Dear Editor,

I wish to call attention to an state of affairs that has been ongoing for some length of time. I am referring to the dismally slow reimbursement of medical claims by the insurance company with whom Public Servants of Anguilla are insured.

In cases where private medical practitioners do not accept insurance, the seeker of medical care must pay all costs up front. (In many instances, private care is the only option available, as there are few specialists operating in the Health Authority.) In most cases, this is a considerable sum of money. It is then the onus of the insured to submit a claim to the insurance company, who then reviews the claim and issues the appropriate reimbursement to the claimant. This procedure in and of itself I have no fault with. However, when the insurance company takes three months or longer to issue reimbursement, then there is a real problem. I know of no business that allows a customer three months to pay a debt – not Anglec, not Cable and Wireless, not any restaurant. Imagine telling a grocery clerk that you will pay for your items on some as yet to be determined date! Certainly, however, if one were three months delinquent in paying one’s insurance premiums, one can be assured that one’s policy will be cancelled.

Why then, does this insurance company operate (and has operated for some time) in such a manner? It is unconscionable that an insurance company withholds funds for reasons such as poor staffing and a large backlog, which is what has been cited to me as the reason for the delay. This was told to me a year ago and continues to be told to me today. Claims that I submitted the beginning of June have not been reimbursed to me as of the beginning of September.

In these difficult economic times it is burden enough to have to come up with funds to pay for necessary health care. Unfortunately, the Health Authority does not provide specialists such as orthopaedics, cardiology, or even ophthalmology. Nor does it provide for many common screening and diagnostic tests such as mammograms and endoscopy. Persons needing specialized treatment are forced to either go overseas or seek attention at private facilities at considerable cost. I know I am not alone in having to choose between seeking health care and providing for my children. The excessive length of time it takes for reimbursement has certainly prohibited me, and many others, from obtaining needed health care. Apparently, the truism of an ounce of prevention is worth a pound of cure is not a policy this company subscribes to.

Sadly, there seems to be no one to intervene and require timely reimbursements. Sadly, my health deteriorates because I cannot afford to put forth hundreds or thousands of dollars for care and treatment with no assurance that I will be reimbursed in the foreseeable future. Isn’t that what insurance is for?

Name withheld at writer’s request

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