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Jo C.
Jo C., Barrister
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Experience:  Over 5 years in practice
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I have a private health insurance with the same provider for

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I have a private health insurance with the same provider for more than 13 years. I have not used it or needed much until recently. i have alway paid monthly by direct debit. i moved in 2006 and wrote to the insurance with my new address and contact number. i have recieved correspondence from them to the new address over the last few years but there was no contat by phone. I recieved a document confirming that my insurance cover is valid from september 2014- september 2015 and in this document it give me a breake down of my monthly dd payments and says no action required as the money will be taken from my bank account. I needed an appointment with a doctor last month and passed my insuance details, subsequently i recieved an email from the doctor saying that I do not have an insurance cover.
I called the insurance in question and was told that they called and left a message, and then said they called and spoke to a colleague. I did not get a call. they also claim initially that they have send us 3 letters but I recieved none. today theu said they have send one letter only. when i was speaking and asked them what address they used they asked me to give my address and then they said that is the one they send the letter to. when asked about the telepohone number they gave us the house number and the mobile from the old property I moved from in 2006. they are now refusing to reinstate the insurance as they did not recive payment for 3 months but i was not made aware of it. we did change the bank account and it became clear that this was missed by the bank. the issue now is that when i joint the health insurance 13 years ago I was healthly and have no health issue so i did not need it. recently I was diagnosed with condition that will require an ongoing health care and any new insurance will not cover exisiting condition. this particular health insurence is known to get rid of costomers who are high maintanence!! i need to know if I have a case to argue?
Submitted: 2 years ago.
Category: Law
Expert:  Jo C. replied 2 years ago.
Hi.
Thank you for your question. My name is ***** ***** I will try to help with this.
Surely your bank statements would have shown that they weren't being paid?
Customer: replied 2 years ago.

we changed banks and we depended on recieving lettere telling us that the DD was cancelled and we have recieved these correspondence from elect boards etc but not from the insurance. unfortunatly , i am a doctor and have very hectic working hours and rarely look at my bank statements in details.

Customer: replied 2 years ago.

I have just finished work, I can be here waiting for up to an hour if needed so please tell me how long I needed to wait and if any possibility we could deal with it tomorrwo

Expert:  Jo C. replied 2 years ago.
Yes, I do realise that. I am realistic about the amount of time all of us spend examining our bank statements.
However, unfortunately, if they were not paid they were entitled to cancel. Come what may, it is for you to ensure payment goes through.
It would have been best practice of them to send out letters informing you of the default and perhaps even to call occasionally. You might think that is not too much to ask. However, the fact that they failed to do so does not mean that you have a challenge under the contract.
What you could do is complain to the Financial Ombudsman about them. That is not particularly quick but it is an option for you.
The only way this could be challenged really is if the default were their fault - for instance failing to collect rather than being unable to collect.
The only other thing I can think of is if you could argue that the condition developed when you were insured. Possibly that is clutching at straws but it is an option.
Sorry if that is bad news.
Can I clarify anything for you?
Jo
Customer: replied 2 years ago.

they have given us different informations, they said they written three letters then admitted they only did one. they failed to update thier records, they also failed to make me aware of the non payment when i contatced them last year. what could i say to the ombnesmen?

Expert:  Jo C. replied 2 years ago.
There is another issue and that is that clearly, they are in breach of contract and in breach of the provisions of the Supply of Goods and Services Act for failing to carry out the job (insurance) with reasonable care and skill.
On their own admission, they sent the notification of missing premiums to the wrong address.
However it is your duty to ensure that the premiums are paid and there is actually no absolute duty on the insurance company to chase you for them.
The reason the premiums were missed is that you changed banks and if you instructed the new bank to take over all the direct debits from the old bank and for some reason, this one was missed then you have a claim to make (perhaps to the Financial Ombudsman unless you want to instigate court proceedings), for the banks breach of contract and also breach of the same Act.
You are going to have to establish however whether it was the original bank that did not pass over all the direct debit details or whether it was the new bank that didn’t instigate it.
Jo C., Barrister
Category: Law
Satisfied Customers: 69983
Experience: Over 5 years in practice
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