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How best to resolve errors/mistakes with Health Insurer's Income Continuance scheme??

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  • 08-10-2012 8:14pm
    #1
    ivorystraws
    Registered Users Posts: 251 ✭✭


    Hi,

    Just some quick questions on Permanent Health Insurance Income Continuance policy:
    1. If a member of a Permanent Health Insurance scheme wants to obtain a copy of the policy for that scheme and asks the scheme administrator for it, does that administrator have to get confirmation from the employer in order to issue the policy document?
    2. If an a member of an income continuance policy is supposed to have the payment indexed annually by 5% per during payment, yet it turns out that it hasn't been, is it the administrator of the scheme that's responsible and what's the best and quickest way to correct this?
    3. Shouldn't employee payslips reflect the scheme member benefits such as pension benefit during payment?
    4. If an employee income continuance (group) scheme pays out to an employee, doesn't the change in social welfare payments (i.e. decreased amounts in subsequent budgets) have to be taken into account? If so, when is it taken into account and re-calculated - once annually or as and when those social welfare changes are made?

    Thanks in advance for any helpful feedback or advice.
    Tagged:


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  • Options
    #2
    ivorystraws
    Registered Users Posts: 251 ✭✭ivorystraws


    I made some enquiries and did some digging and it's all positive for the scheme member.

    When the scenario I detailed happens to anyone and if the health insurer continues to ignore outstanding queries and serious concerns, just contact the public contact unit of Central Bank who advise that the best way to move forward with such issues is to keep everything in writing in order to have copies of everything and maintain the audit trail of communications between all parties involved.

    Then simply obtain the details of the financial broker or health insurer from their website in order to lodge a formal complaint with them and they have 5 working days to acknowledge that they have received my complaint.

    The financial broker/Health Insurer then have 20 working days to provide the complainant with the internal processes that they're going to use to investigate the complaint.

    Lastly, the financial broker/Health Insurer have 40 working days to issue the complainant with a final resolution.

    However, if the financial broker/Health Insurer financial do not adhere to those specified rules or if the complainant is not 100% satisfied with the details they provide, then you can escalate this issue to the Financial Ombudsman!

    A member of any health insurance policy is legally entitled to a copy of the policy for that scheme and if the Health Insurer/Broker ignores requests for it, see above steps because they obviously have something to hide or have a hidden agenda if they are that that ignorant/reluctant.

    If a policy is supposed to have the payment indexed annually by 5% per during payment, yet it turns out that it hasn't been, they are liable for all payments due, interest, compensation etc. A solicitor who specialises in employment law is extremely helpful here.

    Yes, employee payslips definitely should reflect the scheme member benefits such as pension benefit during payment (if that's what is part of the original health policy).

    Changes in variable payments such as social welfare payments (which are used to calculate the member benefit) certainly do have to be taken into account re-calculated annually.


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