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Frequently Asked Questions

Before you consider taking health insurance, here are some questions to ask yourself before choosing a policy.

Q: What kind of hospital cover do I want?

A: Most products concentrate on in-patient and day-patient benefits, although some also offer substantial out-patient benefits. It might be advisable to concentrate on the core benefits of in-patient and day-patient treatment when choosing between products.

Q: Which benefits would be of most value to me?

A: There may be elements of your lifestyle or you may have plans for the future which would make some benefits more attractive to you than others. For example, you may need regular physiotherapy or you might be planning to have a baby, in which cases out-patient cover and maternity cover might be of particular interest to you.

Q: How much could I benefit?

A: Sometimes it can be difficult to gauge the value that a benefit can provide, especially when it involves excesses, allowable amounts and maximum claim amounts. It might be useful to consider how often you would expect to make a claim under a particular benefit and work out whether it makes financial sense to opt for this benefit in your policy, based on the number of times you would claim.

Q: How much risk am I willing to accept?

A: Sometimes private health insurance contracts include an excess. If you are willing to take on the risk of paying part of the cost, choosing a policy with an excess can result in a lower premium. If you are not willing to accept this risk you can choose a product without an excess. In another scenario, you may choose a policy with no significant out-patient benefits, thereby taking the risk that you will not require an unusual amount of visits to say, your GP or physiotherapist, but allowing you to pay a lower premium.

Q: Which product offers the best value for my circumstances?

A: After considering all of the above, as well as any other factors you feel are relevant, you should look at all the products that you consider are suitable for your circumstances. You should then consider the differences between the products and decide whether the differences in benefits provided are worth the differences in premium. Consider the health insurance needs of all the family individually-consider different plans and levels of cover for each.

Q: How to make a complaint

A: If you wish to make a complaint about your private health insurer, you should first discuss it directly with your insurer. If you are unable to resolve your complaint, you may contact the Financial Services Ombudsman. The decision of the Financial Services Ombudsman is binding on all parties but when one party is dissatisfied with the decision, it may be appealed to the High Court. You also have a right of access to the courts in respect of disputes with insurers.