Insurers overrule consultants on best treatment for patients

Patients are being left in pain and having operations delayed or denied because insurers are overruling consultants’ decisions on treatment.

Policy holders with breast cancer, heart conditions, arthritis and knee problems are among those who have been unfairly denied procedures, The Times has found.

Analysis of Financial Ombudsman Service reports shows that complaints about private medical insurers have risen sharply.

Richard Packard, chairman of the Federation of Independent Practitioner Organisations, estimates that hundreds of patients a year are denied recommended treatments. “Consultants have reported that their expert decisions for the benefit of the patient are being overturned,” he said. “This is being done by insurance administrators at the end of a telephone. Some would seem to lack medical knowledge and [make] decisions based on computer algorithms, which can result in delayed treatment and patients suffering pain for longer than necessary.”

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Source: The Times, 18 November 2019