{"id":1,"date":"2013-07-31T13:20:08","date_gmt":"2013-07-31T13:20:08","guid":{"rendered":"http:\/\/davedub.co.uk\/davedub\/wordpress\/?p=1"},"modified":"2015-09-20T17:40:38","modified_gmt":"2015-09-20T10:40:38","slug":"william-russell-withhold-treatment","status":"publish","type":"post","link":"http:\/\/davedub.co.uk\/davedub\/wordpress\/william-russell-withhold-treatment\/","title":{"rendered":"william russell withhold pre-authorisation for essential medical treatment"},"content":{"rendered":"<p><img decoding=\"async\" src=\"http:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/4\/42\/Civil_War_Red_Tape_01_%28redeemed_CSA_bond_coupons%29.jpg\/800px-Civil_War_Red_Tape_01_%28redeemed_CSA_bond_coupons%29.jpg\" alt=\"civil war red tape\" width=100% \/><\/p>\n<h2>September 2015: Update<\/h2>\n<p>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 <a href=\"https:\/\/www.william-russell.com\/making-a-claim\/\">here<\/a>.<\/p>\n<h2>July 2013: red tape used to deny treatment for possible cancer<\/h2>\n<p>Today I went to hospital to have a possibly dangerous mole removed. I have what I thought was very good medical insurance &#8211; I&#8217;d never claimed before, but I had confidence in my insurers.<br \/>\nAfter 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&#8217;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.<br \/>\nIf you think that taking out comprehensive medical insurance specifically tailored for expats means you will automatically receive good medical care, read on&#8230;<\/p>\n<h3>background<\/h3>\n<p>I&#8217;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.<br \/>\nHaving taken legal advice before publishing this article, I&#8217;ve been advised not to mention specifics of money, but suffice to say, over the last few years, I&#8217;ve given William Russell roughly enough money to buy a brand new small car &#8211; a not insignificant sum. I&#8217;ve never made a medical (or any other) insurance claim before.<\/p>\n<h3>flash forwards<\/h3>\n<p>I find myself in Bangkok for a few days, and so decide to have a mole on my cheek looked at, as it&#8217;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.<br \/>\nAfter a doctor&#8217;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&#8217;s way out of my budget at the moment (I&#8217;m currently in the first year of a new business, and cash is a bit tight), and I certainly can&#8217;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).<\/p>\n<h3>obstacles<\/h3>\n<p>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&#8217;d be running the risk that I would end up paying my medical bills with my credit card. Not ideal.<br \/>\nI 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 &#8211; I&#8217;ve seen this working first hand. I also have a Canadian friend for whom pre-approval is a simple phone call. Just one.<br \/>\nBut for William Russell&#8217;s customers, things are not so civilised. I&#8217;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 &#8211; I can&#8217;t fault the lady I spoke to, she was as polite and helpful as she could be.<br \/>\nI 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 &#8211; or so I thought.<br \/>\nJust 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&#8217;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 &#8211; 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&#8230;<\/p>\n<p>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&#8217;re abroad. This, I&#8217;m told, is the same form used to request reimbursement after you pay for treatment. Let me give you an example question:<\/p>\n<div style=\"font-size: 0.95em; font-style: italic;\">&#8216;Have you ever suffered from any other medical condition or injury in the past?&#8217;<\/div>\n<div style=\"font-size: 0.95em; font-style: italic;\"><\/div>\n<div>I tick yes, as I&#8217;m sure most of us of us would. Now here&#8217;s the kicker:<\/div>\n<div><\/div>\n<div style=\"font-size: 0.95em; font-style: italic;\">&#8216;If YES please give full details including dates and the name and address of any doctors you have consulted.&#8217;<\/div>\n<div style=\"font-size: 0.95em; font-style: italic;\"><\/div>\n<div>So, I am expected to retain detailed medical records for the last forty-something years, ready for regurgitation on demand by William Russell? The form asked for details of every doctor I&#8217;d ever seen, in every country, complete with details of the doctor\u2019s specialisations!. Also required (and obviously not to hand) were consultation dates, address, exact descriptions of every 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! Yes, apparently I am supposed to remember all this on the spot in order to obtain pre-approval \u2013 and if I am unable they will not grant pre-approval for the treatment. Forgive my cynicism, but one could be forgiven for thinking they are trying to avoid giving pre-approval by insisting on questions that are practically impossible to answer. I&#8217;ve had many, many minor injuries and complaints over the years. I&#8217;ve seen more doctors than I can count \u2013 and I&#8217;m not even a particularly sickly or accident prone person! Of the four pages comprising the form, two pages are full of such questions. Needless to say, I couldn&#8217;t get my pre-approval and my operation had to be cancelled.