Insurance in Mexico

Having read the saga of Neil regarding his unfortunate experiences with the auto rental people and auto insurance, decided to add another caveat, regarding health unsurance, misspelling, I think not.

Over the years we have had a few unpleasant experiences, so decided to add yet another, our latest.

The subject of exclusions comes up, and for the uninformed, they can sound benign, however beware.

Last year I purchased a policy, had a nice little chat with the agent, a very cool guy. All appeared to be just fine. He said great news your only exclusion is for spinal problems. Trusting this guy implicitly, yes I know that was dumb, but I have an excuse, blondness. I failed to read the fine print, another excuse, couldn't find my reading glasses without having a pair on to assist.

This year, I had a closer look, there was another exclusion, tabaquismo. WHAT!!! As some of us smokers know, just about every single health issue can be attributed to smoking, if in doubt one can review The Forces. Several phone calls later, and a promise from the agent that he was not going to hand over the cheque to the company without a satisfactory answer, we still have no answer, either satisfactory or otherwise.
Apparently no one in the history of the company has ever questioned this. The company is baffled, and has no idea of how to word the written description of exactly which illnesses would be considered to have been caused by smoking. Heart, circulation, stroke, or other. Naturally I want it all in writing and in detail.

The only exclusion which I am willing to accept, is lung cancer, and since even that is debatable, we are at an impasse. Now in the unlikely event that I do develop lung cancer, I would not resort to traditional medical treatment in any case. Nor would the top 100 oncologists in the U.S. or our friend from Canada, also an oncologist. Just gimme the morphine thank you.

Anyhow, now exhausted after yet another tricky day, full of pitfalls, I think I may have a nap, and a pill.

GLTA

Actually, raqueteer, you may be the first person who ever tried to read an insurace policy but since you brought this up, my health insurance policy excludes illness related to the usage of alchol which, I am sure is also open to interpretation. I don´t think there is anything anyone can do about this so I don´t worry about it. This problem points to the importance of having a good insurance agent which Dawg does.

My favorite exclusion, however, came to my attention about three years ago when I became deathly ill in Chiapas and had to have my gall bladder removed. The insurance company, which has my Ajijic address as my principal residence, offerred to fly me at their expense from Tuxtla Gutierrez to Mexico City, Guadalajara, Monterrey or another city with better medical facilities but I declined and had my emergency operation in San Cristóbal de Las Casas which, for some reason, I survived. Later, I was talking to my agent and told him how pleased I was that the insurance company offerred this medical evacuation service but he told me that that would not be offerred again. When I inquired as to why that was the case, he responded that when that was offerred it was because the company has coverage that will ferry the patient back to a city where medical facilities are superior to facilities in remote areas such as Chiapas but now that they knew that I actually lived part time in Chiapas and maintained a residence there voluntarily, it was my decision to have moved to the boonies and, thus, take my chances with marginal medical facilities so that was my responsibility and they would no longer offer the medical evacuation service from Chiapas. No problem from Oaxaca State I guess but never from Chiapas if I was dumb enough to live there.

Dawg, that is yet another exclusion which I would not be willing to accept. Where is the cutoff for usage of alcohol? Where is it stated, and exactly which illnesses would not be covered?

Just like the smoking issue, which I have a sneaking suspicion that the insurance companies had their grubby little paws on. They went from heavy smoking, to moderate smoking to any smoking to second hand smoke exposure.

This is just a personal opinion, and I kinda know I'm going to get slammed for it, however I think a certain amount of alcohol is good for you. Now I'm going waaaay out on a limb here and add in that I also think a certain amount of cigarettes are also good for you.

Alcohol is a vasodilator, that ¡s not a bad thing, in fact people take vasodilators in pill form. Make mine a margarita, or something equally tasty.

Stress is a major killer according to our overlords in white coats. Well, cigarettes are known stress reducers, as is alcohol. Maybe we ought to get a reduction in rates.

On to good agents, I also have an excellent agent, however when the ink goes on the cheque, if it does, his name isn't on it. So far after over a week of waiting, he has no answer, and neither does the doctor in charge of approving claims.

I have made my statement, they are still mumbling about respiratory infections. I'm also not going to bite on that one, so we're currently at an impasse. I will probably no longer be insured because I doubt that they will change their policies for one lone stubborn gringa.

Update, insurance cancelled. Too much waffling, no answers, just some mumbling about respiratory problems, no comments on vascular or other ailments. Nothing. Hasta la vista baby.
No info, no cheque.

Insurance is indeed a racket. At least you found out about these exclusions early-on and not when you were ready to claim benefits. The idea is usually to keep you paying premiums at least until they reject your claim some time down the road.

Indeed, when I specifically asked about heart, stroke and vascular, their answer was see your own doctor. Since my doctor isn't going to be signing any cheque for reimbursement, I found that answer to be not only insulting but extremely evasive. Perhaps some customers would be silly enough to accept that answer, however, I am not one of them.

I am pretty sure that they would reject any claim, based on inaccurate studies using highly questionable data regarding the effects of smoking.

A suggestion to anyone purchasing private insurance, read the fine print and exclusions very carefully. If in doubt, duke it out.

Good work on the insurance, Raqueteer. Care to share the insurance company's and/or agent's name?

Jim

The insurance company was AXA, but I'm sure they're all the same. Mention smoking and you're toast. One interesting study indicated that on autopsy it was impossible to distinguish whether the person was a smoker, a coal miner, or had lived in a polluted city. Go figure.

Cheers,
J.

We have AXA insurance, and so far as I know that exclusion is not there. Linda and I poured over it pretty carefully. But now I need to go check it again. We have had our policy for awhile, and perhaps it is the newer policies that automatically include this exclusion.

Thanks,

Jim

Well Jim, maybe you guys got lucky. Apparently they can't add any new exclusions after the policy is issued. Just look for the word tabaquismo. Good Luck.

Cheers,
J.