HEALTH

Emergency

Our Insureds can count on our support to face during 24 hours a day, 365 days a year. Following are some indications on how to proceed in case of emergency:

  • The insured should go to the nearest affiliated hospital facility.
  • The policyholder or beneficiary undergoing an emergency should present the correspondent Identity Card.
  • The admission personnel of the hospital facility will contact the Permanent Attention Unit to request an emergency code of admission that will permit the necessary assistance and admission, as the case may be.
  • Before being released by the hospital facility, the patient should ask to be shown the invoice and verify that the billing is in accordance with the attention received.

IMPORTANT:The Letters of Guarantee and Emergency Admission Codes are a company service subject to its discretion.

Letters of Guarantee for affiliated hospital facilities

The Letter of Guarantee:This is an undertaking by the insurance company with the hospital facility to guarantee payment for medical and hospital services provided to the insured. The requirements for the utilization of this service are the following:

  • A signed application submitted by the insured. This form can be obtained through the insurance agent servicing the insured or directly at our offices nationwide.
  • Photocopy of the Identity Card of the insured and beneficiary of the services.
  • A detailed medical report (signed by the treating physician) containing the final diagnosis or surgical procedure, or both, to be provided.
  • The results of the preclinical tests that confirm the diagnosis should be attached.
  • Cost projection emitted by the Hospital Facility.
  • In the event that the insured is unable to secure the Letter of Guarantee in person, the same can authorize another person (insurance agent, family member or messenger). To avoid delays and expedite the service, the Letter of Guarantee can be sent directly to the hospital facility or by facsimile.

In case of Reimbursement

After payment has been made on hospital expenses, doctor's fees and other expenditures, the insurance company will reimburse the covered loss within thirty days following reception, at its offices, of all information and supports indicated in the policy.

Steps in the processing of reimbursements

  • The insured will obtain the Loss Declaration form, either through the insurance broker, or at our offices, wherein the insured will enter the personal information, services beneficiary information and signature.
  • Attach all original invoices, a broad and detailed medical report with final diagnosis.
  • The preclinical results that confirm the diagnosis, including imaging studies performed.
  • In case of traffic road accident, a written narrative prepared by the insured on how the accident occurred and the report made by the traffic authorities involved.
  • Pharmacy cashier tapes, numbered and attached to the medical prescription.
  • The expense vouchers (doctor's fees, medications and exams) should be itemized, signed and stamped by the issuing institution; specifying the method of payment.
  • In case of fractures, the X-ray images should be attached.
  • In case of injury to the mouth, attach the x-rays and pre-diagnosis.
  • In the event that the loss has been submitted previously to another insurance company, the fact should be notified within thirty (30) calendar days of the occurrence, and submit the originals and the claim-release form of the same.
  • Any other information that may be necessary for the claim-analysis determination, once the aforementioned documentation has been verified.
  • Should the loss have occurred abroad, the medical report should be authenticated by the Bolivarian Republic of Venezuelan Consulate in the country where the expense was incurred.
  • In claims wherein were removed organs, tumors, http://www.viagrabelgiquefr.com/ cysts, polyps, etc.; it is imperative that an anatomy-pathological report (biopsy) be attached.
  • Should additional further documents be requested, these are to be submitted within a 30 continuous-days period, as of the date of such request .
  • If the claim is for maternity expenses, please attach the special examinations practiced.