A top surgeon is suing BUPA for libel and slander alleging that the medical insurer accused him of overcharging his patients.
The row threatens to attract widespread publicity about shortfalls between fees for surgery and benefits paid out by insurers.
In a writ issued in the High Court in London last month, knee surgery specialist David Johnson presents evidence of letters and phone calls between BUPA staff, GPs and patients to back his case.
The letters said a “significant number” of patients had unexpectedly received bills higher than the insurer’s maximum levels of benefit. The phone calls allegedly accused him of overcharging his patients. But Johnson says only 10% of his charges exceeded the BUPA benefit maximum.
The writ also alleges that rival insurers pay higher specialist fees than BUPA, and that up to a fifth of invoices handled by BUPA involve a charge over its benefit maximum.
A BUPA spokesman commented: “We refute quite strongly that we have defamed this gentleman.”
He added: “The priority of BUPA is, and always will be, to look after our members. We want to keep our members from additional surcharges. We conduct rigorous annual negotiations with hospitals and specialists to control costs and ensure quality.”
The medical insurer also drew attention to its specialist partnership scheme. Through this 4,500 specialists, responsible for 50% of all BUPA-covered medical procedures, work with BUPA to agree charges in advance.