The Spanish Private Healthcare Alliance (Alianza de la Sanidad Privada Española, ASPE), which brings together over 1,300 healthcare organisations and represents more than 80% of Spain’s private hospitals, has announced a plan consisting of 10 measures to tackle the possible systematic fraud committed by several British insurance firms, which act with impunity in the face of the passivity of the British and Spanish authorities.
The private medical healthcare business association has been reporting these possible fraudulent practices to the British authorities, the autonomous regional government, the Spanish central government and the European Commission for the past three years.
Some British companies sell travel insurance policies which take advantage of the cover offered by the British and Spanish state-provided healthcare systems through the European Health Insurance Card, and up until now no precautionary measures have been adopted against these companies despite the action taken by the ASPE.
As has been the case over the last few years, although more intensively during the summer months, thousands of British tourists will once again fall victim to these possible fraudulent practices when they purchase policies which include healthcare assistance cover but which, in reality, prevent them from accessing private hospitals and clinics.
Therefore, these companies are selling healthcare provided by public medical establishments, which is against the law, as they are offering healthcare British citizens are already entitled to and for which they bear none of the cost.
These British insurers, which are profiting from selling a service provided by the public healthcare system, are committing possible fraud against British travellers who believe their healthcare is covered at any healthcare centre. However, their policies require them to have a European Health Insurance Card so they can be transferred to the public system.
When they are informed of the situation, the tourists either assume the cost of the private medical service or consult their insurance company, which immediately refers them to public healthcare, alleging that the private healthcare service is deficient. This is completely untrue, given the high international standing of Spanish private medical healthcare. The real goal of these practices of attempting to discredit Spanish private medical healthcare is to avoid meeting their responsibilities as insurers.
This situation places the health of British travellers at serious risk. The insurer forces the private hospital to refer them to a public hospital as soon as possible, sometimes even in cases where a transfer compromises the patient’s health.
These practices mean high costs both for the Spanish national health system (the SNS), which must handle a greater volume of patients, including those who, in theory, have paid for private care, and for the British National Health Service (NHS) which must cover the cost of treatment at Spanish public healthcare facilities.
However, it is Spanish private medical healthcare which is most affected if the patients are treated or admitted. The private hospitals incur medical costs, which are very high on some occasions, which are borne neither by the patient nor by the insurer. In addition, the private facility is often unfairly requested to pay the cost of transferring the patient and any subsequent healthcare provided at the public hospital.
In 2016, the ASPE reported the irregularities detected in travel policy healthcare assistance to the competent British agency, the FCA, regarding the travel policies of up to 15 British companies: Travelinsurance4medical.co.uk, Insurefor.com, Ok To Travel, Insure Pink, Suretravel Citybond, Covered 2 Go, Good to Go, Alpha Travel, ERV Medi-Care, Leisurecare Multi-traveller X5, World First Traveller and Get Going Travel Insurance.
Reports filed with public organisations and other bodies
In 2016, ASPE began filing complaints at both regional and national level in Spain, in the UK and in Europe, to make the various authorities aware of these practices with regard to insurers registered with the British regulatory body. The ASPE reported the case to the European Commission, which referred the matter in Britain to the FCA (Financial Conduct Authority), although to date no information is available about any actions taken.
Likewise, in Spain neither the state authorities nor the authorities in up to six autonomous regions have acted in any way whatsoever. The Ministry of Foreign Affairs, the Ministry of Health and the Ministry of Economic Affairs–General Directorate of Insurance have been restrained in their response or have simply given no response at all. This has enabled these insurance firms to continue to act with impunity.
The association is asking for these abusive practices to be ended, practices which affect patients, public healthcare systems and private medical healthcare; it is calling for these insurance firms to provide consumers with clear information about the cover included in their travel insurance policies; it is calling for users to sign a specific document regarding the healthcare assistance service and is asking for clear information so that patients, if they decide to go to a private healthcare centre, know they have to bear the cost of the healthcare service.
Among other actions, the entity intends to demand precautionary measures from the British authorities against the unlawful enrichment achieved by these insurance firms, in addition to continuing to report this unprofessional behaviour to the relevant Spanish, British and European agencies.
The ASPE will call for the Spanish government to assume its responsibilities in view of the possible fraud affecting healthcare on Spanish territory. The association plans to inform the various Spanish, British and European political forces to analyse the matter and ask parliamentary questions. In addition, it will defend its image from the defamatory tactics used by these insurers with citizens of the United Kingdom and institutions and will make this situation known to as many British travellers as possible.
To this end, it has published a leaflet containing information, which it will distribute to the ASPE-member healthcare facilities in tourist areas to make affected patients aware of their rights and it has also launched a website – safetraveltospain.com – where more detailed information is available. In order to publicise the website, it has implemented a number of digital campaigns.
In addition, ASPE will look into legal measures to prevent the Spanish state authorities from passing the cost of transfers and/or medical treatment on to private healthcare.
ASPE also plans to participate in the International Travel & Health Insurance Conference (ITIC) in May 2020, in Windsor (Berkshire, England), and is organising explanatory meetings with the British and international insurance sector.