Health clinic objects to conditions imposed by insurance agency
A private clinic has filed a judicial protest claiming that a company offering health insurance was behaving in a way that did not allow a level playing field by informing clients to choose only those clinics or hospitals forming part of its approved list.
St Edward's Clinic further claimed that, in its letter to clients, Bupa Malta Ltd, through Global Capital Health Insurance Agency Ltd, said that if they chose private clinics or hospitals not on the approved list they would only be reimbursed 80 per cent of the expenses incurred. The clinic said such behaviour was not conducive to a level playing field among competing clinics and hospitals.
St Edward's Clinic further complained that it was suffering as a result of the agreement struck by Bupa with the private hospitals and clinics in order to feature on the approved list. The clinic therefore called on Bupa Malta Ltd and Global Capital Health Insurance Agency Ltd to withdraw the directive to its clients and held them responsible for damages.
Lawyer Michael Tanti-Dougall signed the judicial protest.
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In Discussion
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Frank Portelli 2BFRANK
Aug 4th 2008, 16:20
A patient who has adequate insurance cover must be re imbursed in full by the insurance company.
BUPA (Malta ) has been selling policies as Hospital Policies - therefore they have to re imburse all local hospital costs.
If they do not reimburse in full they are in breach of their licence.
I would have expected the Office of Fair Trading and the Financial Services Authority to defend the Consumer.
I will certainly not be recommending BUPA to anyone in the future
Dr Frank Portelli MD FRCS(Ed)
Director St Philips Hospital
Leo Said
Aug 4th 2008, 11:19
Companies offering health insurance are, must be, profit centres. This necessity applies not only to health insurance companies in Malta. In other words, health insurance companies do have a prerogative to choose their business partners.
The website of St.Edward's Clinic carries a menu item "Services & Specialists". One can see there what services are offered by St. Edward's Clinic but one has neither access to further information nor access to the identity of the specialists.
Moreover, there is also no information about respective professional charges.
Prospective patients/clients/customers would definitely wish to have more information.