then it might help to talk to the doctor to establish why the child was admitted overnight. Also check with VHI if it's acceptable for the doctor to submit that information to them so they can re-assess the claim.

I hope that helps to some degree.
 

There aren't any private children's hospitals, and there are very few private beds in the public children's hospitals, but children can be admitted as private patients to general public and private hospitals for more routine operations for gromits, tonsils, appendix, etc.

I'm not trying to scaremonger or anything; for serious illnesses and emergencies, children will still be admitted as soon as possible, regardless of the level of health cover if any.
 
Hi Wab,

I know it can be frustating when you have insurance cover and expect the cost of the hospital visit to be covered, I wonder too if your child would have been admitted if you didn't have any insurance cover, but unfortunately, I had reason to use hospitals on several occasions and Vhi covered everything without any quible what so ever.
Several times I had thought of cancelling the policy but was very happy I had it when it was needed.
As I have never had a different health insurer I can't comment on how painless they are but maybe you could get plenty of reviews before you change insurer.
Hopefully you won't have to claim again.
 
Just to add that all the health insurers are tightening up on claims. As novaflare says must be medically necessary.

I really sympathise with your experience. How are you to know if your child is sick enough to be admitted and then to know if your health policy will cover it or not?

If there was not an overnight stay, what was the charge for and how miuch was it? Which hospital ?

I would be inclined to decline to comment about presence of health insurance when initially asked to prevent situations like this.

Patrick
 
We are also family of 4 with 2 children who have in the past required LOTS of consultant and gp visits. We changed from vhi to quinn10 yrs ago and always found them excellent to deal with. However I always shop around for all types of insurance we purchase as I find the differences in costs can be huge. As a result of this we found aviva matched and bettered our existing quinn policy last year. Again this time when it was due for renewal I checked around and got a better price again with aviv through their corn market broker. Our claims last year were refunded as agreed by the policy and within a week of submitting them at the beginning of this month. I have found aviva user friendly, prompt and very competitive. I think health insurance is a very personal decision and believe that as a health professional myself you do get better prompter treatment if you have it. I know this isn t right or fair but as a mother of 2 young kids who have been sick a lot I am too chicken not to have it.
 
Am just trying to renew policy for adults and 4 children. Am looking at one plan 500 for ourselves and kids (VHI) or with aviva level 1 hospital for adults and health starter for kids. Its really difficult to compare plans even with the very helpful HIA as there are always minor differences. What is the cheapest cover for 4 kids, does anyone know? Basically I want them to get in quickly if they need gromits/tonsillectomy etc. (not to be on waiting list) After that, I am only looking for very basic cover as money is tight. Any pointers/assistance would be reallly appreciated.
 
do you have any use of day 2 day cover (i.e Gps, physio, consultants). If so the quinn company care suite are good for that but note the prices are going up on the 1st of Feb

Also VHI have a similar plan (but only for a limited set of visits) its on the hia news section. currently the prices are reduced. else look at starter policies from quinn for cheaper options. BTW Nothing to do with quinn just find the policies suit my needs (prior to the above mentioned price increase!!)

Its all about timing!!

S.
 
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