newindxb

an odd rambling question....

how connected are the hospitals / insurance companies / etc?

the issue is someone went to a hospital and paid for treatment as they have no insurance. while there they were told they had a condition that is fully treatable but costly.

if they get insurance and be honest they'll not be covered, but if they lie and get insurance and go to a different hospital they will be covered.

so - the dilemma is if the original hospital had the patient's name and Dubai medical card details - is there anyway these records could be accessed by an insurance company even if the patient was to never return / have any contact whatsoever with the first hospital?

Yes I realise this is fraud.

Any thoughts on this one?

TA5

it's normally called 'pre-existing condition', no they will not pay for it

newindxb

that's what I am getting at - it's only pre-existing if it is known about. and the only people that know about it are hospital A.

If I don't tell any one, sign up for insurance and then go to hospital B it will be newly discovered and therefore covered....

The only fly in this cunning plan is if the insurance people can get the info out of hospital A even though they do not know I had been there...

Happiness

I've been in this situation. If hospital B make any reference on the insurance claim medical notes that it was pre existing (they may know this without even asking hospital A) your going to have to cough up the cash. It depends on how 'understanding' your doctor is, and how good you are at denying and lying that you had it before. Dates are the key issue when they come to write out the insurance notes. The dates when the condition started have to be AFTER you signed up for the insurance and doctors aren't stupid, if they see you had the condition previous, you are going to have to get on their right side.
I don't think that Dubai's medical records are that advanced that they are held on a national medical database, so I doubt hospital B will find out about treatment in Hospital A.

TA5

No, if it has the potential to be a previously existing condition, it will not be paid or, whether a hospital knows about it or not has no bearing.

You will in all likelihood have to answer a questionairre when applying for insurance asking if you have any possible conditions which will require future treatment. If you say 'no' and go for whatever you have, it will be classed as a pre existing condition and you will pay.

uk4uae

Also there is always the chance that the medical insurance co will ask you to undertake a medical and that may show up the illness. IMHO it is not worth lying IF it ever catches up with you I would not like to be on the wrong side of the law here in respect to fraud.

newindxb

Thanks all - the question of the pre-exisiting condition is the interesting part I guess.

The condition is hypertension (high blood pressure) which is a symptomless condition - you will only know you have it after a blood pressure reading has been taken. So, I guess technically it is pre exisiting - however it is 100% undetectable until a test has been taken.

So - for insurance if I had never had a blood pressure reading I would be unaware of this condition.

So if I go with insurance and deny the knowledge of the condition - the only way the insurance company can possibly question if it was pre exisiting is if they contact hospital A. Hospital A have my name and contact details, possiblly the UAE medical number.

So - assuming I never revisit hospital A, the question is - will insurance comapny be able to do a search for such information...

IndieG

Unless you have put in a claim from Hospital A to the insurance company and they have this on file - I don't see how the insurance company could get this information from hospital A. There is no intelligence sharing

The answer to your original question is therefore No.

uk4uae

No

TA5

No offense, but hypertension is easily remedied with diet change, weight loss, and exercise.