Archive for March 23rd, 2007
One night when I was a young student at University, I got pissed and ended up playing Rugby in the snow with a few mates who were a bit bigger than me. This led to a fall, an awkward one, and a dislocated right shoulder. A shoddy recovery programme meant it gave me problems for a few years, and I missed many months of football as a result. So, by my mid-twenties it appeared that surgery was my only option if I wanted to continue playing competitive sports.
I did not like that idea, and as I was covered by BUPA at work I visited a local physio who specialised in shoulder rehabilitation, and thanks to her, I have not had any further significant trouble with that shoulder.
Fast forward seven years.
“Hello Mr Angry, this is BUPA member services, how can we help you.”
“Hello, yes, I have a shoulder injury and have been given the name of a Orthapaedic Surgeon from my GP, but I need your approval to book the appointment.”
“I see, can you tell me exactly what you have done?”
“Sure, I dislocated my left shoulder whilst on holiday last week, it was treated abroad, but I have seen my GP this morning in order to get some physio treatment now I am back in the UK.”
“Just one moment”
[Cue annoying on-hold music]
“Err, Mr Angry, there is a restriction on your policy regarding shoulder injuries. I am afraid you aren’t covered.”
“Oh, hang on, I had to declare some treatment to my right shoulder a few years ago, this is my left shoulder and completely unrelated.”
“OK, let me check.”
[Cue further annoying on-hold music]
“Mr Angry, I’m afraid the restriction doesn’t mention which shoulder it was, it just says shoulder treatment.”
“But it is a different shoulder? How can that be restricted? If someone stuck a fork in my right eye, would I be screwed if someone stuck one in my left eye the year after? Apart from me being blind and that.”
“It’s fine if it’s unrelated, but the record here just says ’shoulder injuries’.”
“Well, the treatment was done through yourselves, whilst I was at my previous employer, you have it all on your records, look it up.”
“It would be much easier, and quicker for you, to get your GP to fax us confirming what your previous injury was, and how it is unrelated to the current one.”
And so I spoke to my GP, who I had seen about an hour earlier, and created yet more paperwork for an already overworked service, just because BUPA are such a bunch of cost avoiding shysters. I sometimes forget they are an Insurance company, not a medical one. Claiming from them is not disimilar to making an auto-insurance claim. If they can avoid paying, they will.
Has anyone else had similar trouble getting treatment for a condition they had deemed pre-existing?
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