Two topics on this week’s show, a health insurance issue, and one about online gambling.
And here are my notes:
I contacted the VHI about this and am happy to say that they have resolved the matter to the
customer’s satisfaction. He should have got a call recently from VHI and will get his payment
Vhi cannot comment of the specific of an individual case .Most claims are settled in 5/6 days . The average time for processing a claim is 5 to 6days of receiving a fully completed claim form and the necessary supportingdocumentation. In cases where the medical information is incomplete we make everyeffort to follow up with the medical provider to gather this information on behalf ofour customer.What might cause certain claims to take longer to process?The main reason for a delay would be where we receive insufficient information tosupport the payment of the claim from the provider . Rather than reject the claimoutright we make every effort to follow up with the treating hospital or the consultantto get the information we require so that we can pay the claim . This can be a lengthyprocess but we do keep the customer informed so that they know the matter is beingpursued on their behalf with the provider.Is there a complaints procedure for customers who feel their claim is taking too long?Yes, we do have a complaints handling procedure in place and all complaints whetherverbal or written are handled efficiently , fairly and in accordance with the consumerprotection code.
VHI also placed great stress on the fact that only 2% of claims to them are refused.
Preexisting conditions may render a claim invalid. For example, some policies don’t cover
you for a preexisting condition for several years (5 to 10 depending on your age) after you
commence your cover. Policies also may not cover you for any illness at all for between 6
and 24 months after you sign up (again, this depends on age).
More generally, health insurance is subject to 3 main principles:
Open enrolment - insurance companies must accept anyone who wishes to join
Lifetime cover – once signed up, you can’t be kicked off a scheme
Community rating - all adults pay the same amount for the same benefits, unlike
motor or life insurance.
“Lifetime Community Rating” was brought in with the aim of spreading the overall cost of
insurance in order to pay for this principle of equality.
Pokerstars is owned by the Rational Group, who also operate a number of other major
gambling brands. Like many gambling sites, they are based in the Isle of Man.
I’ve searched in vain for a press office for Pokerstars or their parent company, but they don’t
strike me as a company who like to be contacted. I eventually found a press email address,
but they haven’t made any reply. They do have a sister company in Ireland, Full Tilt Poker,
and sponsor a poker event in Ireland in February 2016, so I may have another crack at getting
hold of them in the coming weeks and months.
The traditional position of the courts regarding gambling was that they’d have no part of it. So
if someone welshed on a bet, you couldn’t go to court to get him to pay up. The courts
believed gambling agreements to be immoral contracts, and wouldn’t enforce them.
In our listener’s case, it seems that the money was literally lost by the company, either
through an administrative error or through poor security which allowed someone else to hack
the account and steal the money. This is more like negligence than a gambling loss, so you
might have a case.
A problem is caused by the location of the website, though. The Isle of Man is a crown
dependency, which means that it is subject to the rule of the Queen of England, but is not a
part of the UK. This means that it is also not a part of the EU. The upshot of this is that it is
harder to sue people there. The EU has a system which makes it easier to sue people and
companies across borders. This isn’t available in respect of the Isle of Man.
People can and do pursue Isle of Man registered gambling sites in the Manx Courts. For
example, last year a Scottish punter won £24,000 on an accumulator, only to find that the
betting site 666Bet had its gambling license suspended just days later. The question for our
listener is whether the amount of money is worth the trouble of instructing a Manx solicitor.