What do I do now?

I've just found out that my application for additional health insurance has been rejected, although they are happy to continue taking my money until January. It just seems so ridiculous. I barely drink, never smoked, do regular exercise though am bit overweight, and seem to be paying the penalty for being too honest on my forms. When I spoke to the company they apparently have no obligation to tell me why I was refused but will deign to phone me back on Monday. I'm blaming the BBC... when I was back in England I listened to a programme on Radio 4 about people suffering from failed insurance claims for not thinking something was important when completed their initial forms... hence my exagerrated health issues on my forms.

Just for closure's sake... I now have a letter telling me to ignore the rejection and that everything I asked for was ok and is covered. I think this is down to the insurace agent chasing them up as I'd got nowhere with the company. So the advice is obviously to persevere.

Does anyone know what agency or regulatory body to contact when your health insurance denies the request for supplemental insurance?

In our case, the insurance company, SWICA, simply sent a letter stating that supplemental insurance was denied. I want to know why, what their decision is based on, but more importantly I want to challenge their decision. I think they are denying the request for supplemental insurance based on wrong understanding of a pre-existing condition, certainly not one that will increase the risk of breaking a leg for example..

Thus far I found a pointer to a health insurance ombudsman, but I wanted to check if others have had experience with this, and know another / better option.

Many thanks

find insurancejenny here on the forum, I am sure she can help.
there are heaps and heaps of providers - can you shop around ?

They're not obligated to provide you supplemental insurance, nor an explanation why they reject you. The ombudsman can't help you in this regard. If you really want to know why you didn't get the insurance, better ask SWICA directly.

It is speculated that some insurers factor in the residence permit on their decision, but this is only hearsay. Maybe Jenny or somebody else can give you more details, if the permit or specific pre-existing conditions are important factors.

You seem to have answered your own question ! There's no need to exaggerate - just tell the truth.

I am flabbergasted, quite frankly. The Swiss tout being so democratic, and every issue is decided in a referendum (which you could interpret as the Swiss not trusting the people they elect, but that aside..). Yet they allow a health insurer to be this undemocratic?

It isn't per se the point that supplemental was denied. It is however the fact that they do not provide any explanation. Was it age? Religion? Race? I doubt those are factored into their decision, but the mere fact that they offer zero explanation does not help to take away such doubts...

The democratic aspect of contract law is that any two parties can make a contract if they agree, which was not the case with you and Swica. This is the standard law and not something that was crafted for supplemental health insurance.

I see the point that it's bad form to not explain the rejection but it's nothing more. Religion and race aren't collected on the forms, age is relevant for the insurer.

The OP, India, said he had exgerrated his previous health issues. What would be interesting to know is what the real situation was and what was said on the application. Just bad did he present it ?

The OP kind of explains it. Coming from the UK, there have been many scare stories where people had (in good faith) not declared minor issues such as a visit to the GP for blood tests for a minor ailment or the fact that a relative suffered from a condition which could be classed as hereditary.

This has coincided with a rise in the number of rejections of insurance payouts because these cases were omitted from the original application. Many, however, have been investigated by the ombudsman and overturned because they were deemed unfair and unreasonable. Unfortunately, the people involved have had to go through hell and high water to get this decision.

__________________
Don't sweat the petty things. Don't pet the sweaty things.

I looked at supplementary insurance when I wanted kids. They ask you to list all operations in the last 5 years, how much you drink and smoke, illnesses, weight and height and any issue you have seen a doctor about that isn't treated.

I didn't bother applying and paid to lower my franchaise/excess instead - a much better use of my money in my opinion.

I recently changed my insurance mid way through the year (on lowest deductible so apparently you can change whenever) I applied for 2 supplementary insurances extra and got them no problem (I am not a perfect specimen of health either! - and didn't lie on the forms)

I applied for semi private hospital cover also with the same company before I went with them for basic and supplementary insurances and they declined due to me having to declare a recent operation even though there was a conclusion to the operation and no further treatment needed - I mentioned this to my doc and he called up the insurance company and explained to them in better detail the case surrounding my op, soon after his phonecall to them I got a nice letter from them asking me to re submit my application and they would accept it. After they agreed to this I decided to go with them for all other insurances also.

FYI the insurance company is Concordia

Also I can highly recommend jenny on this forum to help out with insurance matters, she is extremely knowledgeable and helpful and tells you lots of things that you wouldn't normally know about insurance