Good Levels of Satisfaction

In previous years the health insurance industry had a bad reputation for high levels of customer dissatisfaction. This image has improved and the UK now has one of the most reliable medical insurance industries in the world.

The poor image that health insurance had was not totally unfounded. The main complaints were about people not being able to get their treatments covered when they had been expecting to do so.

Policy definitions and procedures have now been tightened. It was inevitable. The medical insurance industry's reputation was being tarnished by sensational reports of unfair treatment in the tabloids.

The Association of British Insurers (ABI) who have most private medical insurance companies as part of their membership, took the lead in generating guidelines which were fairer to consumers. The industry on the whole has adopted its proposals and the statistics reflect higher levels of customer satisfaction.

Non-disclosure
One of the main problems occurred because of health insurance non-disclosure. Now companies have developed better ways to avoid this. Non-disclosure refers to customers not giving the full medical facts about their history. This can come about for several reasons including health insurance companies not asking the right questions in the right way when they are taking details from a new customer.

Evidence of non-disclosure can invalidate a claim. And this is where problems can really get out of hand.

The ABI proposed that customers had to be treated fairly despite problems with non-disclosure. Instead of ruling a claim to be null and void they proposed that part-claims could be honoured depending on the nature of the non-disclosure.

Standard Life Healthcare, for example, have integrated the Treating Customers Fairly diective into their company policies:

'We believe that the Treating Customers Fairly (TCF) principles-based initiative by the Financial Service Authority (FSA) in the United Kingdom is complementary to our approach to all our customers. TCF requires us to assess and monitor our performance against our customer values in a robust way. To do this we have established a group TCF policy with standards that Standard Life group’s UK Business Units1 must adhere to in relation to the six TCF outcomes.'

Complaints
When people are not happy with the treatment they receive from a health insurance company they can follow the company's complaints procedure. If they are still not happy they can take the matter to Financial Ombudsman Service (FOS).

FOS have final say over whether a claim is upheld or not and they regularly publish their statistics. This makes health insurance companies accountable. If they have high rates of upheld complaints this filters through to the media.

Since the changes in the medical insurance industry complaints to the FOS have declined and so have the number of cases that are upheld.

Currently according to Melissa Collet from FOS only 1% of insurance complaints were about health insurance and only 31% of complaints are upheld whereas overall in the insurance industry the figure stands at 70%.

Only 514 complaint cases out of 127,471 were about private medical health insurance. Melissa Collet congratulated the industry on its low levels of complaints. This is very reassuring for those with health cover or those considering taking it out.