Pricewatch: Readers’ queries

Consumer concerns this week relate to a VHI rule on vaccines, and changes to an Aer Lingus flight

Our reader was floored not by illness but trying to claim back for the expense of travel vaccines from VHI

Our reader was floored not by illness but trying to claim back for the expense of travel vaccines from VHI

Mon, Jan 27, 2014, 01:00


A reader called Tom was recently on honeymoon in southeast Asia. In preparation for his travels he was prescribed and given travel vaccines. He was floored, however, not by illness but trying to claim back for this expense from VHI.

“In early November I attended [a medical centre] where I first saw the doctor, who prescribed the vaccines. Then I went into the nurse to receive the vaccines. I went down to reception to pay for the services and was issued a receipt by the receptionist. On this day they were changing their computer system.

“The receipt for the vaccines happened to have the name of the nurse who had administered them, which is not the normal practice: it usually only contains the name of the vaccines received,” he writes.

When he submitted his claim to VHI, it refused to pay for the vaccines as they had been administered by a nurse – the terms and conditions state they must be administered by a doctor.

“I then rang the doctor’s surgery to ask them if this had occurred in the past, and they were clueless about this condition of VHI, stating that none of their patients had experienced similar difficulties in claiming for vaccines or medicines.”

He dug a little deeper into the terms and conditions, and he noticed that many of the medicines that are covered for payment must be administered by a doctor. This has raised two concerns for him.

“Many of the payments already made for medicines administered are not actually covered for payment, as they have been administered by a nurse, which is accepted practice within a doctor’s surgery or hospital. The anomaly with my receipt was the only reason that VHI got out of paying me compensation for my vaccines.

“With the vast majority of doctors’ surgeries employing a nurse, a very high percentage of payments made by VHI in compensation would have been made under invalid circumstances,” he says.

The second point is, he suggests, “much more important”. Insisting that a doctor administer all medicines “is a massive waste of doctors’ time. It is very much within VHI’s interest to have a more streamlined and cost-effective healthcare system. Instead they are promoting inefficiencies in an attempt to get around paying for someone’s medicines. It is also worth noting that any medicine received in hospital care is administered by a nurse. You would never expect to have doctors doing such tasks.”

He says that, in spite of a long argument with the company “on a number of occasions, I have received no justification for such a term to exist, or why more payments for medicines have been declined.

“I hope that you can air this issue and get a response from VHI detailing their reasons to insert such a clause. While I am not considering taking my business elsewhere, as my company pays for my medical insurance, I would certainly have moved by now if my situation was different.”

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