Private healthcare needs to understand why complaints figures are on the rise says Charter UK.

Sun 16th June 2013

An investigation into private healthcare by the Competition Commission has revealed complaints about Britain's leading health insurance companies have increased by 38 per cent over the past two years. 

Amongst the issues raised were unexpected bills for "excess" payments after routine operations, a limited choice of consultants and poor handling of claims when longstanding members fell ill. 

Complaints about Bupa, which accounts for nearly half of the health insurance industry, increased by 50 per cent over two years to 12,165, Aviva saw its complaints rise by 87 per cent to 3,544, while those relating to Prudential were up 36 per cent to 1,878. Only Axa PPP saw complaints fall. 

The Competition Commission said the industry was "characterised by a lack of information" for patients. However Paul Clark, CEO of Charter UK, says that unless "insurers want to risk being entangled in a new mis-selling crisis" it is imperative that they take steps to understand why complaints are on the rise. 

"Medical insurers such as Bupa and Aviva need to ask themselves why they're experiencing this surge in customer complaints and, more importantly, must take steps to identify the root cause of these problems," he says. 

"Bupa have claimed this recent spike in complaints may be the result of consumers becoming more willing to challenge insurers after the PPI mis-selling scandal in the banking sector, but that still doesn't explain where – and why – things are going wrong within the business itself. 

"Most of these complaints are actually the result of a failure to meet customers' expectations. This could be masking a larger problem, however, if it means that patients are purchasing products that they don't fully understand, either as the result of mis-selling or because of inadequate or confusing documentation. 

"The real problem could be either, or both of these things, but it is impossible to know without first determining the root cause. Either way, a trend is clearly developing here and medical insurers need to take action now in order to make sure that customers know exactly what they're buying. Otherwise, these insurers risk becoming entangled in a new mis-selling crisis."