1Cover - requiring pre-payment / going hard on pre-existing conditions?

[LucyB70]

Looks like you didn't read the article.

I note that you signed up to AFF today and this is your first post (welcome by the way).

You wouldn't happen to work for 1Cover by any chance?

The article reports that employees of 1Cover took to social media to discredit the claimant:

'When a friend replied in support, they received a message from the 1Cover Travel Insurance Instagram account which said: “kindly refrain from commenting on situations you have very little insights on”.

“The initial post [made by Bennett-Stenton] is a far cry from reality, but that’s the joys of social media. Warm regards, Eva,” said another message.'

Your post feels eerily similar

 

[LucyB70]

Thanks for the welcome. No, I don’t work for 1Cover. I did read the article, but it seems to change every time I read it. Haha

The journalist must be finally fact checking.

How do you know that? That's not what the article says.
Why 2 days after the first operation did the was the hospital chasing 30k for that operation while the insurer agreed to pay 50k for the second operation? Couldn't they sort both out?


Looks like she tried to get the insurer's side but was hung up on.

Read the original article from the Age or SMH. It’s changed again, including the title.

 

[Lucy70]

How do you know that? That's not what the article says.
Why 2 days after the first operation did the was the hospital chasing 30k for that operation while the insurer agreed to pay 50k for the second operation? Couldn't they sort both out?


Looks like she tried to get the insurer's side but was hung up on.

 

[Rich]

Thanks for the welcome. No, I don’t work for 1Cover. I did read the article, but it seems to change every time I read it. Haha

The journalist must be finally fact checking.

Read the original article from the Age or SMH. It’s changed again, including the title.

I did read the original article before I read it here and yes it has changed, but the original version is quoted at the start if this thread and some facts are still disputed.
As I stated the journalist did try to get both sides if the story but 1Cover weren't interested. It seems they have something to say now they realise how diabolical their first efforts were on social media.

 

[levelnine]

On the grapevine, I heard that 1Cover had approved full and final costs prior to any knowledge of the article or it being published.

'On the grapevine' = email from your boss

 

[LucyB70]

'On the grapevine' = email from your boss

No, my frustrated boyfriend works there.

 

[LucyB70]

I kind of feel sorry for Lucy. Told to clean up Eva's mess and isn't doing a lot better. Came to the wrong place!

I didn’t mean to set up two accounts by the way. The login process wasn’t intuitive. I tried both Facebook and Google and both processes said they failed - but alas, I’m here.

 

[Quickstatus]

On the grapevine, I heard that 1Cover had approved full and final costs prior to any knowledge of the article or it being published. I

Thanks for this. I wonder which grapevine this is. It's not the Chardonnay variety, maybe it's the insider knowledge variety?

 

[LucyB70]

Happy to be banned. Yes, I do have insights into the truth but I don’t work at 1Cover.

The article is so far removed from reality and I can’t be bothered informing people that can’t see the obvious holes in the story:

Aussie guy has a medical emergency overseas and the insurer fits the bill. Full stop.

Bye bye.

 

[Rich]

Happy to be banned. Yes, I do have insights into the truth but I don’t work at 1Cover.

The article is so far removed from reality and I can’t be bothered informing people that can’t see the obvious holes in the story:

Aussie guy has a medical emergency overseas and the insurer fits the bill. Full stop.

Bye bye.

It's highly inappropriate for your boyfriend to be discussing the case with you and for you to be commenting here. You are not doing him or his employer any favours.

 

[Pushka]

Happy to be banned. Yes, I do have insights into the truth but I don’t work at 1Cover.

The article is so far removed from reality and I can’t be bothered informing people that can’t see the obvious holes in the story:

Aussie guy has a medical emergency overseas and the insurer fits the bill. Full stop.

Bye bye.

I guess the issue for me is whether he was required to pay $30,000 upfront before the insurance cover kicked in. I have skin the game as I've used 1cover for a trip to the US in September. I hope you are right that the insurance provided all funds and there were no immediate demands for payment from the hospital from him.

Can you confirm that?

 

[serfty]

Happy to be banned. Yes, I do have insights into the truth but I don’t work at 1Cover.

The article is so far removed from reality and I can’t be bothered informing people that can’t see the obvious holes in the story:

Aussie guy has a medical emergency overseas and the insurer fits the bill. Full stop.

Bye bye.

I guess the issue for me is whether he was required to pay $30,000 upfront before the insurance cover kicked in. I have skin the game as I've used 1cover for a trip to the US in September. I hope you are right that the insurance provided all funds and there were no immediate demands for payment from the hospital from him.

Can you confirm that?

Agree - what if the insured did not have sufficient funding available to cover the upfront costs that were charged?


Would there now be a "go fund me" to get the person back to Australia for their funeral?

