We look at Rohan's complaint about his insurer insisting that he use a hospital 40 miles away, when there was one closer to his house.
Rohan was due to receive six fortnightly sessions of chemotherapy to treat cancer. The sessions were due to take two to three hours. The insurer said he needed to use a private hospital from their approved list. The nearest hospital was 40 miles away (a 50 to 60 minute drive in the car).
Rohan said it would be much easier to use a private hospital six miles down the road from where he lived.
How we helped
We looked into where Rohan lived and checked the distance between his home and the insurer’s hospital. We also checked whether the hospital nearby offered the treatment Rohan needed and asked him to get quotes for the treatment. We compared this to how much the insurer’s hospital would charge and saw it was only slightly more expensive than the insurer’s hospital. We talked to Rohan how he intended to get to the hospital and back. He told us he’d need to rely on friends and family for lifts but this was going to difficult because the insurer’s hospital was so far away. He explained it would be much easier to use the local hospital.
We explained to the insurer that we didn’t think it was fair for them to prevent Rohan from using his local hospital. There wasn’t much difference between the cost of treatment and it would involve Rohan making a two-hour trip round trip each time. This would make it difficult for him to make arrangements to get there, which didn’t seem reasonable in all the circumstances.