by Information Help » Wed Nov 21, 2007 06:16 pm
My younger sister who is married in Spain is down here visiting us in Jakarta Indonesia. She has medical insurance and since insurance company is of Spain, she had severe stomach cramps due to menstruation.
We called the insurance company in Spain and they guided us to an representative down here in Jakarta, Indonesia.
Twice check up with a gynecologist they covered for it. Which was hardly 60-70 USD. During first check up also doctor said must operate as soon as possible as she has a huge fibroid in her uterus. The second check up she needed a blood test where they were stalling until even the lab at the hospital closed. The next day I took her for blood test at another clinic.
While keeping in touch with the representative down here they told me that they had not received any reply from the Spain as to what action needs to be taken. We went ahead with the surgery.
After the surgery I sent a claim letter to them in Spain as well as a Cc to them down here. I had attached to them all copies of Doctor's letter (who did her surgery), bill copies and photographs taken during the surgery. Also saying there that she will need to pay another visit after 1 week. No reply whatsoever. When I spoke to their representative down here in Jakarta, they said that Spain has told us to close the file on this case. After 3 weeks I sent them the same e-mail with reminder saying is this the way they work and treat a customer of over 5 years and they replied that they do not cover any pre-surgery, surgery and post surgery as their doctor there says that surgery can wait until patient returns back to Spain. I wonder who their doctor is and where did he get his medical degree.
With the patient in pain also with a 9.5 cm fibroid in her uterus how can it wait till she were back there and also down here expenses are much less.
Please advice as to how I need to reply to them so that they take immediate action towards settlement. The claim is only about US$ 2200.
Thanking you in advance.
GOD Bless!
Best Regards,
Yuvraj Sadarangani
We called the insurance company in Spain and they guided us to an representative down here in Jakarta, Indonesia.
Twice check up with a gynecologist they covered for it. Which was hardly 60-70 USD. During first check up also doctor said must operate as soon as possible as she has a huge fibroid in her uterus. The second check up she needed a blood test where they were stalling until even the lab at the hospital closed. The next day I took her for blood test at another clinic.
While keeping in touch with the representative down here they told me that they had not received any reply from the Spain as to what action needs to be taken. We went ahead with the surgery.
After the surgery I sent a claim letter to them in Spain as well as a Cc to them down here. I had attached to them all copies of Doctor's letter (who did her surgery), bill copies and photographs taken during the surgery. Also saying there that she will need to pay another visit after 1 week. No reply whatsoever. When I spoke to their representative down here in Jakarta, they said that Spain has told us to close the file on this case. After 3 weeks I sent them the same e-mail with reminder saying is this the way they work and treat a customer of over 5 years and they replied that they do not cover any pre-surgery, surgery and post surgery as their doctor there says that surgery can wait until patient returns back to Spain. I wonder who their doctor is and where did he get his medical degree.
With the patient in pain also with a 9.5 cm fibroid in her uterus how can it wait till she were back there and also down here expenses are much less.
Please advice as to how I need to reply to them so that they take immediate action towards settlement. The claim is only about US$ 2200.
Thanking you in advance.
GOD Bless!
Best Regards,
Yuvraj Sadarangani
Posted: Thu Nov 22, 2007 08:05 am Post Subject: Some options which I sought..
Hi there!
One thing I'd like to tell you over here is that there are somethings in this world for which you don't always have the right answer & thats because of the order that follow up!
In my country I've often observed that since we have universal health care, it was easy for all to make the Spanish health care unit pay for it. Especially, those who qualify for the invalidity benefit need to avail the E121 or E106 form. In your case, I firmly believe that it would be difficult for you to negotiate from where you're...& probably thats the benefit that your carrrier is also looking forward to. So its better that you pack your bags & get the better of them as soon as you reach Spain. Regars, Smallfry_Kylie
Posted: Thu Nov 22, 2007 08:19 am Post Subject:
See if this one is of any help to you - dh.gov.uk/travellers
Posted: Thu Nov 22, 2007 08:28 am Post Subject: How can people be so irrational !!
This is ridiculous!
How can your insurance company shed off all their responsibilities now that you are into this juncture. There was no question of getting back with her in such an awful state!
How can someone be so irrational..I truly had a hard time believing it!
But remember, that you'd need to play clever & stay cool! Please go through your policy papers in order to find out if any of the clauses state any restrictions for the expatriates or travelers out of Spain.
Thanks,
Dr. Maddock
Posted: Thu Nov 22, 2007 06:05 pm Post Subject: Replies all..
Packing my bags and flying down to spain will cost me as much as my claim.. policy says that coverage up to 90% outside of spain and especially in home country.. i was thinking to reply them asking their doctor's name and his expertise as well as where he got his medical degree from.. also telling them firmly that they will pay pre-surgery, surgery and post-surgery in full within 72 hours otherwise i will be forced to appeal as well as seek legal aid.. moreover i will file a complain of their company to the spanish embassy down here in jakarta..
what say you all.. how should i reply to them..
ur advices will be so much helpful..
best regards...
Posted: Tue Dec 04, 2007 08:41 am Post Subject: Thanks for your advices. Have sent them this reply. Lets c..
