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INTERCASA ROCKS VS ALLIANZ MEDICAL IN MEXICO

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Post by Jim W on Wed Nov 07, 2012 5:35 pm

Most Mexico insurance companies wave deductible for accidents, Allianz no exception. My deductible was 25,000 pesos! I suffered a torn Meniscus(accidental fall), in November, and the MRI showed I had arthritis, and denied the accident claim, and took the position that arthritis was a pre existing condition, therefore not an accident!

Me, being a Scorpio, flipped out, took the advice of CG, cancelled my insurance with Allianz. I hired Spencer, to represent me! I've paid for Allianz insurance since Jan. 2006.

My agent was Parker Insurance, and when the issue came up, they told me the decision had been made, and basically, live with it! I was on my own! They would not intervene on my behalf, even though a 15 year old could search the web and determine arthritis has nothing to do with torn meniscus! I was so PISSED off!

I will receive my 25,000 pesos next week, thanks to Spencer, and because there is justice in Mexico!

My recommendation to NEWBIES, click on "search" bar inthe quick jump menu, key in IMSS or medical insurance, read and post questions if you don't find the answer.!

If ya been done wrong, don't be afraid to fight......Intercasa is the "MAN"
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Post by CheenaGringo on Wed Nov 07, 2012 5:49 pm

CG?

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Post by Jim W on Wed Nov 07, 2012 5:55 pm

CheenaGringo wrote:CG?

You told me to dump them last year.....going thru Deb's stroke....look it up my friend! 8 months fighting for reimbursement!
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Post by CheenaGringo on Wed Nov 07, 2012 6:02 pm

Maybe so? Since I have zero experience in dealing with a Mexican Insurance company, it is hard for me to believe I said something. But I could have?

Either way, it is of no importance since you and Spencer managed to beat them at their game. Congratulations!

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Post by Jim W on Wed Nov 07, 2012 6:09 pm

Thank You, CG, just an FYI, many told me I was wasting my time going after Allianz, I suspect, they paid off knowing this was a lost battle, and a waste of legal expense. Good news for many newbies......avoiding bad agents.
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Post by E-raq on Thu Nov 08, 2012 7:27 am

Great News Jim. Parker did the same to us on a $6,500 CDN claim with AIG. I went to Condusef, which is the watchdog agency for banking and insurance.

I had to go through an hour and a half discovery in Spanish. Was told by their attornies that we had an airtight case. Then they said, well you need to take them to court. Hmmm, a crap shoot really. We decided to write it off. I will NEVER do business with that agency again. Ghastly people.
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Post by Jim W on Thu Nov 08, 2012 7:49 am

That sucks Raq! The Parker agent laughed when I told her to cancel the policy and that I had hired someone to present our case to Condusef!

I hope everyone will ask their agents about support when issues like this happen. Moving to Mexico, people think medical insurance is a good deal, however, with large 25,000 to 50,000 pesos deductible, per incident, it is not a good deal. Had we gone self insured 7 years ago, we would have over 200,000 pesos in our medical fund, after paying for the knee surgery.
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Post by E-raq on Thu Nov 08, 2012 8:05 am

Jim W wrote:That sucks Raq! The Parker agent laughed when I told her to cancel the policy and that I had hired someone to present our case to Condusef!

I hope everyone will ask their agents about support when issues like this happen. Moving to Mexico, people think medical insurance is a good deal, however, with large 25,000 to 50,000 pesos deductible, per incident, it is not a good deal. Had we gone self insured 7 years ago, we would have over 200,000 pesos in our medical fund, after paying for the knee surgery.

Agree 100%. When we came here 13 and a half years ago, we were offered the high priced spread. In those days I think it was New York life. Horrifying premiums, as in $5,000 a year, can't remember if that was for both of us, but have a feeling it was actually closer to $10,000 for both of us.

