September 2015: Update
William Russell recently contacted me to tell me that they have updated the pre-authorisation forms in response to this article. I have been sent a copy of the new form and it appears to be far more reasonable, comprising only two pages and specifically only asking questions related to the condition for which treatment is being sought, which is a HUGE improvement. I then asked for a copy of the claim form which they sent me, along with a link to a page that gives information on how to make a claim here.
July 2013: red tape used to deny treatment for possible cancer
Today I went to hospital to have a possibly dangerous mole removed. I have what I thought was very good medical insurance – I’d never claimed before, but I had confidence in my insurers.
After a wasted day accumulating ream upon ream of pointless bits of paper, I am no better off than I was this morning in terms of health, but I’ve had a day of frustration, disappointment and financial loss. If you, like me, have never claimed anything on your medical insurance, prepare for a shock.
If you think that taking out comprehensive medical insurance specifically tailored for expats means you will automatically receive good medical care, read on…
background
I’m a British businessman living abroad for the last five years or so. Like any sensible expat, I spend as much money as I can afford on decent health insurance. Five years ago, I did my research, both online and via word of mouth before finally choosing William Russell as my health insurance provider.
Having taken legal advice before publishing this article, I’ve been advised not to mention specifics of money, but suffice to say, over the last few years, I’ve given William Russell roughly enough money to buy a brand new small car – a not insignificant sum. I’ve never made a medical (or any other) insurance claim before.
flash forwards
I find myself in Bangkok for a few days, and so decide to have a mole on my cheek looked at, as it’s shape and colour have undergone changes recently. As you may or may not know, Bangkok is famous for providing relatively cheap, but very high grade medical services.
After a doctor’s appraisal at a good hospital (at my own cost), the doctor informs me that my mole is quite possibly cancerous, and definitely in need of immediate removal and testing. Coupled with treatment I also need for a cyst and a nasty case of tennis elbow, I obtain a quote for the surgery. It’s way out of my budget at the moment (I’m currently in the first year of a new business, and cash is a bit tight), and I certainly can’t afford any large credit card bills, so for the first time I contact William Russell for help (outpatient surgery is covered by my policy).
obstacles
I telephone William Russell in England and ask how to go about getting pre-approval for my treatment, as I know that without pre-approval I’d be running the risk that I would end up paying my medical bills with my credit card. Not ideal.
I should note at this point that I have a Japanese girlfriend who simply shows her medical insurance card at hospitals and gets treated with no hassle – I’ve seen this working first hand. I also have a Canadian friend for whom pre-approval is a simple phone call. Just one.
But for William Russell’s customers, things are not so civilised. I’m told by a very nice lady at William Russell that I need to get the doctor to fill out a form, which she duly faxes to me – I can’t fault the lady I spoke to, she was as polite and helpful as she could be.
I then see the doctor, we eventually get the form filled out and book the operation for tomorrow morning. Again, I pay the consultancy fees out of my own pocket, but I can accept that, as I can accept the need for the doctor to fill in the form with the details of the procedure. Fair enough, job done – or so I thought.
Just to be sure, I call William Russell again, updating them on the situation, and asking for confirmation that they will pay for the treatment, as I simply can’t afford to risk getting in debt right now. I have every detail of my condition and the treatment to hand except a final figure for the overall cost – at this stage, the hospital can only (and understandably) give an estimate. This is not good enough for William Russell, and besides, now they now have a second form for me to fill in…
Now this, dear readers, is where William Russell disgrace themselves. They will send you a form that is clearly designed to be next to impossible to fill out, even if you were back in the UK, let alone if you’re abroad. This, I’m told, is the same form used to request reimbursement after you pay for treatment. Let me give you an example question:
my complaint
Let’s not beat around the bush. At best, the form I was sent is clearly designed to put people off actually claiming. At worst, it’s been designed to be impossible to fill out.
If these questions are so important, why was I not asked them when I initially applied for the insurance? In fact, shouldn’t the answers to these questions have already been asked, as I’m sure they would have a direct effect on my premium? Something is more than fishy. Do these guys ever actually pay out? They certainly weren’t going to give me any sort of guarantee that they would hold up their side of the bargain. They obviously know that nobody can have access to all the information they suddenly require.
When I think of all the money I have given William Russell, all those years of not making a claim, I feel duped, ripped off – I paid for a peace of mind that was not actually based in reality – I’m left feeling that they never intended to give me the help I both needed and paid for.
