Appealing Against Private Health Care Treatment Rejection

[Andy12]

Hi,

Could anyone advise me if they can assist me in appealing against a refusal for treatment decision from our Private Healthcare company?

Any pointers would be very appreciated.

Andy

[Billculbard]

Sorry Andy. I've never been down this road before. Good luck! Bill

[EmmaG]

Hi Andy, I've checked with our information officers and they aren't familiar with this. However I found this organisation online who may be able to help you. Just copy and paste the code below into your address bar.

docs.google.com/viewer?a=v&...

Hope this is useful.

Emma

[Andy12 in reply to EmmaG]

Hi Emma,

Thank you for taking the time to look into this. It looks like this particular body look at complaints while having treatment.

I have found that the Financial Ombudsman are responsible for arbitrating claim disputes with private health insurance companies.

In order for a case to be referred to the Financial Ombudsman Service (FOS), the firm has to issue what is known as a ‘final decision’ letter at which point the complainant has six months from the date of that letter to take their case to the FOS. The FOS will then ask the firm for a copy of their papers and an adjudicator will review and issue their decision.

financial-ombudsman.org.uk/

I will keep you posted on our progress with this.

best regards

Andy

[EmmaG]

Please do and good luck. If I find out anymore information in the meantime I'll update you.

Good luck