Naturally we passed. As a result, we saved well over $130,000 since the premiums would have gone up. Well, all in all, other than medication, we had a nice little war chest. Now my recent incident with the blood clot, cost nothing, IMSS emergency, and the big guy once spent $7,500 for private hospitalization and surgery. Self insurance clearly is the way to go. We did decide immediately upon arrival to get IMSS just in case of a nasty traffic accident, and other than that emergency service for me, have never used it. However at about $500 a year, we're now well and truly in the black even on that.
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Post by gringal on Thu Nov 08, 2012 10:02 am

Dropped Medicare Part B; signed up for IMSS so there'd be a place to take the body splattered on the road: paid for all doctor visits, drugs and recent eye surgery out of pocket and we are WAY ahead after 9 years.
I think it depends on your personal risk tolerance, whether you buy private health insurance here and you surely do need to have a good agent and read that fine print. If you intend to live and die live here full time.....Medicare is no use to you, so we saved the bucks. Adds up fast.

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Post by CheenaGringo on Thu Nov 08, 2012 10:14 am

Jim:

You raise an interesting point for those who are not permanent residents. While I am on Medicare, I had not even considered that possibility nor done any research on the topic. In our case, with me being 65 and Kathy 61, we pay $13/month through AMEX for some pretty darned good coverage that covers emergency and casual medical anytime we are over 100 miles from home and that does include Mexico:
https://www295.americanexpress.com/premium/travel-medical-insurance/home.do

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Post by joec on Thu Nov 08, 2012 10:55 am

As others have said, most important to get recommendations from others on the Health Insurance companies. We have had Seguros Monterrey for 11 years now, our agent being Edgar Cedeno Cadenas and have been reimbursed in a timely matter always (within 3 - 4 weeks).

E Raq quoted some high prices on health insurance which seem quite high.
Here is my insurance premiums, year and pesos and USD with Seguros Monterrey.
YEAR------PESOS---USD/Xchg rate 12.75
2003------15060------1,180
2005------20540------1,610
2007------27645------2,168
2008------29625------2,323
2009------31425------2,465
2010------34360------2,695
2011------37735------2,960
2012------41740------3,273

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Post by E-raq on Thu Nov 08, 2012 11:12 am

joec wrote:As others have said, most important to get recommendations from others on the Health Insurance companies. We have had Seguros Monterrey for 11 years now, our agent being Edgar Cedeno Cadenas and have been reimbursed in a timely matter always (within 3 - 4 weeks).

E Raq quoted some high prices on health insurance which seem quite high.
Here is my insurance premiums, year and pesos and USD with Seguros Monterrey.
YEAR------PESOS---USD/Xchg rate 12.75
2003------15060------1,180
2005------20540------1,610
2007------27645------2,168
2008------29625------2,323
2009------31425------2,465
2010------34360------2,695
2011------37735------2,960
2012------41740------3,273


There is no comparison between New York life which was international coverage including the U.S. for absolutely everything and Seguros Monterrey. In those days we travelled a lot.
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Post by Jim W on Thu Nov 08, 2012 11:24 am

joec wrote:As others have said, most important to get recommendations from others on the Health Insurance companies. We have had Seguros Monterrey for 11 years now, our agent being Edgar Cedeno Cadenas and have been reimbursed in a timely matter always (within 3 - 4 weeks).

E Raq quoted some high prices on health insurance which seem quite high.
Here is my insurance premiums, year and pesos and USD with Seguros Monterrey.
YEAR------PESOS---USD/Xchg rate 12.75
2003------15060------1,180
2005------20540------1,610
2007------27645------2,168
2008------29625------2,323
2009------31425------2,465
2010------34360------2,695
2011------37735------2,960
2012------41740------3,273

John, Deductible plays a major part in premium cost.....some have 5000 pesos deductible......others 25,000 or more. I've been told, several companies here will not renew beyond the age of 70, while the ones that will, may price one out of game.
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Post by joec on Thu Nov 08, 2012 11:26 am

E Raq - You are confused. Seguros Monterrey is a division of New York Life. We both had the International Policy that also covered $ 50 K in the US. Same policy you had.

