Who do Intermediaries Work For?

Who does your broker work for, you or the medical insurance company? Some brokers deal with just one company or a small group of companies and others can offer you a whole range of products. People usually go with an 'intermediary' (the official word for broker) because they should have a wide range of product knowledge and are able to compare health insurance policies across the board and find the best policy for you and your family and business. So why does it matter who your broker works for?

If there is ever a dispute between you and your medical health insurance provider then it might become very important for you to know whether the intermediary was acting for you or for the health insurance company. In cases of non-disclosure it becomes particularly relevant.

Recent industry guidelines promoted by the Association of British Insurers (ABI) encourages providers to treat customers fairly. Whereas in the past an inaccuracy in your initial forms may invalidate your claim completely now the onus also falls on the medical insurance company to make sure that there have been no misunderstandings.

It's a little bit like Chinese Whispers - the more people involved in the chain (you, the insurance company and the broker) the more likely it is that there could be a misrepresentation or misunderstanding of the facts. In the case of a claim rejection it becomes very important to know who said what to whom. For example, if the broker is representing the company and they misinterpreted something you said when they took your details then the onus is on the company to deal with you fairly as it is not your fault that you gave the wrong information.

The Financial Ombudsman Service (FOS) provides information on what you can do in disputed cases and can get involved and have the right to get a company to reinstate a policy and pay claims . They state that,

'If the “intermediary” firm was acting – technically speaking – on behalf of the insurance company, then the insurance company cannot claim that information you gave to the “intermediary” wasn’t properly disclosed.'

Intermediaries usually make money by taking a percentage commission based on the premium the health insurance company charges for its policies. Companies are offered incentives and rewards to sell as many policies as possible. PruHealth, for example, offers Broker Vitality Rewards which include hospitality events, training courses and advertising support.