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TAS Bupa and Misleading Private Health Fund?

Discussion in 'Insurance Law Forum' started by Rach.kennedy77, 14 October 2015.

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  1. Rach.kennedy77

    Rach.kennedy77 Active Member

    29 May 2015
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    My aunt purchased private health cover for her husband to cover the cost of knee replacement surgery x2. After several meetings, phone calls, email between my aunt and bupa they settled on a plan that they were assured would cover all the specific needs they had outlined.

    The surgeon was seen and booked for 11 Nov along with anesthetist only to be informed by bupa yesterday that the cover they took only covers the cost of a private doctor and even though they pay $254 a fortnight they still have to go on the public hospital waiting list which is approx 2 years.

    Is this fraudulent sales practice? They were on a waiting list at public hospital for 7 years and were getting close to the top but have been taken off the list due to the new circumstances, due to this they now seem to have no choice but to continue to pay bupa a ridiculous amount for the next 2 or 3 years until a bed becomes available or rejoin the public list.

    Any help would be appreciated
  2. JS79

    JS79 Well-Known Member

    2 October 2015
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    Does your Aunt still have copies of her insurance policy with Bupa?
    Does she have copies of the correspondence between Bupa and herself?

    Usually private health cover covers both the doctor and the hospital stay. If you gather the evidence that stated that she was covered (prior to purchasing) for the knee replacements and she has served her waiting time before the policy can be used for pre existing ailments then write a letter to BUPA asking them to review their decision and keep to what was agreed in the first place between your Aunt and them.

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