How to avoid the refusal of reimbursement by your expatriate insurance?

How to avoid the refusal of reimbursement by your expatriate insurance?
How to avoid the refusal of reimbursement by your expatriate insurance Expatriation alone or with your family is a human and personal adventure, the success of which depends largely on serious preparation and good adaptability. Taking out insurance is one of the essential formalities for leaving with peace of mind. In order to avoid the risk of your healthcare reimbursements being refused, you should be vigilant on many points of your insurance contract.

Carefully read the general conditions of the contract

As with all contracts, it is crucial to read your entire expatriate insurance contract. You must pay particular attention to the general conditions which specify the nature of the guarantees offered, the persons insured as well as the effective and end date of the contract and its duration. You will also find the deductibles that apply for each benefit as well as the grounds for exclusion, that is to say treatments that are not covered by the insurance. Indeed, if you fall ill on the other side of the world, it is important to know whether the care you are going to receive will be covered or not.

Every detail matters and every word matters. If certain technical references escape you or if you are in doubt about the meaning of a particular passage, it is better to waste a few minutes contacting your insurer's permanence rather than suffering a bad surprise later. In addition, it will also allow you to assess the responsiveness of the broker you are dealing with.

Learn about the ceilings

Most health insurance contracts include a reimbursement limit. This term indicates the threshold that you cannot exceed, under penalty of seeing your request for support partially reimbursed or even refused.

For more understanding, here is an example: suppose that your contract mentions a limit of 30,000 € per period of cover for all care and hospitalizations. If you have already totaled € 29,700 in health expenses and you are requesting reimbursement of an invoice of € 420 for the purchase of a new pair of glasses, the insurance will therefore only pay you € 300. And if, in the future, you still have health bills relating to this period of coverage, you can be sure that the insurance will refuse to cover them. To avoid such a disappointment, it is safer to ask for the remaining coverage amount before seeing a doctor or buying any medicine.

Take into account the waiting period

The elimination period is the period during which you are not covered by your insurance. This means that if you incur health care expenses during this period of time, your insurer will not be able to reimburse you. The length of this latency period varies depending on the insurance company and the type of coverage. Typically, it lasts from 1 to 12 months.

To avoid abuse, most of the time insurers apply the waiting period to services requiring high indemnities such as hearing or dental prostheses in particular.

Avoid misrepresentation

When you want to purchase health insurance before moving to Canada, Australia or anywhere in the world, the insurer will ask you to complete a questionnaire about your health. Since the cost of your premiums depends largely on your answers, you may be tempted to gloss over some of your health concerns or leave out details about your general condition.

This is a miscalculation because the insurer will almost certainly sift through your statements and find that you have made a false statement. Article L. 113-2-2 ° and 3 ° of the Insurance Code requires you to "answer exactly to the questions asked by the insurer" and to declare during the contract the circumstances which may aggravate the risks. If you made a false statement out of ignorance, you may be forced to pay an additional premium if it is found that you are acting in good faith. Insurance may also reduce the amount of its reimbursements. If your bad faith is established, you risk the cancellation of your contract which may also be accompanied by other financial penalties.

Seek treatment for a pre-existing illness

A pre-existing illness is defined as a condition that affects the insured before the effective date of his expatriate insurance. These could be accidental injuries, emotional or mental disorders that require hospital admission, or pregnancy complications. You must enter this pre-existing disease in your declaration of health.