Insurer deaf to offer of refund

By ELEANOR BLACK

Most phonecalls to Southern Cross Healthcare these days are from people trying to obtain money from the insurer, but one woman has been trying to give money back - also without luck.

Aucklander Victoria Jantke sent an obstetrics claim to the healthcare insurer late last year after having a baby, but was overpaid $1600.

She has contacted Southern Cross five times in an effort to return the money.

Three times no one answered the phone, and twice staff did not get back to her, despite promising to do so.

Now her patience has run out and she has invested the money in her young son's bank account until Southern Cross contacts her.

"I've sat on that telephone waiting for someone to answer for so long. I'm not prepared to do that [any more]. It's up to them now, even if they have got problems," she said.

Southern Cross has admitted it is four to six weeks behind in processing a pile-up of 50,000 claims from members and healthcare providers.

Chief executive Roger Bowie said last night that it was inappropriate to comment on individual cases.

'We are trying to fix the problem, but the priority is to get the claims backlog paid. That's our number one priority."

Mr Bowie admitted last week that the January 31 deadline for clearing the backlog would have to be extended to the end of next month.

An unusually high number of claims this month had compounded delays caused by the switch-over to a new computer system.



Mrs Jantke told the Herald that on her "Supercare" plan the maximum payout for obstetric claims was $300. She rang Southern Cross in late October, the day after receiving a cheque for $2183, which also covered several ultrasound examinations. Unable to get through to anyone, she left three messages over the next two weeks.

"They never rang back when I left a message. I actually said, 'you've overpaid me a lot of money'."

A fourth call was answered, but the woman who took her details and promised to investigate did not phone back. The last call reached a different claims worker, who said a letter of explanation would be sent in the next five weeks. It never arrived.

"I asked what do I do with the money in the interim. I said, 'What if I put it in a bank account?' She said, 'Do that, that's fine'."

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