Health insurance for children - companies unethical

Troy McClure

We just got a renewal notice for our 2 year old son from Laya. They changed his policy and are offering the new policy at half price €153, saying the old policy is no longer on the market. Fine you think.

There is a 'Product suitability statement' with the renewal saying this is the most suitable policy for him base on what he was on before.

However a whole raft of benefits have been removed. Basically anything that was out patient cover has been removed for starters. Doctors and out patient expenses are pretty much gone. Excess hugely increased. This for most parents is where they claim. Laya are taking the view that this would be a huge saver for them as a consequence I imagine.

When I called them I asked them why they are putting him on a policy that bares little comparison to what he was on. They said it was on special at half price. They have a policy that would be similiar but its almost €400. I asked them why they send out a product suitability statement then?, when clearly the product is unsuitable based on what we had him on. Why a like for like policy was not sent out as renewal? They even sent a document, documenting how great this new policy is. They just said people want to keep cost down. I said to them it's up to us to choose the policy and pick the price not them. I am guessing most people will just send this back with payment not realising they have 'slashed' their child's cover. If it was not on special there is only €80 of a difference in policy's, which is easily redeemable with outpatient expenses over a year.
So basically the Laya 'product suitability statement' for your child is drawn up on what they think you will pay, rather than your previous cover choice's, or your policy needs as previously directed by you.

I find this very sinister and underhand. They are trying to get my child onto a policy most suitable for them, where Doctors or any outpatient treatments will be removed. They did not list a couple of options for renewal only one, which in our view is completely unsuitable.

Parents be aware of such underhand tricks and be very careful renewing.

rainbowtrout

I was under the impression that with insurance policies that if you were on a policy that was no longer available that they could not force you off the policy. However if you chose to move to a new policy you wouldn't have the option of moving back to the old one anymore.

antoinolachtnai

It may be that the old policy was not viable for the insurer. You say it was possible to claim 80 euros every year in expenses. This was probably the problem. The insurer wasn't making enough profit to make it viable. In addition to the 80 euros the insurer has to pay the administration costs of dealing with your claim every year. That administration cost will easily be 20 or 30 percent of the claim for such a small claim and that has to be priced into the policy.

In general, insurance is better value for large claims. Policies with large excesses are good value for this reason. You are much less likely to claim, but on the other hand the insurance bill will be much lower.

You might be better using the money saved to build up a bit of a 'sinking fund' towards the family's health. This is why I would think that the insurer's decision is perfectly correct or at least defensible. If you don't like this option might be better options with other insurers too.

Troy McClure

antoinolachtnai wrote: »

It may be that the old policy was not viable for the insurer. You say it was possible to claim 80 euros every year in expenses. This was probably the problem. The insurer wasn't making enough profit to make it viable. In addition to the 80 euros the insurer has to pay the administration costs of dealing with your claim every year. That administration cost will easily be 20 or 30 percent of the claim for such a small claim and that has to be priced into the policy.

In general, insurance is better value for large claims. Policies with large excesses are good value for this reason. You are much less likely to claim, but on the other hand the insurance bill will be much lower.

You might be better using the money saved to build up a bit of a 'sinking fund' towards the family's health. This is why I would think that the insurer's decision is perfectly correct or at least defensible. If you don't like this option might be better options with other insurers too.

It is in theory possible to claim €80 Euro in out patients expenses, or more or less. This was the same for the period of years the policy was on the market also. This is not new news to them. They still have a policy that allows this, which I am guessing has got something to do with having to offer it.

Your missing my point however. The only policy offered to us is no where as good a policy we had previously been on. The 'Product suitability statement' suggests it's the next best thing and states it the most 'suitable' for our son.
Fact is they have a policy that is much closer to what our son was but didn't offer it. They are trying to get us onto a policy that has little out patient benefits. The lure is the special offer.
I am cynical about this because they didn't offer us a few options, or even 2 other options. The offered one and said' here take this' and btw it's on special so your lucky.
We choose the policy for our son last year and we will choose it this year. Why are they trying to do so and not taking us into account.

wmpdd3

I would make a formal complaint about their policy and see what their take on it is. This really should be the type of thing the ombudsman should be looking into.