On top of that, I’ve had half a day of my life wasted. Two doctors and a number of administrators at Bangkok Hospital have had their time wasted too. I’ve paid consultancy fees for nothing, not to mention the cost of all those phone calls to England.
And I still have my mole.
It’s just not cricket.
Comments (below) welcome.
appendix – questions asked
For completeness, here is a list of the questions that you can expect William Russell to fire at you before they will pre-approve or reimburse. Simply, if you cannot answer the questions, you are forced pay for your treatment yourself or to go without the treatment you need.
It’s ludicrously difficult to answer their questions without a full set of medical records obtained from every doctor you have ever seen, in every country, complete with details of the doctor’s specialisations, dates, address, exact descriptions of every little injury or illness, exact descriptions of any medicine prescribed, results from any tests taken and of course details of every medical insurance policy you have ever taken out! Hardly practical (or even the realistically possible) for people who live, work and travel abroad. This is a direct transcript taken from the form I was sent in Bangkok:
Have you ever suffered from or required any investigations, treatment or medical advice for skin conditions in the past (Yes / No checkboxes)
If YES, please give full details including dates and the name and address of any doctors you have consulted:
Please also detail the medication prescribed and the date first administered.
Have you ever suffered from any other medical condition or injury in the past? (Yes / No checkboxes)
If YES please give full details including dates and the name and address of any doctors you have consulted.
Have you had any repeat prescriptions in the past? (Yes / No checkboxes)
If YES, please give full details including dates and the name and address of the doctor(s) who prescribed the medication:
Have you had any routine preventative health checks / test in the past (Yes / No checkboxes)
If YES, please give full details including dates, the type of tests, the results and the name and address of the doctors who performed the tests:
Please list all doctors that you have consulted in the last five years, and their specialism:
Name of Doctor
Specialism
Date Consulted
Reason Consulted
Do you have any other insurance cover? (Yes / No checkboxes)
If YES, please provide the full details of the insurance company and your policy number:
Are you entitled to benefits under any state-funded medical care scheme and/or do you hold a European Health Insurance Card (EHIC)? (Yes / No checkboxes)
If YES, please provide the full details of the insurance company and your policy number:
Please provide details of any previous health insurance cover you have held:
Name
Address
Policy Number
PLEASE CONTINUE ON A SEPARATE PIECE OF PAPER IF NECESSARY
what do you think?
Have you had trouble getting pre-approval from William Russell? Or conversely, have you actually been reimbursed by them after paying for treatment and subsequently making a claim? Am I alone in feeling ripped off by William Russell?
If these questions are pertinent to any and all claims, shouldn’t companies like William Russell ask these questions initially, when the insurance is taken out, and not after the customer has become a patient?
Since (in my opinion) this form is clearly just a tool of obstruction, do you think that companies like William Russell should be forced to justify to an independent body such as the Financial Services Authority (FSA) as to why these questions are so necessary before authorising treatment, but not at all relevant at the time when the insurance is taken out?
I’m really interested to hear about your experiences and opinions, as I fully intend to push this issue much, much further. Please feel free to add your comments below:
Hi Dave
That’s disgraceful conduct from William Russell. So disgraceful I think that you must have got the wrong end of the stick. Will they definitely not pre-approve unless you can provide comprehensive answers to all of their questions? Those questions are staggeringly unrealistic and obstructive. How are you possibly to know what specialism a doctor has, for instance.
I’ve never had private health insurance, so can’t comment on other companies. What this episode will do though is make me ask some searching questions of any private health company I may look into getting insurance from. My new job actually offers it, and I was thinking of paying extra to get Callum on it, but wouldn’t consider it if any of the questions were like those from William Russell.
Like you said, why weren’t those questions asked when you signed up? Didn’t they receive an acceptable medical history before signing the contract and taking your money?
I don’t know the legalities of action against them, or of public campaigning (eg Facebook groups and pages; Twitter etc), but if you were to set up something, and maybe a petition, then I’d sign and do what I can.
All the best
Chris
ps You’re probably worried about the mole, and I’d be worried too. One thing I know though is that most of the biopsies of moles for cancer do return as benign.
@Chris – thanks for the comments. Sadly, no, I didn’t get the wrong end of the stick – on legal advice I’m not able to go into details, but I am still in negotiation with them, and I have still not had my treatment or any sort of guarantee that I will get it.
