© copyright 2007 carsa. seguros / fianzas insurance broker calle 10 no. 326 por 3 y 3 c col.-...

© Copyright 2007 CARSA. Seguros / Fianzas

Insurance Broker

Calle 10 No. 326 por 3 y 3 cCol.- Gonzalo Guerrero 97118Merida, YucatánTelphone: 01(999) 944 4999

www.insurancebrokers.mx

REPRESENTED COMPANIES



All the expenses made by the Insured and/or his insured dependents, incurred for receiving medical attention to restore his (their) state of health, according to a final medical diagnosis.

Some of this expenses are:• Fees for doctor´s appointments and medical and/or surgical treatment

• The Hospital, clinic or sanatorium included within the plan chosen. These include the cost of a standard private room, refreshments and an admission package.

• Cost of an extra bed for a companion.

• Medication obtained in or outside the hospital or clinic.

1.- What´s included?


• Any pre-existing conditions, and the consequences and/or complications caused by those conditions.

• Any facial or aesthetic treatment, except if the treatment is necessary due to an accident.

• Dietetic, medical and/or surgical treatment for obesity, anorexia and bulimia, and the complications thereof.

• Check-ups, medical examinations or studies of any type that are not directly related to the condition that gives rise to the claim.

• Dental, alveolar and lenses.

<<< Declared pre-existing conditions might be included in the basic coverage with a waiting period that the company will stablish>>>

2.- What´s Excluded?


The minimum age to contract is 18 y.o. and the top limit is 64 in most of the companies, and 60 in others. Although for the moment only one company offers insurance without a limit of age if test are aproved.

3.- Age of Contracting

The company will automatically renew the policy every year and the premiums to be paid shall be applied according to the age and sex of the Insured.

The renewal will be guaranteed for life if there are no interruptions on the payments.

4.- Renewal


5.- Diseases with waiting periodFor the following conditions, the insured must have been insured under the policy for an uninterrupted period to get them included in the basic coverage:

• 5.1.- 24 months: Knee, acid-pepctics, spinal column, nose, paranasal sinuses, tonsils, adenoids, hernias of any type, mammary tumorations (benign and/or maligns), anorectal, prostatic and gynecological conditions, varicose veins, kidney stones. These conditions shall not be covered if they already existed.

•5.2.- 48 months: AIDS (Acquired Immune Deficiency Syndrome).


A fixed sum stipulated on the cover sheet of the policy that applies on one occasion only for each accident or illness covered. The liability of the company begins when this sum is exceeded.

6.- What´s a Deductible?

The sum that the Insured must pay of all expenses covered by the policy, less the deductible contracted.

The coinsurance is shown in a percentage that can be reduced to 0% in some companies, and to 5% in some others.

7.- What´s a Coinsurance?


In case of accident:

The insured and any of his insured depedents must wait 30 days to use the policy. In case of Accident, the company will refund the expenses made due to an accident if all the invoices and receipts are given.

In case of disease:

The insured and any of his insured depedents must wait 30 days to use the policy. After that period and once a disease has been diagnosed, all the expenses will be covered.

8.- When does a policy begins to work?


The physicians and independent doctors with whom the Insurance company has entered into an agreement in which the fee that each normally charges is specified.

9.- What´s a Medical Circle?

The company will pay for the medical expenses that the Insured incurs for receiving treatment for normal childbirth or caesarean section, up to the amount specified in the policy.

10.- Maternity Aid


An «insured amount» must be selected.Insured amounts vary depending the company.Basic coverage will use two types of payments once a diagnose is been made

and a treatment or surgery is needed.1. Reimbursment:In case of accident or disease, once the insured has spent an amount the

company will reimburse the generated expenses reducing the contracted deductible and coinsurance.

1. Direct Payment:If «hospitalization» is needed the insured can «program» the direct payment

with the company to pay directly to the hospital and doctor´s involved.

11.- Basic Coverage


• Medical Emergencies Abroad:Will cover the medical services that the insured requieres as a consequence of a medical urgency and/or emergency that arises when abroad. The insured sum limit will be up to 100,000 usd with a deductible of 100 usd. When paying the claim, the company will always use the UCR (Usual, Customary & Reasonable) table of the country in which the medical urgency is treated.

• Zero Deductible per Accident:

this coverage will exempt the Insured from paying the deductible in the event of an accident.

• Coverage for Death:

If the insured party dies due to an accident or illness covered, the company undertakes to pay the “designated beneficiary” the insured Sum contracted for this type of coverage.

12.- Optional Coverages

Cont…


• Catastrophic Illness Abroad:The insurance company will pay for the medical attention, hospitalization fees and other services abroad as a consequence of an illness covered and that originated during the policy time; for the following:

1. Cancer (excluding skin cancer)

2. Neurological and Vascular brain diseases

3. Coronary diseases that requiere surgery (open-thorax surgery.

4. Transplant of the following organs: heart, liver, bone marrow and lungs.

Cont… Optional Coverages


There are four types of plans to choose:

- 3 star plan: i.e. all medium-low rated hospitals

- 4 star plan: i.e. all medium-high rated hospitals

- 5 star plan: i.e. all national hospitals

- International Plan.: i.e. all national and international hospitals around the world.

13.- How can I choose the right plan for me?


• An FM3/FM2 visa.

• An address in México.

• To stay in México for at least 9 months continously.

• To be accepted after completing the application forms and questioner.

14.- What do I need to contract my Health Insurance?


Thank you…

© copyright 2007 carsa. seguros / fianzas insurance broker calle 10 no. 326 por 3 y 3 c col.-...

Documents

insured andor

insured depedents

seguros fianzas slide

insured requieres

insured dependents

insured amounts

medical expenses

insured sum limit