- Natalia Nikolayevna, what should our tourist do if they suddenly have an unexpected illness or an accident?
- First of all, even when purchasing an insurance policy, you should pay attention to a number of essential points: what is the amount of the insurance company's liability; whether a deductible is provided - the amount that the insured pays himself upon the occurrence of an insured event; where you need to turn if you need help; in which countries the policy is valid; how insurance compensation is paid; programs under which coverage of expenses is guaranteed. The client should be wary of a very low cost of the insurance policy - a good product is never cheap. Usually all of the listed information and insurance conditions are specified in the policy itself, so before a trip you should carefully read it. Coordination of customer service abroad is handled by assistance companies that are partners of insurance organizations. For example, the “TAS Insurance Group” cooperates with the well-known international company CORIS, which has a wide network of representative offices and correspondents in almost all countries of the world to ensure constant readiness to communicate with insured persons and provide them with the necessary instructions.
So, if while abroad you realize that you cannot do without a doctor's help, the first thing to do is to call one of the phone numbers specified in your insurance policy to the representative office of the assistance company in the country where you are currently located. You can also contact the CORIS central dispatch service or the Ukrainian office. For the purpose of prompt assistance, the policy specifies what information you need to provide to the operator. Their specialists will immediately know what to do: send a doctor to you or hospitalize you in the nearest medical facility. From that moment on, doctors take care of you, and all financial issues are resolved among themselves by representatives of the medical institution, the assistance company, and the insurance organization. The assistance company acts as a guarantor of payment for your treatment before the healthcare institution, and the insurance company makes payment within the insurance sum of your policy. Thus, you don't receive money directly, but the insurance company fully covers the cost of all treatment.
- And if, say, a tourist was on an excursion, broke a leg, the insurance policy was left at the hotel, and the numbers of phones he doesn't remember?..
- Well, such a case is possible. Suppose a person really had an accident, and his relatives, forgetting about the insurance, took him to a doctor or hospital themselves. Then the action scheme changes. The tourist independently pays for services provided for by the insurance conditions if the expected amount of expenses does not exceed $150, and within 15 days after returning to Ukraine he goes to the insurance company with a claim for compensation and attaches to it all documents confirming his visit to a medical facility. These are the bill and receipts for payment for a doctor's call, payment for medical services, prescriptions and checks for purchased medicines, referrals for procedures, etc. According to the attached documents, we reimburse him all expenses incurred in national currency.
- And if all the documents are in Turkish or Arabic?
- That's not frightening; it's precisely for this reason that we cooperate with the international assistance company CORIS, whose representative offices, as I already said, are in almost all countries of the world. Being in a particular country, its specialists know well the cost of medical services, so they can easily determine whether the submitted documents are legitimate.
- What else should you pay attention to when purchasing an insurance policy?
- Of course, you need to take into account the validity periods of the policy. Most often problems arise for those who go abroad to work, but conclude, say, a short-term insurance contract, or a contract where the policy validity period is long, but during this period the person is under insurance protection for a certain number of days (the so-called intermittent insurance). So it turns out that a person falls ill abroad, turns to us for help, but the contract's validity period, unfortunately, has long expired. Sometimes there are cases when a person is confident that his policy for traveling abroad also works in Ukraine, but that is not so.
In addition, I would like to draw attention to a number of essential points related to payments. We consider each specific case separately. For example, if you with a sore throat went to a doctor by taxi at your own wish, that is an additional expense, but if your state of health threatens further life and health, then calling a specialized vehicle is necessary actions. Secondly, we do not reimburse the cost of medicines purchased by a person at their own discretion, without a doctor's prescription. Thirdly, treatment of chronic diseases (unless it is a sudden exacerbation), planned treatment (dental prosthetics or plastic surgery), purchase of prostheses, etc. is not paid. The insurance contract also does not work if the accident or illness was a consequence of alcohol intoxication. Well, and finally, so-called moral damage for, say, a vacation spoiled by illness is not compensated.
- What would you advise our tourists who already have an insurance policy?
- The most important advice: try to always have this document with you, because sometimes its presence is the only information about you and the only guarantee of receiving timely help.