Reminder of Changes to Solutions T&C’s
Published: 28 Feb 2017
Back in October 2016, we communicated some enhancements to the Terms and Conditions of our Solutions policies.
These changes would have applied to your client’s renewals and new client policies written on or after 1 December 2016, so we thought we’d use this opportunity to remind you.
These changes were a demonstration of our commitment to clients in a forever evolving market. We constantly review our products to ensure they continue to meet your clients' needs, as well as being as clear and straightforward as possible
Changes to Solutions Terms & Conditions
Your clients saw the following changes to their terms and conditions. These key changes were implemented to bring us in line with the rest of the market and provide a more sustainable price in the future.
- Networks - we introduced a number of networks for diagnosis of, or treatment for specified medical conditions. A network is a specified group of facilities and/or specialists or other practitioners that are the only providers we recognise to provide the treatment required for a particular condition.
- Hospital charges - we no longer automatically recognise all NHS hospitals under Solutions policies. This means that if we don't have a network in place for your clients treatment and they want to use an NHS hospital, then they will need to check with us to ensure it is recognised.
- Consultation Fees - if your client has an eligible consultation with a specialist or other practitioner who is ‘fee approved’ then we will pay in full. However, if they have an eligible consultation with a specialist/practitioner who isn't fee approved, we will only pay up to the limits we pay our fee approved providers.
- Annual premium discounts - for Solutions 2-99 employee policy renewals after 1 January 2017, annual payers will no longer receive the annual payment discount of 5%.
View our Solutions Policy Update Flyer to read the full details of all the changes made - this can also be shared with your clients.
If your client's Solutions policy has an excess, it will now apply to physiotherapy received through our BacktoBetter service. If clients have an out-patient limit, this continues to be unaffected by physiotherapy received through BacktoBetter.
We also enhanced our claims journeys to make it easier for clients to claim.
Our BacktoBetter service should still be the first port of call for clients with musculoskeletal conditions with no need to contact their GP. However those who have already seen their GP or a specialist, and who suffer from specific musculoskeletal complaints, no longer need to go through the Telephone Clinical Assessment (TCA) and case management process.
This applies if:
- the member's GP has recommended osteopathy or chiropractic treatment, or
- the member's condition does not relate to their back or neck, and
- the member's GP has recommended radiology, pathology, or referral to a specialist.
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