BUPA WILL NOT PAY MY CLAIM

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Bupa Health Insurance
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Hanley1's review of Bupa Health Insurance

“BUPA WILL NOT PAY MY CLAIM”

★☆☆☆☆

written by Hanley1 on 31/01/2017

I have been a member of BUPA for over 40 years, myself and my family and my senior employees.
I asked BUPA for an authorisation code to go and see a cardiologist due to chest pains. They gave me an authorisation number.
I visited the cardiologist at 8am on Friday the 20th of January 2017 for a stress test. After 3 minutes the cardiologist stopped the treadmill as he saw a problem on the ECG. He spoke to his colleague who works with him and they decided I needed an angiogram immediately followed by surgery if necessary.
I was admitted to the cardiology unit at 10am, given an angiogram and told that they would need to insert a stent immediately into one of my arteries which was 99% blocked. I returned a few days later and they inserted another 4 stents due to blocked arteries.
I rang Bupa on 30th of January and they asked me for the codes of the procedures carried out. I gave them the codes and they said they would pay for the second procedure but not the first. I pointed out to BUPA that the situation was so serious and traumatic at the time that the last thing on my mind was ringing BUPA just before going into the operating theatre at such short notice. Surely they must realise that giving authorisation for a stress test has a good chance of developing into a major medical problem.
Next day they said they would pay nothing because the surgeon is not a BUPA doctor.
BUPA have taken tens of thousands from me over the years yet now refuse to pay a bill of £2,200. They are looking at every excuse not to pay a legitimate claim.
Quite simply I needed urgent surgery, I was insured, the procedure was carried out and now they will not pay. 

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Simonc72's Response to Hanley1's Review

Written on: 02/09/2017

Why would they pay, as an insurer, for treatment carried out by a consultant who isn't registered with Bupa? Sorry but you're wrong there I'm afraid. Hope you're feeling better.

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Jdubs's reply to Simonc72's Comment

Written on: 19/10/2017

We have used BUPA extensively over the past 9 years (many, many claims), even with a consultant who is not registered with them. We merely had to pay the difference between his fee and the BUPA approved amount. In two other cases, even though the consultant was/is not BUPA registered, they paid the fee as his fee was within BUPA's limits. They are expensive--but good.

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