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Health Insurance payouts

  • 11-12-2017 2:16pm
    #1
    daveyjoe
    Registered Users, Registered Users 2 Posts: 1,464 ✭✭✭


    Went to a private hospital a few months ago and ended up costing €500. I had health insurance at the time but I was still within the 6 month initial period so I don't think I could use my health insurance for it but I explained the situation and asked them to try it anyway and they did.

    I got a letter a few months ago saying that the health insurer had successfully paid €360 for my claim. Great news but I haven't been paid anything into my bank account (2 months later). Did the €360 go directly to the hospital rather than to me (since they submitted the claim on my behalf) and I have to contact the hospital to claim it?

    I would usually contact my health insurer to ask but because I was within the initial six month period and I don't want them to realise that they made a mistake and not pay out on the claim.


Comments

  • #2
    muminpajamas
    Registered Users, Registered Users 2 Posts: 45 ✭muminpajamas


    daveyjoe wrote: »
    Went to a private hospital a few months ago and ended up costing €500. I had health insurance at the time but I was still within the 6 month initial period so I don't think I could use my health insurance for it but I explained the situation and asked them to try it anyway and they did.

    I got a letter a few months ago saying that the health insurer had successfully paid €360 for my claim. Great news but I haven't been paid anything into my bank account (2 months later). Did the €360 go directly to the hospital rather than to me (since they submitted the claim on my behalf) and I have to contact the hospital to claim it?

    I would usually contact my health insurer to ask but because I was within the initial six month period and I don't want them to realise that they made a mistake and not pay out on the claim.

    Did you login and check your account online for the claims history? If you didn't pay anything up front it will most likely go straight to the hospital in the former of direct settlement (depending on the procedure) but you should be able to see it is marked "paid" regardless. It really depends what you paid up front to the hospital if you are expecting a refund.


  • #3
    daveyjoe
    Registered Users, Registered Users 2 Posts: 1,464 ✭✭✭daveyjoe


    muminpajamas wrote: »
    Did you login and check your account online for the claims history? If you didn't pay anything up front it will most likely go straight to the hospital in the former of direct settlement (depending on the procedure) but you should be able to see it is marked "paid" regardless. It really depends what you paid up front to the hospital if you are expecting a refund.

    I paid €500 up front to the hospital, this was the full cost without health insurance. They put a health insurance claim through anyway. I've attached an excerpt of the letter. The 'Payee' in the table is the hospital. Does this mean I should contact the hospital for a refund.


  • #4
    muminpajamas
    Registered Users, Registered Users 2 Posts: 45 ✭muminpajamas


    Yes, I would start by contacting the hospital to see if you can get a refund from them as it appears they have been paid twice. You may want to send an e-mail though, so it is all set out in writing, so there is no confusion later on, about what they said about the claim. I have found errors before in my health insurance claims (not in my favour) and just asked them to review and got it sorted. Dealing with the hospital complicates things but do persevere.


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