It’s actually quite frightening when you realise your health (and possibly even life) is in the hands of companies who’s principle concern seems to be in wriggling out of their obligations.
I’ve spent many, many hours over the last few days filling out forms, writing emails and generally having my time wasted. I’m quite convinced that at this point they must have spent more money paying people to communicate with me (read wasting my time) than if they’d just paid up fair and square in the first place.
It’s insanity!
Regarding Callum’s insurance, before spending a penny, I would strongly suggest asking to see the following documentation before proceeding:
Notification of treatment form
Pre-approval form
Claim for reimbursement form
I’d also ask if there are any further forms, as I’m not the whole way through the sordid process yet, there could be more nasty surprises in the pipeline for all I know.
Well, just about to sign up with those guys following a quote, but then as part of my due diligence i did a couple of Bing searches, and uncovered this. This all looks quite believable to me, having had a run in myself a few years ago with a 1 year travel insurance provider (forget name) who decided not to repair my snapped cruciate ligament following a motorbike accident. I will look elsewhere, thanks for your time in recording this… piss take.
Dave edwards
Glad I found your site, kept me from signing up with them. So, them not giving you that tiny surgery has cost them an extra small car!
wish you all the best with it!
Dutchman
Just read this as I was about to go ahead and sent the application form off after a decent quote. I like doing my own research! I’m glad I did, think I’ll be going with someone else.
Can anybody recommend good cover? I’m from the UK moving abroad to Saudi Arabia soon to work.
Many thanks to the original poster.
Ryan
I was about to buy their insurance plan in Hong Kong & this shows up in my research. Well, not any more!
Thanks for sharing!
I’ve used WR for 10 years. Have had pre-approval for surgery in Japan. And had countless visits to the doctor. I found it quite easy to get pre-approval and completed the forms as required. I don’t recall it being so difficult. Also I’ve had quite a few emergency hospitalization and all reimbursed easily. No issues duty them. Sorry for the trouble you have faced but from my experiences they have always honored my plan.
Hi Tokyo T,
Great to hear a good report, thank you for taking the time to reply. But can you tell me, did you manage to answer all the questions listed above on you pre-approval form? Could you really list every doctor you had ever seen, complete with dates, doctor’s specialisation and the names of any prescribed drugs for example?
Or were you sent a different form to the one described above?
– Davedub
Dear Readers
My family and I have been insured with William Russell for more than 20 years and I have to say that William Russell have always been professional and efficient in their response to claims, policy renewals and client servicing.
As a family we have always had fair treatment and a service I would always be happy to recommend to any one that is fit and healthy that needs a quality international medical policy. Why do I say this …… well because health insurance policies are designed for fit and healthy people without pre-existing medical conditions. Then when you suddenly fall sick or ill or have an accident you have the cover you need when you need it most. The transfer of risk relating to the medical bills becomes the potential liability of the insurance provider for insured medical bills and certain benefits.
As an independent financial advisor amongst other insurance providers we also recommend William Russell. We usually offer fully underwritten policies; these are the insurance policies that ask all these medical questions at the time of your application. Any pre-existing condition is then usually excluded unless specifically agreed by the underwriter at outset.
Yes it is true that your insurance company need to know what you are claiming for and how much it might cost and we all agree that this is only fair, however insurance companies do need to rule out pre-existing conditions; as the majority of insurance providers exclude pre-existing conditions. William Russell exclude pre-existing medical conditions…that means any claim for any pre-existing medical condition will be not be covered.
I cannot comment on your specific case as I was not the agent involved in your policy. In my experience insurance companies usually decline claims for the main reasons:
non payment of premiums
non disclosure of material information such as pre-existing medical conditions at the time of application
exclusion of pre-existing medical conditions
out of area of cover at the time of the claim
fraudulent claims
Have you been given a reason why your claim has been declined?
Paul Beale
GMS-Financial.Com
Hi Paul,
Thank you for taking the time to relate your experience. However, in the interests of giving my readers all the relevant information, I’d like to highlight the following:
1) Your question ‘Have you been given a reason why your claim has been declined’ demonstrates very clearly that you did not actually read my article – as I never actually made a claim. My entire complaint was based around the fact that the pre-approval forms supplied by Willaim Russell were literally impossbile to fill out – a fact that William Russell themselves have acknowledged by updating and simplifiying their claim forms.
2) The company you work for act as agents for Willam Russell – so you have a vested interest in making your comments.
