A word of advice on health insurance

Ruapehu Bulletin, Volume 12, Issue 569, 17 January 1995, Page 11

A word of advice on health insurance

By Ani Waaka, Ministry of Consumer Affairs. Many people these days have health insurance either as protection against unforseen illness or to recover costs on medical/pharmaceutical charges. Whatever the reason, consumers should do some checking of their policies - either by reading it or by asking the salesperson - before they sign up with a health insurance company. There are few rules on insurance policies, basically the insurance company can offer any terms they wish to consumers and it is" up to the consumer to check all the offered terms and conditions and accept them only if they are suitable to their needs. In practice, there is no room to negotiate different terms than the ones offered and if you are unhappy

with any of the terms then you should consider 'shopping around' for a policy that suits you needs. There are many types of insurance policies for health care and consumers should seriously consider what their needs are before approaching an insurance company to take a policy. Some consumers may wish to pay a smaller premium for cover only in the event of needing surgery or hospitalisation, others may be prepared to pay a higher premium and have all their medical bills and pharmaceutical charges refunded. When considering health insurance, it pays to remember that all insurers will want to know of any previous illnesses or medical conditions that you have had in the past before they will consider the

risk of insuring you. You will be required to disclose all pre-existing medical conditions to the insurer. A pre-existing condition is any illness or medical condition that you have prior to taking out the policy. Any failure to disclose these conditions may result in the cancellation of your policy at a later date. Some insurers will accept pre-existing conditions as part of their policy - check with an insurance company that you are considering taking a policy with what their position is on pre-existing conditions Make sensible decisions about the type of cover you need. Some policies are so comprehensive that they will cover every possible health expense but will also be very expensive. What you really need

is a policy that is appropriate for the needs and likely needs of you and your family. Don't be sold a policy that has more features than you require ... it will only cost you more in the end. Check also if there are any restrictions, maximums or exceptions that you will need to know about before assessing whether or not the policy is a good one for you. . As with any contract you should read all the terms of the contract. If the policy refers to a 'master' policy that contains a full explanation of the terms, get that from the company and read through it. It may seem to be a long way to go about buying an insurance policy but it is well worth Please turn to Page 12

Health insurance

FROM PAGE 11 knowing exactly what you are or are not covered for. If you do end up having a dispute with your health insurance company, it is worth you while knowing in advance what structure the company has set up internally for dealing with disputes. This is another important question to ask when you shop around for the best policy to suit your needs. Any company that has an effective complaints handling procedure in place will have commitment to consumer services and may be worth considering as your health insurer. A good complaints handling procedure will allow consumers to take a claim to the Disputes Tribunal or through the Court system if the parties cannot agree to a satisfactory solution. If you have any problems, contact your local Citizens' Advice Bureau, Community Law Centre or ring me at the Advice Service of the Ministry of Consumer Affairs, tollfree on 04 473-4490.