Direct Insurance Claims

Re: Direct Insurance Claims

Ian Mostyn — Thu, 06 May 2010 14:20:19 GMT

I take it all back - looking at the E&L cheque, it has been damaged, looks like someone has tried to rub out a number so the bank wont accept it! Let's see how long it takes to reissue. E&L didn't seem surprised by the damage - happens a lot???

Ian

Re: Direct Insurance Claims

Niall Taylor — Sun, 02 May 2010 09:45:58 GMT

[quote user="Clive Ansell"]Credit where is it is due[/quote]

Niall

Re: Direct Insurance Claims

Ian Mostyn — Sat, 01 May 2010 19:49:59 GMT

Well, Penguins can fly. Turns out they just weren't flapping hard enough

http://news.bbc.co.uk/player/nol/newsid_7320000/newsid_7324100/7324112.stm?bw=bb&mp=wm&asb=1&news=1&bbcws=1

Ian

Re: Direct Insurance Claims

Clive Ansell — Sat, 01 May 2010 17:30:55 GMT

Credit where is it is due, maybe they have turned over a new leaf? - - - and if pigs run fast enough they eventually become airborne and can actually fly.

Re: Direct Insurance Claims

Niall Taylor — Sat, 01 May 2010 16:50:31 GMT

[quote user="Ian Mostyn"]

Normally my exact thoughts but they have just settled a claim in 17 days. Must be some kind of a record

Ian

[/quote]

Must have been a new boy who hasn't been through the induction process yet!

Niall

Re: Direct Insurance Claims

Laurence Webb — Sat, 01 May 2010 16:19:57 GMT

But the letter to the client excluding cover for all illnesses ever is already in the post too

Re: Direct Insurance Claims

Ian Mostyn — Sat, 01 May 2010 13:56:50 GMT

[quote user="Clive Ansell"]I would avoid E&L at all costs. I even advise clients to change insurers.[/quote]

Normally my exact thoughts but they have just settled a claim in 17 days. Must be some kind of a record

Ian

Re: Direct Insurance Claims

Hanna Bennett — Sat, 28 Nov 2009 20:01:07 GMT

daft question, but if the money is available on a credit card surely you just get them to pay and claim the money themselves? Our direct claims are restricted to Petplan and those individually judged cases where the client cannot afford to pay for the treatment up front but has insurance with another company. If you try and pre authorise the credit card like hotels do, the money must be available on the card. If you take the details in order to process payment at a later date if the insurance do not pay, again the money must be available on the card, or any effort to take payment will be refused surely.

We inform all new clients that we only do direct claims for Petplan as we are not allowed to discuss insurance claims with other providers without the clients consent. In the cases where the animal is insured and emergency treatment is required we will do direct claims on production of a current insurance schedule and claim form. Any non emergency treatment is not eligible for a direct claim.

Re: Direct Insurance Claims

Evelyn Barbour-Hill — Sat, 28 Nov 2009 19:16:29 GMT

[quote user="Utlendigur"]Not organised enough to get credit or debit card authorisation in case of non-payment though - are there special forms for this?[/quote]

I'm not quite sure, and I expect someone who really knows will be along shortly, but I think if you make an extra contract with your card processors and have a slightly different terminal, you can "reserve credit" as hotels always do nowadays. Could possibly be a good idea but it might cause a bit of resentment.

Re: Direct Insurance Claims

Utlendigur — Sat, 28 Nov 2009 14:17:15 GMT

Officially we don't do direct claims. Unofficially we do bend the rules but on a case by case basis. We do for longstanding clients although mostly these are the sort of "good" clients who pay at the time anyway. We will also consider it for cases where owners have taken out insurance because they know they wouldn't be able to afford a massive vet bill upfront (*), but we would only do this in clear cut cases eg RTA where there are no uncertainties over whether the condition was present before the policy was taken out, whether it's excluded for some reason etc. We ask them to pay the excess up front and ask to see proof of insurance. Not organised enough to get credit or debit card authorisation in case of non-payment though - are there special forms for this? And never ever do direct claims via E&L.

(*) We seem to be seeing more people doing this and it seems a shame to penalise clients who are trying to make provision to pay - especially compared to the large number who just dump the pet on the table, say the magic words "no money" and expect us to sort everything out for nothing

Re: Direct Insurance Claims

Rob Loxley — Sat, 28 Nov 2009 12:11:34 GMT

If you have a blanket no-'direct claims', then I bet lots of clients will just go elsewhere where vets will accommodate this.

Write some ground rules, give them to the client and stick to them (which companies, must bring in statement of insurance and claim form, must pay excess and any %/excluded items on discharge, written term that any outstanding amount is payable and any dispute is between the client and insurer, get a signature esp if taking card details for balance or they can dispute the transaction).

At the end of the day it's a balance between cash flow and potential problems for the practice, against a client being able to fund treatment and a client that is happy with a helpful/useful service.

By the by, a centre we refer to wont do direct claims for NFU (as well as the obvious E&L) - anyone had any issues with NFU?

For non-'direct claims', we will insist that the bill is settled in full before the claim is made, or that the client brings in a form for direct payment to us.

Re: Direct Insurance Claims

Glen McIntosh — Thu, 26 Nov 2009 11:06:07 GMT

I tend to follow Gillian's approach, but would try and avoid direct claims if at all possible, and if the client requests a direct claim, make it clear to them that we are doing them a significant favor, get them to fill out forms that also point out: that we are doing them a significant favor; that this is an exception to our usual practice policy; that they remain responsible for the account until paid in full; and that they give us permission to deal directly with the insurance company. In addition I would take copies of two forms of ID, copies of insurance policy documents and a significant deposit - at least the excess but would usually try for half the account. I think it is right to make a bit of an administrative song and dance when doing direct claims for clients, hell, you couldn't even take out a rental video without 2 forms of ID and a full credit score back in the day, and we are talking about hundreds or thousands of pounds in the case of direct claims.