You can get SM WITHOUT International Coverage which is cheaper.

The one thing about SM is that there are NO LIMITS, unlike other policies, MetLife for example.

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Post by joec on Thu Nov 08, 2012 11:29 am

Jim W wrote:
joec wrote:As others have said, most important to get recommendations from others on the Health Insurance companies. We have had Seguros Monterrey for 11 years now, our agent being Edgar Cedeno Cadenas and have been reimbursed in a timely matter always (within 3 - 4 weeks).

E Raq quoted some high prices on health insurance which seem quite high.
Here is my insurance premiums, year and pesos and USD with Seguros Monterrey.
YEAR------PESOS---USD/Xchg rate 12.75
2003------15060------1,180
2005------20540------1,610
2007------27645------2,168
2008------29625------2,323
2009------31425------2,465
2010------34360------2,695
2011------37735------2,960
2012------41740------3,273

John, Deductible plays a major part in premium cost.....some have 5000 pesos deductible......others 25,000 or more. I've been told, several companies here will not renew beyond the age of 70, while the ones that will, may price one out of game.

Jim - We started with 10,000 peso deductible for a few years which makes no sense. I increased mine to eventually 30,000 pesos. Most people can afford that, while my partner remains at 22,500 pesos. SM will continue the policy forever.

Different companies accept you at different age limits. SM has a limit of 69 y/o. Some go over at a heck of a premium.

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Post by Intercasa on Thu Nov 08, 2012 11:37 am

While there are ways to try to reclaim money owed through PROFECO and CONDUSEF, trying to do it yourself is foolish if one doesn't dominate the Spanish language and thoroughly know the Insurance or Banking law as well as the law of the administrative agency.

If I was a bank or insurance company I would love to see a foreigner show up without counsel. If a good size chunk of change is at stake then you need to have good representation or else you will lose. There are many tricks and many lawyers locally do not know them.

On the subject of this post, we made 3 or 4 trips to CONDUSEF as well as prepared 2 written requests and requests for evidence and other things and as you see had good results.

Insurance agents sometimes can nudge the companies but in the event of a dispute there is only so much they can do.
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Post by E-raq on Thu Nov 08, 2012 12:21 pm

Intercasa wrote:While there are ways to try to reclaim money owed through PROFECO and CONDUSEF, trying to do it yourself is foolish if one doesn't dominate the Spanish language and thoroughly know the Insurance or Banking law as well as the law of the administrative agency.

If I was a bank or insurance company I would love to see a foreigner show up without counsel. If a good size chunk of change is at stake then you need to have good representation or else you will lose. There are many tricks and many lawyers locally do not know them.

On the subject of this post, we made 3 or 4 trips to CONDUSEF as well as prepared 2 written requests and requests for evidence and other things and as you see had good results.

Insurance agents sometimes can nudge the companies but in the event of a dispute there is only so much they can do.



Right Spencer, however I do speak Spanish, and did the discovery myself including incriminating evidence. I won the discovery. Their comment, take them to court now.

Slip twixt the cup and the lip? They asked for a financial statement. We gave them my husband's pension numbers. Their answer, hire a lawyer. Our decision, who is going to be first in line with money? AIG or us?
Result we decided not to throw good money after bad.

End of story.
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Post by E-raq on Thu Nov 08, 2012 12:24 pm

joec wrote:E Raq - You are confused. Seguros Monterrey is a division of New York Life. We both had the International Policy that also covered $ 50 K in the US. Same policy you had.

You can get SM WITHOUT International Coverage which is cheaper.

The one thing about SM is that there are NO LIMITS, unlike other policies, MetLife for example.


UNLIMITED INTERNATIONAL NO DEDUCTIBLE

Not 50,000 in the U.S. Sure fire route to bankruptcy.


