Latest News
Barrister takes health insurer to court over refusal to pay for ADHD diagnosis
A Waikato barrister is taking Southern Cross Health Insurance (SCHI) to the disputes tribunal after it refused pay out $1000 for his ADHD assessment.
The lawyer, who doesn’t want to be identified as someone with ADHD, had health insurance which included cover for psychiatrist consultations.
He booked a consultation with Psychiatry NZ, which provides consultations by telehealth.
The assessment was done by a doctor at the practice who was in training to become a psychiatrist. RNZ has agreed not to name him.
But, he was supervised by Dr Han Chung Lim, a registered psychiatrist, who then signed off on the assessment.
Despite this, Southern Cross declined the claim because the assessment was not done by a registered psychiatrist. Instead it categorised the consult as a GP visit, and paid $65 for the hour-and-a-half long, $1000 appointment.
“If I had gone to my GP, and they had done this, the cost would be much lower, and would be appropriate for SCHI to apportion it this way,” the barrister said. “My GP did not offer this service.”
GPs have recently gained the ability to conduct ADHD assessments – but the doctor who performed the assessed was not technically a GP, either.
The Medical Council’s register lists them as having a “general scope of practice” which is not the same as being a GP.
“General practice is a specialty area of practice,” it said. “Doctors registered in the general scope of practice can work in any area of medicine. They are required to participate in an approved recertification programme to assist them in maintaining their competence.”
The barrister told RNZ it wasn’t about the money – rather, he thought Southern Cross had denied the claim in bad faith.
“Working as a criminal barrister, I see the significant impact the lack of access to affordable, and timely psychiatry care has on my clients, particularly those remanded in custody and sentenced prisoners,” he said.
“The benefit for me, as someone very privileged, to have access to psychiatry care has been life changing. SCHI’s approach limits, rather than improves access across the board.”
If his case was successful, he intended to donate the money to ADHD NZ.
Supplied / Southern Cross
Southern Cross Health Insurance chief sales and marketing officer, Regan Savage, told RNZ in a statement the policy only provided cover for psychiatrist consultations with vocationally registered psychiatrists.
“The member was informed of the policy terms and extent of cover before undertaking the assessment but chose to proceed with receiving the service from a GP.
“In this case, the provider was not registered as a psychiatrist, so the claim did not meet the benefit criteria.”
Savage said it was important that Southern Cross applied policy terms consistently for all members to promote fairness. “The policy terms are clear that, for specialist benefits such as psychiatrist consultations, providers must hold the relevant vocational registration.”
The company regularly reviewed products and policy settings to make sure they remained appropriate for members and sustainable over time, but “we are not currently considering changes to enable cover for GP consultations under the psychiatrist consultations benefit”.
Dr Lim from Psychiatry NZ said his doctors had been providing telehealth assessments for ADHD under his supervision for the past two to three years.
He said they always advised people to get pre-approval, or check with their insurer that the appointment would be covered, at the time of booking, as they knew some insurers would refuse cover.
rnz
The chief executive of the Parliamentary Service is confident there will be enough room to accommodate the increased number of MPs and their staff coming into Parliament.
On current numbers, up to 131 MPs could be sitting in the Chamber following the election, brought on by a record overhang result.
Clerk of the House of Representatives Dr David Wilson told the Spinoff that currently the debating chamber had enough chairs to seat 124 MPs – including the Speaker of the House – and work was being done to accommodate more by altering the seating arrangement.
In a statement, Parliamentary Service chief executive Rafael Gonzalez-Montero said planning for a larger Parliament had been going for “some time”.
“Now that the election results have confirmed an increase to the number of members we are looking at several options.
“We are confident we will be able to accommodate all members within the Chamber.”
VNP / Phil Smith
Gonzalez-Montero said office accommodation for members and their staff would be “stretched” for a short time, but the new Members’ Building was only a few months away from “practical completion”.
That building – located behind Parliament – was due to be ready to occupy in April next year and had capacity to accommodate around 30 backbench MPs.
“All members should be in fit-for-purpose accommodation from that point,” Gonzalez-Montero said.
Following the 2023 election, 123 MPs sat in the Chamber – a record number at the time. That decreased to 122 following the resignation of National MP Judith Collins.
Collins held the seat of Papakura and stepped down in May and Parliament voted against holding a by-election because it was too close to the election.
The election result also meant high-ranking National Party MPs like Chris Bishop, Paul Goldsmith, Nicola Willis and Gerry Brownlee – Speaker of the House and an MP for 30 years – would likely not make it back into Parliament.
Only resigning or retiring MPs were permitted to give a valedictory speech meaning none of them would get the chance to give a valedictory statement.
Asked if their would be special allowances for valedictories, Wilson said in a statement that normally only MPs were allowed to speak in the House but the House could suspend its own rules or temporarily alter them.
“It could do so to allow former members to address the House.”
Wilson said no such arrangements could be made until the next Parliament opened and members sworn in.
rnz
Police say person who fired gun at officers still at large
New Zealand sides named for RLWC finals
Parliamentary Service working on extra chairs and offices for increased number of MPs
-
Latest News2 months ago‘Chilling’: Business groups speak out against National’s supermarket break-up plan
-
NZ News2 months agoTom Phillips report: The missed opportunities to find the children
-
Politics2 months agoNational vows to try to split Pak’nSave and New World
-
Latest News2 months agoCars bearing Chinese police markings stir unease in Auckland
-
Fiji News2 months agoPlans to have new Constitution by Dec 24th 2026
-
NZ News2 months agoCop who stole $68,000 can now be named as champion Muay Thai fighter Haimona Tamati-Te Paki
-
Politics2 months agoMBIE confirms botched biometric projects costs blown out to $50.7 million
-
Latest News2 months agoFive Karangahape Road venues lose their liquor licences after police intervention