Medical insurance traps consumers

Some patients are waiting years for their private medical insurance to pay out, after being caught in injury blocks from insurance companies.

Many patients with private medical insurance are waiting up to four years for money to come through, according to PruHealth.

The insurer has revealed that many medical policies have clauses that allow insurers to avoid paying-out for several years, with patients requiring treatment having to wait extra time if claiming for a number of reasons.

PruHealth said the practice often takes place because policies are sold without customers undertaking a medical or declaring full medical history.

And to prevent people discovering a condition and applying for insurance, the companies put a two-year block on claims for treatment of any injuries that already existed in the five years previous to the policy being taken out.

Shaun Matisson, chief executive at PruHealth said this discourages people from taking out insurance when they know they need to make a claim immediately.

"But what most people don?t realise is that if they do need to see a doctor about a pre-existing problem during this two-year period the insurer will start the two-year exclusion all over again," Mr Matisson explained.

This means that if a person suffers from a shoulder injury for four years before signing-up for medical insurance and the problem gets worse, even 23 months after the contract was signed, then the insurer will not pay for treatment and will in fact extend the block on payment for another two-year period.

"It?s a sneaky way of reducing the insurer?s risk and penalises people unfairly at a time of acute need," Mr Matisson said.