cash for a doctor's bill.

The 66-year-old patient, who does not wish to be named, was charged $130 by a bone specialist after she broke her arm last August when she fell over.

However she said: "BF&M only paid $38 of the bill. They said because I saw him at the hospital and not in an office they don't have to pay for this.

"But I didn't choose my doctor. BF&M are manipulating people. People should know about this.

"It's terrible - other insurance companies don't act like this.

"The hospital told me BF&M are the only ones on the island that do this - it's a very bad policy.

"I was in Canada for four months and was treated there but I didn't claim for that. But when I get back there's this bill for the treatment at the hospital.'' The patient said Argus Somers Isles and British American Insurance had told her they would have paid the entire bill.

BF&M Executive Vice President of Operations Judy Panchaud-White said: "Every company has a known policy.

"Whether it's factual that other companies would have paid I don't know.

"We are here to pay bills we consider reasonable, not pay expenses we consider are exorbitant.

She said fees charged by specialists varied wildly.

She said: "The average for this type of work is $47.50. We don't pay all - we look at the average for this type of work and $130 is at the top end of that scale.

"If we paid 100 percent of everything then inflation on medical care would rise even higher.

"It's currently rising at ten percent per annum. For every $1 we get in premiums we pay out 85 cents.'' She said medical care costs were complicated because they were based on a 36-year-old scale which didn't include techniques which have been developed since.

She said: "The Bermuda Medical Association and the Health Insurance Association have been working for the past 18 months with an overseas expert to replace this archaic scheme which creates problems in the medical profession.

"We sit down and work out reasonable reimbursements. The new schedule should be in place by April next year.'' HEALTH HTH