“I am writing to you now with a problem that I have encountered with the VHI and as I’m getting nowhere with them I’m hoping desperately that you can intervene,” begins a mail from a reader called Mary. Mary says she had “a bad fall when going to the bathroom in the middle of the night in September 2024”. She went to her GP “with various symptoms as a result of the fall” and was sent for an assessment to the Blackrock Clinic, as the GP thought Mary might have suffered a brain injury. “Thankfully the results were negative,” she writes. Mary’s GP “also detected some irregularity in my heart” and she was referred to another consultant at the Blackrock Clinic. “He admitted me for various tests and I spent the nights of September 16th and 17th, 2024, in the clinic. When all the tests were completed I was discharged with a diagnosis of vertigo from the fall, for which I subsequently received treatment in the US.”‘I pride myself on paying my bills on time, but I am also a great believer in fairness, and I do not feel that I am being treated fairly by the VHI on this occasion’— Mary, readerFast forward to February 2026, almost 18 months after her brief Blackrock stay. Mary received an invoice from the clinic for €1,784. “When I queried it with them I was told that the VHI had disallowed the claim for the night of September 17th, 2024. I was naturally very upset, and set about querying this with VHI. I had many phone calls and subsequent letters from the [VHI] claims department, and sent them two letters from [the consultant] explaining why I needed to stay the second night. In fact he said that he thought the short stay in hospital for the series of tests was essential.”[ ‘As a long-term VHI customer I was very upset’: Why all insurers, except one, cover an eye surgery unitOpens in new window ]In response, the claims department came back and said that “an Echo [test] was performed at 14.30pm and a Carotid scan at 15.20pm on September 17th, and therefore the medical necessity for the night of September 17th has not been established.” Mary says she “cannot remember the exact sequence of events, but as far as I recall [the consultant] saw me on the morning of the September 18th when doing his rounds, told me my heart was thankfully okay, and discharged me. This seemed to be normal procedure to me, but it appears that the VHI thinks otherwise. Obviously [the consultant] was not sitting at his desk waiting for my results as soon as the tests were done, but received them before seeing me early the following morning.”‘Our responsibility is to ensure that inpatient stays and treatments meet the medical necessity requirements of members’ policies, and that all our members collectively receive value for the premiums they pay’— VHIMary says she finds it “extraordinary that the VHI will not accept the word of a specialist with years and years of training and experience. What was I supposed to do? Call him and tell him that I should not spend a second night in the Blackrock Clinic because the VHI might not allow my claim?”She says she is being penalised to the tune of €1,785 “because of what was normal hospital procedure. I pride myself on paying my bills on time, but I am also a great believer in fairness, and I do not feel that I am being treated fairly by the VHI on this occasion. Nobody wants to stay in a hospital bed for any longer than they have to. One is always happy to be told that one is going from hospital to their own bed, and I am no different. But I am certainly guided by, and respect, the doctor’s instructions.”[ ‘My mother (80s) is paying €2,200 on her health insurance. Could she get a cheaper plan?’Opens in new window ]She says she has “written on numerous occasions to the VHI putting my case to them, and appealing their decision, to no avail, I am hoping that you may be able to intervene on my behalf. €1,748 may not be much money to the VHI but it is a heck of a lot of money to me!”We contacted the health insurance provider to see what it had to say. A spokeswoman said that “each claim submitted to VHI is assessed to ensure that it is medically appropriate and that the claim is valid”.She added that “if the clinical rationale for an admission, procedure or additional bed night has not been clearly demonstrated, VHI has a duty to examine the costs arising. Our responsibility is to ensure that inpatient stays and treatments meet the medical necessity requirements of members’ policies, and that all our members collectively receive value for the premiums they pay. Failing to do so could increase costs across the healthcare system and place further pressure on premiums paid by all members.”However, she added that the VHI also recognises “the importance of reviewing individual cases where questions arise. In this case, we engaged further with the healthcare provider on the circumstances of this case and to seek a resolution. Following that engagement and a further review of the case and all medical notes, we can now approve cover for the two-night admission.”