<\/p>\n<\/div>\n<h3>my complaint<\/h3>\n<p>Let&#8217;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&#8217;s been designed to be impossible to fill out.<br \/>\nIf these questions are so important, why was I not asked them when I initially applied for the insurance? In fact, shouldn&#8217;t the answers to these questions have already been asked, as I&#8217;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&#8217;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.<\/p>\n<p>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 \u2013 I paid for a peace of mind that was not actually based in reality \u2013 I&#8217;m left feeling that they never intended to give me the help I both needed and paid for.<\/p>\n<p>On top of that, I&#8217;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&#8217;ve paid consultancy fees for nothing, not to mention the cost of all those phone calls to England.<\/p>\n<p>And I still have my mole.<\/p>\n<p>It&#8217;s just not cricket.<\/p>\n<p>Comments (below) welcome.<\/p>\n<div id=\"dd-appendix\">\n<h3>appendix &#8211; questions asked<\/h3>\n<p>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.<br \/>\nIt&#8217;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&#8217;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:<\/p>\n<div style=\"font-size: 0.95em; font-style: italic;\">\n<p>Have you ever suffered from or required any investigations, treatment or medical advice for skin conditions in the past (Yes \/ No checkboxes)<br \/>\nIf YES, please give full details including dates and the name and address of any doctors you have consulted:<\/p>\n<p>Please also detail the medication prescribed and the date first administered.<\/p>\n<p>Have you ever suffered from any other medical condition or injury in the past? (Yes \/ No checkboxes)<\/p>\n<p>If YES please give full details including dates and the name and address of any doctors you have consulted.<\/p>\n<p>Have you had any repeat prescriptions in the past? (Yes \/ No checkboxes)<br \/>\nIf YES, please give full details including dates and the name and address of the doctor(s) who prescribed the medication:<\/p>\n<p>Have you had any routine preventative health checks \/ test in the past (Yes \/ No checkboxes)<br \/>\nIf 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:<\/p>\n<p>Please list all doctors that you have consulted in the last five years, and their specialism:<\/p>\n<p>Name of Doctor<br \/>\nSpecialism<br \/>\nDate Consulted<br \/>\nReason Consulted<\/p>\n<p>Do you have any other insurance cover? (Yes \/ No checkboxes)<br \/>\nIf YES, please provide the full details of the insurance company and your policy number:<\/p>\n<p>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)<br \/>\nIf YES, please provide the full details of the insurance company and your policy number:<\/p>\n<p>Please provide details of any previous health insurance cover you have held:<br \/>\nName<br \/>\nAddress<br \/>\nPolicy Number<\/p>\n<p>PLEASE CONTINUE ON A SEPARATE PIECE OF PAPER IF NECESSARY<\/p>\n<\/div>\n<\/div>\n<h3>what do you think?<\/h3>\n<p>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?<\/p>\n<p>If these questions are pertinent to any and all claims, shouldn&#8217;t companies like William Russell ask these questions initially, when the insurance is taken out, and not after the customer has become a patient?<\/p>\n<p>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?<\/p>\n<p>I&#8217;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:<\/p>\n","protected":false},"excerpt":{"rendered":"<p>September 2015: Update William Russell recently contacted me to tell me that they have updated the pre-authorisation forms in response [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":448,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[16,2,43],"tags":[7,91,89,97,10,4,6,95,96,90,3],"class_list":["post-1","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","category-life","category-medical","tag-cancer","tag-case","tag-due-dilligence","tag-experience","tag-health-insurance","tag-medical-insurance","tag-pre-approval","tag-research","tag-review","tag-story","tag-william-russell"],"_links":{"self":[{"href":"http:\/\/davedub.co.uk\/davedub\/wordpress\/wp-json\/wp\/v2\/posts\/1","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/davedub.co.uk\/davedub\/wordpress\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/davedub.co.uk\/davedub\/wordpress\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/davedub.co.uk\/davedub\/wordpress\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"http:\/\/davedub.co.uk\/davedub\/wordpress\/wp-json\/wp\/v2\/comments?post=1"}],"version-history":[{"count":75,"href":"http:\/\/davedub.co.uk\/davedub\/wordpress\/wp-json\/wp\/v2\/posts\/1\/revisions"}],"predecessor-version":[{"id":790,"href":"http:\/\/davedub.co.uk\/davedub\/wordpress\/wp-json\/wp\/v2\/posts\/1\/revisions\/790"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/davedub.co.uk\/davedub\/wordpress\/wp-json\/wp\/v2\/media\/448"}],"wp:attachment":[{"href":"http:\/\/davedub.co.uk\/davedub\/wordpress\/wp-json\/wp\/v2\/media?parent=1"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/davedub.co.uk\/davedub\/wordpress\/wp-json\/wp\/v2\/categories?post=1"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/davedub.co.uk\/davedub\/wordpress\/wp-json\/wp\/v2\/tags?post=1"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}