• PMI – You Get What You Pay For

    Date: 6 August, 2013 | Author: | Category: General

    CGuest Blog by Guy Jones

    I would like to drive a Rolls Royce but only pay for a Mini! And so it is when we purchase a Private Medical Insurance Policy we expect the most expensive Hospital, the most expensive Specialist and the most expensive technology but only expect to pay budget premiums. By the way, expensive does not always mean best or most appropriate.

    I am constantly frustrated when I read in the press or see Watch Dog on the BBC having a pop at Medical

    Insurance companies for not paying for the treatment in full or declining treatment altogether. Generally, people get the benefits they pay for, for example recently on Watch Dog BUPA was being put under the cosh after they introduced “Open Referral”. This is when your GP gives you an Open Referral to a specialist ie. they do not give you a name of a specialist you get that from BUPA who let you know which specialists are in your area and whose charges are within reasonable levels. If you don’t follow the rules then they will either not pay for the treatment or will only pay a fraction of the costs. The main complaint was from the “expensive” consultants not from those whose charges are considered reasonable.

    The names provided by BUPA are fully qualified appropriate specialist consultants, they are not back street charlatans who will do it for “cash”. BUPA has more than 50 years’ experience of working with specialists and have data and statistics to be able to refer you to the appropriate person. By accepting this way of working you will get your treatment fully paid for and the claims administration minimized as they will pay directly to the hospital or specialist.

    The purpose of this is to try to keep the cost of treatment down to acceptable levels, this in turn will help keep premiums down and so maintain PMI as an affordable insurance. If we support initiatives like this the premiums would increase less rapidly. BUPA was not the first to introduce such an arrangement and I am pleased to see other insurers are now following this method.


    1. When buying or renewing your PMI scheme get independent advice.

    2. Ask loads of questions.

    3. Be aware that if you pay budget premiums you will get a budget policy which will have exclusions and limitations.

    4. Buy a policy that fits your needs not the first one you are offered.

    5. Read the policy exclusions on day one not when you need to claim.

    Author: Guy Jones

    Guy On LinkedIn Guy Jones is the Managing Director of Berwick Devoil Healthcare Limited (BDHL) an independent employee benefits consultancy.Having begun his EB career with PPP (now AXA PPP) in 1988 specialising in UK Private Medical Insurance he moved on to International Health Insurance in 1994. He set up Rossborough Healthcare in Guernsey and Jersey in 1996 providing employee benefits for local companies in the Channel Islands, the UK and around the world.He became Managing Director of BDHL in 2002 and set about creating a bespoke brokerage covering employee benefits including Group Risks (Income Protection, Critical Illness and Group Life), Healthcare and Peripheral benefits such as Dental Cover, Cash Plans, Stress Counselling and Travel Insurance. Read on...
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