Why isn’t the insurance company paying? Possible reasons Possible reasons

If you think you’re so healthy and lucky in terms of contingencies, that’s no reason to turn down medical insurance, especially if you’re going to visit the Indochina peninsula. In Thailand you can see how unadapted to the tropical life, pampered by comfort, a man of European blood. In this kingdom the insurance business has its national peculiarities. In this article we will tell you what to do if the insurance company doesn’t pay or withholds payment for a long time and also why it happens in general.

Allocation-responsibility

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The scheme of the insurance business is pretty slick, but the saddest part for the customer is that the primary goal is to make a profit, not to provide you with a service. The liability for an insurance claim is divided evenly among the several entities that form the chain. The practice link is at the very end of it. The insurance company that gives you the policy only has contact with the service providers called “assistance,” and only from them does the path start to the clinic where you get medical care. Assistance of insurance companies, in turn, may have a connection with another intermediary. Usually, the number of intermediaries depends on the cost of the insured event. The more expensive it is, the more intermediaries the patient has to go through.

Which assistants to look at and which ones not to look at is written in the article about finding medical insurance policy through Cherehap’s website, whose widget we’ve placed below. Through it you can get insured with one of the most famous insurance companies (Rosgosstrakh, Alfa, Reso, VTB, etc.).

insurance case

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So your search for adventure ends in illness, injury or maiming. You call the number given by the insurance company to the medical asystance and report what happened. An operator listens to you and wants to know what happened and where you are. He then calls the clinic (this is the ideal case) or another assistant and makes a request for help.

If you’re thinking about going to the hospital.

If you think the caregivers will get right down to it, you’re wrong. This will only happen if the operator understands what happened and is entitled to dispose of the amount from the travel insurance, and will notify the clinic with a letter of guarantee. If the symptoms are unclear, the clinic will conduct an examination and notify the assisted person of the cost of treatment. He can make his own decision only if the price of the service is within his authority and the clinic’s report is not questionable. Of course, he must be medically trained to do this, and there are some in assisted care. For interest you can read the article “What to look out for when taking out insurance in Thailand”.

The assistance station doesn’t have money, the insurance company gives it. For this combination to work flawlessly, they should have a long and trusting business relationship. But it’s not uncommon for an insurance company to refuse to pay without personally checking the bill from the clinic. After all, to them, your unhappiness is a loss of profit. Therefore, if you are conscious and able to move, you will be asked to sit in the hallway until all the “misunderstandings” between the insurer, the assistance company and the clinic are resolved. The process of sorting things out looks like this:

• The medical report from the clinic is sent to the regional assistance provider.

If they can’t decide for themselves either, they ask the insurance company for its opinion.

• If they can’t decide for themselves either.

The insurers are unwilling to part with their money, so they can clarify all the details many times, and the chain of approval will consist of several cycles of paperwork. The process is also slowed down for objective reasons:

1. The time difference between Russia and the location of the victim.

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2. Mismatch of working hours of doctors, insurance company employees and emergency services.

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