Bupa Arbitration?

[dddave]

A friend has had a tough time recently; a few months ago, he was diagnosed with mouth cancer. He spent a number of weeks in a Thai hospital successfully undergoing therapy then , on the day he was due to check out of the hospital, he was sitting on the bed with his bags packed and suffered a heart attack.

He was quickly resuscitated and spent another 10 days in the hospital.

His BUPA had run to the limit for the first hospitalization. BUPA is claiming that the heart attack was related to the initial condition and because he hadn't officially left his room although all the discharge papers had been signed, that it was part of the initial admission, thus denying coverage for the heart attack treatment.

He contends, and his doctors agree that they were totally unrelated.

Has anybody on this forum ever entered into arbitration with BUPA? What was the process and did it seem fair? Is an attorney necessary and are there any that specialize in health coverage issues?

Any information you might think relevant is welcome.

[wasabi]

I have BUPA my only time using it was when I was bit by a monkey and needed a rabies vaccine. I went to Bumrungrad and BUPA paid up no problem. I have the highest level of insurance. I'm not sure about your friend's situation but I've certainly been shafted by insurance companies before.

[Sheryl]

Your friend has a valid case and should aggressively pursue it.

Start by checking the policy fine print to see if it spells out anywhere the procedure for an appeal.

If not, call them and ask to speak to the Financial Ombudsman Office.

If that fails, try contacting their parent company in the UK, although the appeal process will need to go through BUPA/Thailand they may be able to assist you in contacting the right person. Numbers below need the UK country code first:

The Customer Relations Department:

Phone: 0845 606 6726*

Lines open 8:30am to 5:30pm Mondays to Fridays. Calls to this number will be recorded and may be monitored.

Fax: 01784 893175

Financial Ombudsman Service:

South Quay Plaza

183 Marsh Wall

London

E14 9SR

Tel: 0845 080 1800

Good luck