3) I was never given the choice between a fully underwritten policy or a moratorium based one, despite querying the lack of required information at the time. Had I known the difference back then, I would have chosen the fully underwritten option.
However, this was the fault of the William Russell agent who sold me the policy, not that of William Russell directly, so I didn’t mention it here.
I thought long and hard about whether or not to approve your post. I decided to approve it so that my readers can bear witness to the tactics employed by the industry.
Dave
Thank you for sharing. I am looking for international health insurance for my family as well. Was with William Russel in the past (for around 10 years), never made a claim, will now move onto another insurance provider…
Hi Endy,
In fairness, William Russell have updated their pre-approval form as a result of this article. Yes, it took a couple of years, and yes, they only did it because of the bad publicity, but they did do the right thing in the end.
The times of these companies thinking they can prioritise their profits over our health are slowly coming to an end. Through social media we CAN apply pressure, and companies that have recognised this and made real changes (like WR hugely simplifying their pre-approval forms) do deserve a degree of recognition for doing so.
Better the devil you know is my policy – I personally am still with William Russell. I have still never made a claim. If they ever treat me unfairly again (i.e. obstruct me in the event I have to make a claim, deny treatment based on some technicality or come up with some tenuous ‘pre-existing condition’ excuse), I will make it my personal mission to make sure the entire Internet knows exactly what happened – with bold caps, graphic pictures and all the SEO expertise I can muster.
– Dave
Hi,
I have been healthcare adviser and intermediary (not WR yet) in Japan and now Asia and Europe for 13 years. I`m very sorry to hear your story which was a while ago. I hope you had everything sorted out by now.
Why am I here? I do my own due diligence when looking for partnership with new insurance companies. When I see a problem I go deeper and if my instinct says “hold on for a moment” I do.
I do because I care not about commission but about guys like you. It`s your health and maybe life and one cannot just push something that doesn`t work. It damages agent`s trust and reliability, but first of all may effect peoples` health.
I assume that everyone must have clear understanding and have good and honest explanation how insurance they consider to take works.
Sometimes it`s hard to talk about pre-existing condition as some people give up to have insurance all together. I`m adviser who build relationship, not a salesman. I would never mislead or lie to them for money. Sooner or later they would be disappointed at the time of claim.
I always advise to fill in FMU Application with full health disclosure. This makes clear at the very beginning what is and what is not excluded from the cover.
Sometimes clients become my good friends.
All of my clients have direct contact with me through various instant messengers, so they know that there is a guy with whom they can contact direct and receive answer instantly. Someone who is there for them when needed.
Besides, I prefer to partner with a few companies then whoever pays. I must be sure they do the job and I can stay as reliable person who advise on reliable insurers.
@Paul Beale you are very right about why underwriters may refuse to pay. Thanks for pointing it.
@Dave Dub – clients prefer to ask me to ask for pre-approval and I often help them. I call or send email to insurance provider. I have never needed to give any information except what treatment and details of hospital. Got replies within 12hrs
Good Luck and Stay Everyone Healthy
Took out insurance with William Russel one year ago based upon their table of yearly increments (related to one’s age band). Have now received invoice for renewal to find it is USD 700 over the figure provided in their table a year ago for exactly the same age band. Also we have made no claims since signing up a year ago.
I’d say it would be very much worth your while taking this issue up with them. Specifically, ask for the reason why the originally supplied yearly increments were so blatantly misleading.
Please feel free to post updates here, especially if they refuse to reduce your renewal to what they led you to believe when you signed up.
These companies need to understand we are living in the internet age and that their old ways of misleading and conning people simply do not fly in a world defined by internet transparency.
Dear Adam
Which insurance do you recommend on a similar range to Williams Russell?
Many thanks
Frank
Am sorry to say that in the context of this blog post, I do not feel it would be ethical of me to make a recommendation for your insurance provider.
I would say however, that William Russel are not unique in their modus operandi – from my own experience, all insurance companies will do their utmost to wriggle out of any claim. “It’s just business.” we’re told. “It’s in the small print.” “Nothing personal.”
Tell that to the guy who can’t get treatment after paying a small fortune for what turns out to be fake “peace of mind”.
The problem is endemic, and I don’t know what the answer is – over hundreds of years, brilliant minds have developed all these fantastic medical treatments for us all.
But in the end, it’s insurance companies profits (and the pharmaceutical industry’s horrendous over-charging) that will stand in the way of people actually receiving these treatments.
The entire medical industry is a repugnant farce.