I am never confused John.
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Post by Intercasa on Thu Nov 08, 2012 12:27 pm

But there are ways to win cases and use technicalities to get them to pay. I don't know the specifics in your case but have seen many try to do it themselves without favorable results.
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Post by joec on Thu Nov 08, 2012 12:27 pm

E-raq wrote:
joec wrote:E Raq - You are confused. Seguros Monterrey is a division of New York Life. We both had the International Policy that also covered $ 50 K in the US. Same policy you had.

You can get SM WITHOUT International Coverage which is cheaper.

The one thing about SM is that there are NO LIMITS, unlike other policies, MetLife for example.


UNLIMITED INTERNATIONAL NO DEDUCTIBLE

Not 50,000 in the U.S. Sure fire route to bankruptcy.

Unlimited International - No Deductible - YES, same as I had. But not in the US, only 50 K to get you back here. Nothing would cost 50 K for a very short hospital stay to get you back to Mexico.

They never had an UNLIMITED for the US. You have forgotten. I will ask Edgar next time I see him.

Oh and I forgot, you are always right, just ask you.

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Post by E-raq on Thu Nov 08, 2012 12:30 pm

joec wrote:
E-raq wrote:
joec wrote:E Raq - You are confused. Seguros Monterrey is a division of New York Life. We both had the International Policy that also covered $ 50 K in the US. Same policy you had.

You can get SM WITHOUT International Coverage which is cheaper.

The one thing about SM is that there are NO LIMITS, unlike other policies, MetLife for example.


UNLIMITED INTERNATIONAL NO DEDUCTIBLE

Not 50,000 in the U.S. Sure fire route to bankruptcy.

Unlimited International - No Deductoble - YES, same as I had. But not in the US, only 50 K to get you back here. Nothing would cost 50 K for a very short hospital stay to get you back to Mexico.

They never had an unlimited for the US. You have forgotten. I will ask Edgar next time I see him.

This was over 13 years ago. Absolutely no limit in the U.S. or anywhere else. The top of the line.
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Post by E-raq on Thu Nov 08, 2012 12:31 pm

Intercasa wrote:But there are ways to win cases and use technicalities to get them to pay. I don't know the specifics in your case but have seen many try to do it themselves without favorable results.


Quite right, however a lot of people lose even with good representation, just saying.
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Post by E-raq on Thu Nov 08, 2012 1:53 pm

joec wrote:
E-raq wrote:
joec wrote:E Raq - You are confused. Seguros Monterrey is a division of New York Life. We both had the International Policy that also covered $ 50 K in the US. Same policy you had.

You can get SM WITHOUT International Coverage which is cheaper.

The one thing about SM is that there are NO LIMITS, unlike other policies, MetLife for example.


UNLIMITED INTERNATIONAL NO DEDUCTIBLE

Not 50,000 in the U.S. Sure fire route to bankruptcy.

Unlimited International - No Deductible - YES, same as I had. But not in the US, only 50 K to get you back here. Nothing would cost 50 K for a very short hospital stay to get you back to Mexico.

They never had an UNLIMITED for the US. You have forgotten. I will ask Edgar next time I see him.

Oh and I forgot, you are always right, just ask you.


Nice little knife in the back there Johnny, hmmmm, to report, or not to report. That is the question?

Oh and I forgot, you are always right, just ask you.[/quote]


Mod Squad?????
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Post by Jim W on Sat Nov 10, 2012 10:47 am

Just received a call from Spencer.......Even though he has Power of Attorney, representing me on this issue, Allianz refuses to release check to him without a notarized POA. They refuse to mail it, so now gotta make a trip to GDL Monday! Allianz is a major PIA! Basta
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Post by joec on Sat Nov 10, 2012 10:51 am

Jim W wrote:Just received a call from Spencer.......Even though he has Power of Attorney, representing me on this issue, Allianz refuses to release check to him without a notarized POA. They refuse to mail it, so now gotta make a trip to GDL Monday! Allianz is a major PIA! Basta

For sure! Who is your health insurance company now?

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