These days I guess I take a fairly frank approach with clients in the consulting room when discussing credit and direct claims (which amount to the same thing) and explain that because of an unscrupulous few we are now no longer able to provide credit/do direct claims, do you or a family member have a credit card, sorry about all the forms that you have to fill in but this is what we need to do to do a direct claim/provide credit etc etc. Having the backup of standard forms, clearly outlined practice protocols and client handouts that detail the nitty gritty of the insurance claims process help immensely.

Of course all the forms and ID taking pretty much amount to not a lot more than showmanship but give the perception that we will follow through with debt collection procedures (which hard core fraudsters and debtors also realise are not much more than showmanship in practice) should the need arise.

In practice, the vast bulk of direct claims are paid out by the insurance company without much issue, but of course, from time to time, we still get bitten, and will follow through with debt collection procedures (for what they are worth) dispassionately. Those, fairly rare, cases where the direct claim cheque is cashed and used by the client tend to wind me up the most. In effect it is fraud, has anyone had any success attempting prosecution of these or do they fall under the category of small claims?

Re: Direct Insurance Claims

Hannah Wynne Richards — Thu, 26 Nov 2009 10:42:32 GMT

Do E&L expect us to biopsy every enlarged prostate ???? They'll probably complain then that we are doing a lot of unnecessary surgery !!!!!!

Wynne

Re: Direct Insurance Claims

Clive Ansell — Thu, 26 Nov 2009 10:30:57 GMT

I would avoid E&L at all costs. I even advise clients to change insurers.

I had a running with them a few years ago now. I treated an elderly ex police GSD that on presentation had prostatomegaly, pyrexia and haematuria, with Tardak and Marbocyl based on an initial diagnosis of prostatitis and/or PBH. The dog did not respond to first line treatment, and further investigation revealed prostatic carcinoma with pulmonary secondaries which resulted in euthanasia.

The insurers refused to pay out claiming that the treatment given was not accepted therapy for carcinoma, and that my "initial mis or missed diagnosis" was not their fault. They would not listen to reason from either the owner or myself. The owner, a policeman, took them to court and won his case.

Re: Direct Insurance Claims

Hannah Wynne Richards — Thu, 26 Nov 2009 09:56:09 GMT

I do direct claims, and don't have too many probs (nice lot of clients ) Until now I had had no dealings with E& L I'm now trying to get them to pay up, and am having endless silly queries-Gillian, I think my opinion of them will soon match yours !!!!

Wynne

Re: Direct Insurance Claims

Laurence Webb — Wed, 25 Nov 2009 23:41:09 GMT

[quote user="Gillian Mostyn"]

Having said that, we don't accept direct claims for E&L. No bloody chance!

[/quote]

Is that actually an insurance company or just a payment plan (not sure what it pays for though)

Re: Direct Insurance Claims

Laurence Webb — Wed, 25 Nov 2009 23:38:51 GMT

1) Don't do them

2) If you're going to do them then get pre-authorisation first.

3) If that's not possible due to time then get them to bring in evidence that the animal is actually insured, confirm with the insurance compant and get them to pay the excess before any treatment then...

4) Take their credit/debit card details and get them to sign a form with giving you authority to take the outstanding balance if the full amount isn't paid within a certain amount of time. As the time to taking the money comes closer it helps to focus their minds, especially for the client who doesn't bring a claim form in for 2 months. Doesn't stop them canceling the card or it being refused but every little helps.

5) Never allow payment of an insurance claim to be made to a client if they still owe you money. Send 2 claims off if required. Last month I spoke to a referral orthopaedic surgeon who is a really nice man so did a hip replacement on a dog, sent the claim off to refund the owner but hadn't actually been paid for the work done. The client had a brilliant result - dog's hip replaced PLUS a cheque for £2000 in the post. Client very happy, vet not (by the way this wasn't our client, just a story he told me)

Whatever you do you should make it clear that the insurance is a contract between the client and their insurer so any unpaid fees are owed by the client even if they 'thought' that they would be paid by their insurance company.

Re: Direct Insurance Claims

Gillian Mostyn — Wed, 25 Nov 2009 23:31:55 GMT

We have just taken on a full time practice administrator and the majority of her time is spent doing and chasing up insurance claims. We do accept direct claims but have had very similar problems to you. We have made a couple of rules - that people pay their full excess and also bring in a claim form at the start of treatment. It also helps to have a thorough conversation before you start about exactly how the insurance process works - as you say, people just don't know or understand the system. This seems to prevent a few problems but we also get very frustrating situations- including a client who was paid by the insurers but who is with-holding payment from us (for no good reason they have cared to tell us!) The biggest problem by far though is getting excesses, percentages and not-paid for items out of very long-standing insured conditions. The bills just get too complicated and the owners seem to forget they do have to pay it every year....especially when more than one condition is present. Nightmare!

I am of the opinion that people take out insurance because they can't afford expensive treatment - so making them pay the full amount seems contradictory to what I am telling them (that insurance will prevent unexpected big bills). And making the majority of clients suffer for the moronic few wouldn't be fair and may drop our insured client levels. So we tolerate it because of the benefits insurance brings.

Having said that, we don't accept direct claims for E&L. No bloody chance!