In my work insurers are both a valued partner and also (sometimes) a barrier to things running smoothly. For the most part things run pretty well. I cam across a situation yesterday that shows that sometimes the insurer really does want things to work in their favour regardless of the situation.
Usually when there is a renewal on a case pending the insurer will auto renew the case (in other words renew it, take the first direct debit payment automatically and assume the individual or group is going to stay with them). However, yesterday I had a panicked call from a client letting me know that a member was claiming the following day (due for a procedure in a private hospital) and the claim had been declined.
It transpired the case was a 1st of April case that they hadn't received any renewal notification on (obviously hadn't opened my e-mail). Now, I'm guessing here, but the claim was set up on their system pre-renewal and I'm guessing the group didn't auto-renew because of this - interesting that when a payment is pending their auto system stops working.
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I appreciated your work very thanks
ReplyDeleteMultiple Sklerose Versicherung