 

[LucyB70]

Happy to be banned. Yes, I do have insights into the truth but I don’t work at 1Cover.

The article is so far removed from reality and I can’t be bothered informing people that can’t see the obvious holes in the story:

Aussie guy has a medical emergency overseas and the insurer fits the bill. Full stop.

Bye bye.

I guess the issue for me is whether he was required to pay $30,000 upfront before the insurance cover kicked in. I have skin the game as I've used 1cover for a trip to the US in September. I hope you are right that the insurance provided all funds and there were no immediate demands for payment from the hospital from him.

Can you confirm that?

As per the revised article, the title is no longer “insurance company leaves man $30,000 out-of-pocket” it’s now “hospital presented credit card machine e at his bedside”

And at the bottom the Age confirms he has pending charges on his card. ie, his card was never charged.

 

[Pushka]

As per the revised article, the title is no longer “insurance company leaves man $30,000 out-of-pocket” it’s now “hospital presented credit card machine e at his bedside”

And at the bottom the Age confirms he has pending charges on his card. ie, his card was never charged.

Thanks. So he was asked and needed to have that amount of credit available however it was never processed. So why didn't the Insurance company protect him from that.

I don't have that much of a limit on my card. It wouldn't process even as a pending charge and I'd be refused treatment then?

 

[LucyB70]

Thanks for the welcome. No, I don’t work for 1Cover. I did read the article, but it seems to change every time I read it. Haha

The journalist must be finally fact checking.

Read the original article from the Age or SMH. It’s changed again, including the title.

Hmmm the refusal to comment didn’t happen like that. Wasn’t quite like that.

Anyway, I’m struggling to navigate this site . Can someone tell me how to delete my accounts.

Thanks. So he was asked and needed to have that amount of credit available however it was never processed. So why didn't the Insurance company protect him from that.

I don't have that much of a limit on my card. It wouldn't process even as a pending charge and I'd be refused treatment then?

I bet the insurance company wasn’t asked for a guarantee of payment by the hospital at that point.

 

[Pushka]

Hmmm the refusal to comment didn’t happen like that. Wasn’t quite like that.

Anyway, I’m struggling to navigate this site . Can someone tell me how to delete my accounts.

I bet the insurance company wasn’t asked for a guarantee of payment by the hospital at that point.

So you would have expected the hospital, having known that Icover was involved by then having covered an earlier claim, should have approached the insurer and not the patient?

 

[Happy Dude]

There's a fair bit to unpack here given revelations in recent posts. Most concerning is the eerily similar implication of dishonesty levelled at the doctor at the centre of the story, both here and on Instagram by 1Cover, who refused the opportunity to provide "the correct" version of the details.

Post automatically merged: Yesterday at 10:36 AM

I guess the issue for me is whether he was required to pay $30,000 upfront before the insurance cover kicked in. I have skin the game as I've used 1cover for a trip to the US in September. I hope you are right that the insurance provided all funds and there were no immediate demands for payment from the hospital from him.

Can you confirm that?

 

[Quickstatus]

Aussie guy has a medical emergency overseas and the insurer fits the bill. Full stop.

Not so fast... Ill use the "full stop" later

So the story goes like this:
Patient goes to hospital - possible heart attack
Patient tells hospital they are covered by 1Cover
Hospital proceeds on this basis - 1st surgery whatever it is - we dont know
Hospital then comes to patient before 2nd surgery to get CC payment - why?

One scenario is that the 1Cover tells the hospital the patient is covered EXCEPT if it was a preexisting condition - a general statement which is correct.
Now an acute myocardial infarct (assuming that is what it is) could be due to a pre-existing condition such as coronary artery disease because it is a disease process that does not occur overnight. The problem is that the hospital does not know that the patient does not know about it, but it could be based on the findings of disease at surgery. (Remember a pre-existing condition, in insurance terms, is effectively only pre-existing if it is known to the patient at the time - in this case that he had coronary disease)
As a result, the second problem is the hospital then tries to get CC payment before 2nd surgery in case it is a pre-existing condition known to the patient

This is where i have major problems with insurers.
The time to litigate liability for medical costs is never at the patient's bedside unless it is CLEAR that the condition being treated is an excluded condition, or a pre-existing condition - especially when it is an emergency situation.. If it is a grey area such a this then the situation should ALWAYS be intepreted in light most favourable to the patient.

If the above scenario is correct then 1Cover does not have clean hands IMO. When it does not have incontrovertible information of a pre-existing condition or an excluded condition, 1cover should simply have said- "the patient is covered full stop"

Additionally, 1Cover inserting itself into the patient's or family's social media is EXTREMELY poor form. If a doctor does similar like that in Australia they would very likely be hauled up before AHPRA/medical board.