Greetings from Jakarta,
First of all I would like to know certain details of you so called "INHUMANE DOCTOR"
1. His/Her Name
2. His/Her Qualifications
3. Where he/she got their medical degree from?
This is ridiculous!
How can this insurance company shed off all their responsibilities now that we are into this juncture. There was no question of getting back with her in such an awful state!
It does not take a doctor to make a prediction, any normal person who attended school and taken biology would know the normal size of a female's uterus is 4.5 cm. With a 9.5 cm fibroid inside it what will be the size of the uterus then? How can the person travel in such a state.
How can someone be so irrational I truly have a hard time believing it!
Therefore claim still stands, which you are advised to settle within 72 hours which covers PRE-SURGERY, SURGERY & POST-SURGERY.
Total Claim for this case are as below:
PRE-SURGERY
Blood Test Prodia - Rp. 678,040.00
SURGERY
Hospital Expenses Medistra - Rp. 10,876,233.93
Doctor's Fees Medistra - Rp. 8,870,000.00
POST-SURGERY
Check-Up on 25/10/07 - Rp. 215,600.00
Pharmacy on 25/10/07 - Rp. 37,100.00
Check-Up on 08/11/07 - Rp. 175,000.00
Pharmacy on 25/11/07 - Rp. 57, 200.00
Total amounting to: Rp. 20,909,173.93. (Twenty Million Nine Hundred Nine Thousand One Hundred Seventy Three Rupiah and Ninety Cents).
The amount is not much, in Euros it works out to less than 2000 Euros but it is the principle of the matter that counts. If you have medical insurance why is your insurance company not paying?
Thanks and Best Regards,
Yuvraj S Sadarangani
Posted: Wed Jun 02, 2010 12:57 pm Post Subject: Vaastu Naresh
Where to start...January of 2005. Events covering the last 16-17 monts: I was struck by a car that pulled out in front of a UPS truck from a stop sign. I was in the left lane next to a large delivery truck. The car pulled into my lane quickly to avoid being hit by the truck, but did not see me (I don't think). The thing is he kept hitting me pushing my vehicle onto the raised median forcing me off the road. the truck beside me never stopped. I did get the name of a witness that heard the accident, but didn't see anything. He heard me honk then heard the crash. The police were called, but no report made. The officer told us (the other driver and me)that since we had exchanged information it was not required. I did say that I was hurting, but did not want to go to the hospital right then. The accident was on a Friday and I stayed home through Monday. I scheduled an appointment to see my doctor, but had to cancel due to events that followed. My father and mother both had heart surgeries within the 2-3 weeks that followed. I talked to an adjuster and told her that my mother was seriously ill and that I could not think of dealing with anything relating to the accident at that time. I later went to see a doctor and consulted with an attorney. My injuries increasingly became worse. Injuries included in a diagnosis with the first doctor are lumbosacral strain, sacroiliac strain, left shoulder strain, cervicothracic strain, and posttraumatic cephalgia spasm. I could not drive far without increased pain in my left shoulder and arm and my back would hurt so bad that I could not work at a computer for more than a few minutes at a time. I had been in treatment for injuries to my shoulder and back for about a month when low-and-behold I was hit again from behind in a second accident six weeks later. There was a police report on this accident, and they claimed I was 30% at fault. I had gone through so much from the first accident it was not worth fighting the report, but myself and a witness disagreed with the findings of the officer that wrote the report that I was at fault at all. The other person in the second accident was speeding and failed to yeild my car exiting the highway. The insurance company from the second accident settled with me. What my questions are for the January 2005 accident: 1) The first doctor I was seeing for the January accident released me when I told him I was in another car accident and includes in his chart notes that I had a second accident and that he was releasing me to pursue treatment elsewhere for the second accident, and abruptly stopped treatment for the January accident. 2) After going through an additional 3 months of therapy with another doctor and then seeking further treatment with a specialist, including surgery on my shoulder (sought two opinions before surgery) and a few more doctor visits and therapy...now my attorney after 16 months tells me that they are releasing my case. The attorney's office had staffing problems and had said that it was not in the best interest finacially for them to pursue my case. Will this hurt my claim? I have since lost my personal insurance and can't afford to get further therapy treatments that I really need. I understand that there is a time frame for these types of claims, so that is a concern. I have prepared a demand letter, but my medical bills are very high compared to my car damage. Car was $2131.29 and my Medical is over $25,000.00 and loss wages approxiamately $4700. I don't want to ask for too much, but certainly don't want to ask for too little. I am also a little concerned about their insurance company asking to see all my medical records and that they can share that information...What does that mean? Should I sign these documents? Will they try to blame my injuries on the second accident, even though the doctor mentioned those injuries were being treated for the January accident? Sorry there are so many questions, and I hope that I didn't completely confuse you, but need to know if the second accident will hurt my claim for the first accident.
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Posted: Thu May 26, 2011 11:42 am Post Subject: IcEvxeOLZYP
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Posted: Fri Jun 03, 2011 01:04 pm Post Subject: TLpPrqGYQjbrNV
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Posted: Wed Jun 29, 2011 03:30 am Post Subject:
one can claim for the surgery to the medical insurance
Posted: Fri Jul 15, 2011 04:22 am Post Subject: pbZzKxrJiFqbhlip
Gosh, I wish I would have had that information earleir!
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