TRUST PILOT and the MEDICAL INSURANCE reviews.

Working in the industry I often refer to Trust Pilot reviews to check on how customers are finding their experience with medical insurers.

Remember Trust Pilot have a Spanish version and also a UK version from which I take the time to compare Spanish reaction against British reactions.

All to often people take up medical insurance without really knowing how it works, what it covers and who will provide the assistance they need at their most stressful of times - when ill.

From my experience the majority will buy a private health insurance based on price with no thought for the actual cover. The truth is for a Spanish medical insurance the more you pay the better the cover will be. Lower cost policies have a lot more exclusions.

Insurance Companies will display on their web page bullet point vague detail of what is covered and may even provide a similar vague bullet point list of exclusions - things that are NOT covered. These bullet points showing you exclusions are simply marketing ploys that make you think you have read the exclusions. The reality is that there maybe 2 to 6 pages of exclusions in the real policy document.

So delve into the Trust Pilot review pages for any Spanish medical insurance companies and you will see the stats scores are generally poor for all the companies with many complaints providing only 1 or 2 stars. Below I will tackle the more prolific complaints where I see an absolute complete failure by the complainer to understanding the policy. Of course the British Trust Pilot reflects a worst score for each insurer when compared with the Spanish equivalent.

So lets start with REIMBURSEMENT.

Many people on the review pages condemning the fact that they went to a Hospital or Clinic and saw a Doctor then were charged for the consultation or treatment. The policyholder subsequently complain in a review that the insurer robbed them by refusing any reimbursement.

DID THEY HAVE A REIMBURSEMENT TYPE POLICY ?

The vast majority of people will have what is known as a network medical policy.

The network insurance is a medical policy where there is no payment to be made to any Hospital, Clinic or Doctor.

With a network policy the insurance company has an agreement that when customers attend a Doctor listed in their network, the doctor will NOT charge the policyholder. Instead the insurer pays the cost direct to the medical facility. The fact that you have been charged could of course be an error by the reception at the medical facility. However this is not common reception will check by asking for your insurance card and checking it on their system.

Reception swiping that card will see that only certain doctors in that facility will be approved to attend you.

UNDERSTANDING A PRE-EXISTING CONDITION.

Whilst I am in no way comparing people to motor vehicles, I use the example of a car so we can comprehend the basic principles of an insurance policy. You have bought a second hand car and when buying it you are very aware of a couple of small dents in the bodywork, accidents by the previous owner but perhaps you bought thinking the dents were minor yet when you come to need a repair the entire panel needs replacing( an unknown pre-existing condition) .

When we buy the car we know we need to get insurance cover to provide a protection from the date we purchased the car. Most of us will accept that we cannot claim for damage the car has that pre-dates the start of your cover.

Medical Insurance works the same way your protection is there to insure you for medical issues that develop from the date you start paying for the protection.

The Trust Pilot review pages reflect many angry people who went to hospital and were refused treatment because the medical issue was shown to pre-date the policy and the review they leave reflects their anger at having been refused treatment for a condition they did not know they had. The Insurance Company will refuse to treat you if the Doctors medical notes confirm a chronic issue that could only develop to that level with time. Many things such as heart disease, lung disease, tumors will result over time. A heart attack can be seen in an ECG scan which will accurately establish the date it happened. So should the insurer simply treat us ? I suggest that if this was possible then insurance companies would not exist.

Lets face it there would be many people queueing up to take a policy the minute a cancer has been detected claiming they were not aware of it.

CANCELLING A CONTRACT IN SPAIN.

I cancelled my contract and yet the insurer refused to accept the cancellation and renewed me.

I cancelled my insurance yet the company kept taking another 6 months of payments.

The medical insurance policy we sell sets out in the small print how to cancel. All the mainstream insurers will set out the process in the policy document. My customers ask me and we send them an easy to understand email explaining what to do.

All of us need to feel safe from fraudulent attempts to interfere with our personal space.

The world these days has many rules and regulations set up to protect us from those who would interfere with our private business and private personal arrangements. The most common fraud is an email hack where someone takes over your email account and starts recontacting friends and business contacts claiming they are YOU.

Financial Services Regulators for SPAIN provide regulations to Insurance Companies, Banks and the Service Business Industry. So to cancel your insurance you will have a deadline date to submit your cancellation notice by. The insurer will be required to make sure that the request for cancelling a medical insurance policy is from you the insured. For that reason you will be asked to email your request with full names, policy number stating you wish to cancel and attaching for security a copy of your iD and a dated letter that confirms your wish to cancel with the policyholders signature on it.

It is my experience that sending the process in a very easy to understand email, about 5 out of 10 people do not read the email and will make errors.

Forget to attach the letter, forget to enter the policy number, forget to sign the letter, forget to attach anything.

So how do we know about these errors ?

As an agency we ask the customer to send the cancellation to the insurer with the attachments and copy us in on the email. If it is correct we submit it as a precaution to our own area office.

We ask for a copy so we can check it - WE THEN ASK for it to be resent correctly.

So again Trust Pilot have a good number of people on the web site cursing the insurer for not cancelling but we know that left to their own devices many will never even ask what the process is.

Francis Payne

THE ONLY DKV ENGLISH COMMERCIAL OFFICE IN SPAIN.