Australian Unity Health Insurance sucks

A few notes on my recent experiences with Australian Unity Health Insurance – I could never recommend them after all the shit I’ve been through with them. So, here’s the story:

In September last year I was involved in a motor vehicle accident. The details aren’t relevant, except that I received multiple injuries, one of which required immediate hospitalisation and surgery. No worries, I thought, I’ve got private health insurance. Off to a private hospital with a good surgeon to get fixed up. Paid my excess and thought little more of it. As is often the case, I received a letter a few weeks after discharge asking me details of the accident. I gave them, and provided them with my lawyer’s contact details. Nothing more till about three months later, when I was preparing to go in for a second lot of surgery related to the accident.

On pre-admission talks with a lady from the hospital, she checked my excess and it turned out I had to pay one. This was a bit funny, seems as I’d paid one in September, and I’m not supposed to have to pay more than one excess a year. I mentioned that the surgery was related to a motor vehicle accident.

Suddenly her tone changed and I felt as though I’d turned into a leper with bad debts and no health insurance.

I was told that Australian Unity refuses to pay the hospital if it is a motor vehicle accident. Full stop. The hospital policy was that in these cases, they required full upfront payment of estimated hospital costs on admission, no exceptions. Apparently no other insurance company does this except Australian Unity.

So, with Australian Unity, if you have a motor vehicle accident, you effectively have no health insurance. At the time you need it most. This must be what it’s like to live in America.

It turns out that, about a month after I’d returned their questionairre after the first hospital stay, they sent my lawyer a letter. A letter, which when read by any reasonable person, would be interpreted as saying “we notice that this bill is related to a motor vehicle accident. if you receive any compensation, we expect that you’ll pay us back”. It turns out, however, after many heated discussions and explanations, that what it actually said was “we notice that this bill is related to a motor vehicle accident. We aren’t going to pay, so you sort out the bill, and if they refuse to pay, then provide us written evidence and we might process it”. Bear in mind that, the way it was written, this conclusion could only be reached after many careful re-reads by my lawyer, after someone from australian unity had summarised the meaning for him.

Right about the same time I was being told by the second hospital I’d have to pony up their estimate of $8000 on admission (this was a Friday, I was being admitted Monday morning) or else not get the surgery, I received a phone call from the first hospital. They were asking why it was I hadn’t paid the $14500 bill from my first stay in September, which was now very overdue. Not happy.

So, in the space of a day, I found out that I’d have to pay $8000 on admission to get my surgery done, and that I owed $14500 for my first hospital stay, which was overdue and ready to be sold to debt collectors.

If not for the pain, I would have laughed at Australian Unity’s hold music which extolled the benefits of being with Australian Unity Health, how you could skip the public health system and have private surgeons, when where and who you wanted, with no waiting or fuss.

I was at absolute breaking point at that stage. Thankfully, my lawyer stepped in and told me he would take care of it. And that he did! Sounded like an absolute shitfight, but he managed to sort out the first hospital bill and avoid me having a $14.5k debt sold off. Since I was admitted first thing Monday morning there was nothing he could do about the pre-payment of fees, but luckily we had the credit capacity to handle this. It did get sorted in the end, but god knows how much it cost me (it took him a couple of days to sort, and he charges $400 and hour…)

What just makes this whole episode so fucked up is that there is just no reason for Australian Unity to have been so difficult. They have a process whereby you sign an irrevocable indemnity, where basically you say that if you receive any compensation, then you’ll pay them first. It’s no big deal, and very standard in any sort of insurance. Think of your car insurance – if you have a crash and make a claim, they don’t tell you that they think someone else might be liable, so ask them for money first and come back if you don’t have any luck. You pay your excess, they sort it, then they chase after the other guy if they think he was at fault. Apparently every other health insurance company works this way too. Australian Unity, once an irrevocable indemnity is signed, works this way too, but it was an absolute shitfight to get them to give us one to sign. Add this to all the bumbling and ineptitude around regular claims, and I’ve just had so much trouble dealing with them.

Ultimately, health insurance is one of those things that “is there for when you need it most”, but with Australian Unity, it isn’t.