Common Plan against the British health insurance fraud

Common Plan against the British health insurance fraud

The Spanish Government and private health service are joining forces against insurance fraud from British companies. ASPE (Alianza de la Sanidad Privada Española) placed a new complaint before the European Commission and together they take measures to prevent a burden to the Spanish healthcare system.

It is believed that up to 800 tourists a day are seeking medical treatment at private spanish hospitals only to find that their insurance doesn’t cover it. They then face a bill of thousands of euros in costs or have to go to a public hospital where their EHIC card will cover emergency treatment.

The Spanish Government has recognized the signs of possible fraud committed by several British insurance underwriters and has outlined a plan of action to resolve this situation. The fraud was reported by the Spanish Alliance of Private Health Care (ASPE), which warned last July that losses of up to 200 million euros in additional costs to the public health service in Spain were being produced.

After the complaint, the Ministries of Foreign Affairs, Health and Work met with ASPE on the 5th September and requested a report with data on the number of British tourists affected in 2019, the percentage of travellers rejected by their insurance underwriter and treated in the private health care and the economic cost these fraudulent practices have for private Spanish hospitals.

As a result of the meeting, the Exterior Minister promised to include information on the website and request the British Foreign Office to take similar measures, asking its citizens to review in detail the coverages under contract.

In addition, the Government has urged ASPE to address the Autonomous Communities to prevent private centres bearing the costs of this possible fraud and to install an Interterritorial Council of the Health System.

“The goal is to tackle a problem that is saturating the Spanish public health system with patients who, having paid a private policy, find that they are not covered by private hospitals and inevitably end up at public hospitals due to only having the cover that is already available from the EHIC”, explained a spokesperson from ASPE.

This “perverse” system of exploitation of resources “may put at risk the health of British tourists, saturating the public health system and adding unjustified economic and administrative burden to the private hospitals”, they pointed out.

Other measures

Another of the issues agreed with the representatives of Government has been the development of a questionnaire for English tourists to report their situation when they are refused private health care because their policy is effectively useless.  Once they have been duly completed and signed, it will be forwarded to the British consular network in Spain to keep an official record of fraud suffered.

In addition, ASPE lodged a new complaint to the watchdog group, Consumers and Gender Equality of the European Commission and will initiate new judicial actions through the European Directive on package travel.  This measure adds to the actions already set in motion by ASPE aimed at curbing the abuse and give support to affected patients. Private hospitals already provide complaint forms to those affected and urge them to continue the process of legally pursuing the insurance companies in the United Kingdom.

In addition, they will begin to offer affected patients a legal consultancy service with specialized knowledge in the field in the UK, to enable them to reclaim for the costs of health treatment or, at least, the original costs of the policy.

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