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I am self employed in the UK. My wife works for companies which give you a family health package while you work with them.

Now my wife changed jobs. Before she was with BUPA and now, via the company, with AXA. Now I need to go to the doctor (mole inspection), nothing expensive but AXA says this issue started before my wife had a contract with them and BUPA says she has cancelled her contract hence she cannot claim anything with them.

I am not sure how the rules are in the UK. I find it difficult to believe that you lose your coverage even though you have never had an insurance gap. Imagine hypothetically the doctor tells me that I have cancer.

What are the rules behind this very common situation. Has HR made a mistake and they actually should have gone with BUPA in our case?

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    As a practical solution, is visiting an NHS doctor an option?
    – JustAnotherCoder
    Commented Sep 12, 2019 at 11:19
  • @TomRevell I imagine the OP is going to visit an NHS doctor initially, but is wondering about cover for specialist referrals and treatment if the doctor finds something untoward.
    – Vicky
    Commented Sep 12, 2019 at 11:20
  • I don't think your wife's HR has "made a mistake" - the job package includes AXA cover and that is that. She might have been able to negotiate to stay with BUPA as a one-off (unlikely) or for the AXA cover not to exclude pre-existing conditions, but she would need to have done that before accepting the job offer, ideally.
    – Vicky
    Commented Sep 12, 2019 at 11:24
  • Could you include the relevant policy wording in your question? My own corporate AXA policy says "Your healthcare scheme pays for treatment of conditions that you were aware of or already had when you joined." and then goes on to talk about different pre-disclosure rules for different underwriting styles, but no doubt what's on offer depends on what your company paid for.
    – Ganesh Sittampalam ♦
    Commented Sep 12, 2019 at 12:20
  • @TomRevell. Viki read my mind correctly.
    – Penny Fox
    Commented Sep 12, 2019 at 12:51

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I'm not sure if there are any regulations or general principles that cover this case. It does seem unfair that if you had continuous coverage from two insurers, either of which would have covered it if held for the entire relevant period, that you end up being uncovered just because of the transition.

What you could try is a formal complaint to each of them followed by a referral to the Financial Ombudsman, making it clear that the two cases are linked and that you believe one or the other ought to be liable, or that they ought to resolve the liability between themselves.

It won't be very quick so won't necessarily help you immediately even if it does work at all.

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