Wednesday, October 5, 2011

In Pursuit Of Medical Insurance
By Michael

The girls use clips, cloth, cups, chairs, and all manner
of things to create forts, stores, restaurants, and pet
homes on the deck.
We decided to buy worldwide catastrophic comprehensive health insurance. I knew of only two insurers in this market: Lifeboat Medical Insurance (the company that Lin and Larry Pardey went with) and Seven Corners. It seemed that Lifeboat accepts only paper applications while Seven Corners works online. Also, whereas I thought they were competitors, I learned that the Lifeboat policies (sold by Kuffel, Collimore, & Co to members of the Charter Yacht Society of the British Virgin Islands and the Virgin Islands Charter League) are simply repackaged versions of Seven Corner’s Reside plan, with Seven Corners administering.
I contacted Seven Corners. Their worldwide catastrophic comprehensive medical insurance policies are underwritten by Certain Underwriters of Lloyd’s of London. I disclosed all our family’s infirmities, per the application. I expected the underwriters to come back with a list of exclusions based on the information I provided. I did not expect the exclusions to be unnecessarily comprehensive.
For example, on the application, they asked:
Within the past ten (10) years, have you or any applicant been medically advised, referred, counseled, treated, had surgery or been treated, diagnosed or currently taking prescription medical for diseases or disorders of the eyes, nose, ears and throat (including, but not limited to: nasal septum deviation, chronic sinusitis, cataracts, glaucoma, allergies or hay fever)?
I disclosed my half-dozen bouts of iritis over the years. (Iritis is a spontaneous and painful inflammation of the iris muscle. Nobody seems to know what causes it, but if untreated, it can lead to terrible cataracts and ultimately blindness--though it is so painful, I cannot imagine anyone not receiving treatment. Fortunately, treatment is both effective and straightforward, involving steroids.) Following my disclosure, Seven Corners offered us coverage, but with the following exclusion (and there were others):
Any illness, disease, or physical disorder of the eyes, including any complications thereof - Michael, Permanent
It seemed like a pretty broad exclusion given my disclosure, so I asked for more specificity and offered an example to clarify: “If Michael accidently stabs himself in the eye with a fork, that injury will be covered, yes?”
A manager underwriter got right back to me:
For the eye rider there is a chance there could be coverage for an accident depending on the medical facts and the diagnosis from the doctor. The eye rider excludes treatment for any illness, disease or physical disorder of the eyes and also any complications of illnesses, diseases and physical disorders of the eye. The most the plan would likely cover would be to stabilize the eye injured during the accident but once stable coverage would typically cease. This would be determined by the medical facts and diagnosis, it is pretty difficult to adjudicate a hypothetical claim as there is/are no actual fact(s) to review.
Whoa. Not exactly the response I was looking for. In short, I injure my eye in an accident and they will only cover the costs of "stabilizing" the eye because I have a history of eye muscle inflamation? And too, what have the Plain English Campaign folks been doing since 1979? They clearly have a lot of work remaining.
Fortunately, I learned there are other players in this market; I am going to continue shopping around. Unfortunately, some of the companies seem obscure and with spelling errors on their websites. Additionally, there are so many agents out there that it is sometimes hard to know when I am applying for the same coverage from the same underwriter through different agents. I’ve got some emails out and I welcome any advice or information.
--MR

This cute little gal is one of the Manos de Amor orphans we hosted on Mexican Independence
Day. It is a lovely picture and I forget her name. I will get it when we do our Halloween event
with them. I suspect our version of Halloween has caught on here, as the bigger stores are all
brimming with the same kind of seasonal merchandise we would see in the States. Mexico's
Dia de los Muertos is November 1 and I can't wait to see what that is like. From what I've
learned talking to folks, a family's particular celebration is open to all passersby,
whether at the cemetary or in the home.

3 comments:

  1. hey guys, we found good health insurance that didn't break the bank. no crazy exclusions came up... maybe worth a try? don't have it handy at the moment but will email you deets when I do.

    ReplyDelete
  2. Hey Micheal--we have emergency evacuation insurance only--as medical care tends to be really affordable. Ours is through DAN and while they were designed for divers it covers all injuries and illness and will get us where ever we need to get for good care. Check their website--we have the highest level of coverage.
    As an unrelated FYI your blog loads faster and easier than most--not sure why it's so streamlined, but it is an excellent feature for when you have slower connections:)

    ReplyDelete
  3. We are also looking into that - right now we have traveler's insurance for while we're sailing in the States (we're Canadian). I was hoping to find coverage through a Mexican Company while down there - you didn't find anything viable there? P.S. Iritis... just had my first case diagnosed while in San Francisco (It's an auto-immune inflammation - for me it's connected to Ankylosing Spondylitis..) Ugh. I feel your pain. Cheers, Kyra

    ReplyDelete

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