Health Insurance Lifetime community rating - record of health insurance cover

[eggerb]

Has anybody figured out the process amongst health insurance companies to prove how long a member has had health insurance? I am asking this in the context of lifetime community rating and proof of previous cover when switching if you're over 34.

I've been insured since my early 20s so I'm not within the scope of the lifetime community rating rules but sometimes wonder if I will be asked to prove I have been insured since I was 35. When signing up for Laya Healthcare recently, I was asked for my previous insurer, membership number, dates, etc. There was an opportunity to provide details on only one company and one start date under the question 'When have you been insured since and with whom'. I provided an answer for this question that only covered 4 years of cover but a good few relevant years with other health insurers (since turning 35) were missing.

Is information relevant to lifetime community rating maintained by the insurance companies? If so, specifically, what information is held? Is there a means for me to confirm that the information held is correct so that I don't run the risk of losing the record of previous cover needed to avoid a loading under the lifetime community rating rules?

Any insight is appreciated!

 

[eggerb]

I asked the HIA does the consumer need to provide proof everytime they switch and if for example, a member switches when they are aged 75, would they need to provide potentially 40 years of records?

I also asked the HIA if there is there a regulatory requirement for an insurer to maintain these records of cover and what happens if an insurer leaves the market and the records they had while they operated in the Irish market.

I'm not very encouraged by the HIA's reply that there is a process that would remove the risk from the member to prove they had insurance so I suggest that everybody keeps these records carefully!

The HIA is saying ...

• You [the insured] do need to provide your full history of cover. I [HIA advisor] would recommend contacting your previous insurer, give them details of you name and address you lived in at the time to get your proof.
• the onus is on you [the insured] to keep records of your history, If have the documents saved and filed you don't need to continuously get the same documents again, Just present the new insurer with the documents that states the years you have been with them.
• Insurers by law need to keep your records for 20 years. So if you [the insured] do lose a document you can always contact them to get a new copy.

 

[Monbretia]

Well not exactly what you asked but when few years ago my grandson was booked in for a procedure his mother got a call the night before to say it was being cancelled by the hospital because health ins company couldn't confirm cover. Turned out that like most people they had switched cover a few times since he was born and one of the companies could find no record of him, think it was because of the takeovers/amalgamation or whatever went on some years back and therefore he in their opinion hadn't served the required waiting period.

Luckily I had in my files ( as I insured them both originally when he was born) physical letters from the missing company giving policy number etc. Since then I have always advised at the very least printing out an email or similar each year before switching to show previous cover!

 

[eggerb]

Well not exactly what you asked but when few years ago my grandson was booked in for a procedure his mother got a call the night before to say it was being cancelled by the hospital because health ins company couldn't confirm cover. Turned out that like most people they had switched cover a few times since he was born and one of the companies could find no record of him, think it was because of the takeovers/amalgamation or whatever went on some years back and therefore he in their opinion hadn't served the required waiting period.

Luckily I had in my files ( as I insured them both originally when he was born) physical letters from the missing company giving policy number etc. Since then I have always advised at the very least printing out an email or similar each year before switching to show previous cover!

Good call Monbretia - everybody would be well advised to keep a record proving cover for both the waiting periods and lifetime community rating.

The odd thing is HIA's advice that insurers only need to keep records for 20 years. Not having records older than 20 years, wouldn't affect waiting periods but it could easily affect lifetime community rating.

 

[misemoi]

I had an issue when changing a work policy due to a new role. It didn't occur to me to check and HR never asked for details so it was only when I looked at the details of my BIK that I noticed the loading was applied. Luckily I had some documents for my old policies and was able to track them down and get some confirmations over and get it dropped. The way companies are consolidating it does make sense to keep this documentation yourself. Though I assume now I can just provide the last one to show I had no loading and that should suffice for the next one? But I will be keeping my records in any case.

 

[charlie007]

I recently needed lifelong evidence of living in Ireland.
Despite the fact that I have not been with them for over 8 years, VHI were able to confirm my cover going back to 1984!
I was quite impressed!

 

[Dr Strangelove]

It really is daft that the state puts in place this elaborate risk equalisation system and in turn puts the full onus on the individual to provide proof of cover.

HIA really should be mandated with storing this information with access only for providers and individuals themselves.

 

[Monbretia]

I recently needed lifelong evidence of living in Ireland.
Despite the fact that I have not been with them for over 8 years, VHI were able to confirm my cover going back to 1984!
I was quite impressed!

See that would make perfect sense to me, VHI are the only real constant player in that market, all the others are newcomers as such either by being sold, amalgamated, taken over or whatever going back to BUPA. Every time there is a handover records have the opportunity to go missing!

 

[eggerb]

It really is daft that the state puts in place this elaborate risk equalisation system and in turn puts the full onus on the individual to provide proof of cover.

HIA really should be mandated with storing this information with access only for providers and individuals themselves.

Couldn't agree more; it's crazy. The older an older an individual gets the more records they need to keep and the more valuable those records are. The risk of not being able to prove cover or the overhead associated with trying to cover it would likely turn many prospective switchers off.

 

[Greenleaf]

Good call Monbretia - everybody would be well advised to keep a record proving cover for both the waiting periods and lifetime community rating.

The odd thing is HIA's advice that insurers only need to keep records for 20 years. Not having records older than 20 years, wouldn't affect waiting periods but it could easily affect lifetime community rating.

This is the reason I'm very reluctant to change health in surance companies.

 

[becky]

This is the reason I'm very reluctant to change health in surance companies.

It's something I hadn't thought about. I wonder would the insurance company give a letter stating no Community rate applied.

 

[becky]

It's something I hadn't thought about. I wonder would the insurance company give a letter stating no Community rate applied.

So I've just checked my VHI renewal and I was issued a Healthcare membership certificate. It outlines my Gross premium and Gross Premium after R.E (risk equalisation) Premium credit & discount. These 2 figures are the same in my case.

There is also a column called Gross Premium After Age At Entry Loading and a colume Age at Entry Loading, so this is your proof, like your car insurance NCB.

So if your changing providers, it might be worth saving or printing the renewal document.

I've found with changing car insurance I couldn't access the online portal after my policy lasped.

I save all car no claim bonus as each company have their own maximum years. I'll just start doing it for PHI.