Medical insurance - Disputed claim: ancillary costs

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Based on resolvers experience to date, if your insurer is refusing to pay for any ancillary costs relating to your claim you should check your policy small print carefully. Insurance providers have varying degrees of exclusions that you should check when taking out any medical insurance policy. You should contact the customer services of your insurance provider, and write giving clear details of your case - such as what happened, when, and why you are disputing the claim. You should make it clear that you do not believe that whatever you are claiming for falls within the exceptions to the policy, and ask your insurer to demonstrate how it does or otherwise to permit you to claim for your ancillary costs.

As a last resort you can contact the Ombudsman, which will act as a mediator in your case. resolver recommends that you submit your concern in writing, and resolver can assist you in submitting, recording and reminding you when and who to escalate to

Resolver can help you resolve this issue quickly, free of charge and without the hassle. We can also help you with the next step of writing your complaint. Click on the link below to create your email.
You should know
  • If you’re making a complaint about making an insurance claim rather than a mis-sold policy, check your documents to see who the “underwriter” is. You’ll need to make a complaint to that organisation.

If you cannot resolve your issue you cannot raise your case to the Ombudsman until 8 weeks after you have first raised your complaint with your provider, or you have received a ‘letter of deadlock’ from the company stating that they cannot resolve the issue as you have asked. Your complaint must also not be older than 9 months. For an accurate decision by the Ombudsman you should provide a detailed file of your communications and supporting documentation. In addition make sure you explain what you want as an outcome as this will help assess your case.

 

 

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