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stela2014     06/01/2014 14:42 PM
 


Dear Insubuy team, I would like to put up a good word about your team and Atlas America insurance. Last year my mother visited us in the US for 2 months, and during her stay she had an extremely painful kidney stone episode. We took her to the ER, where she was stabilized with intravenous painkillers, and a CT scan was done where a kidney stone was discovered. She was lucky that kidney stone passed the next day and she did not need any invasive procedures. However, a ~5-hour stay in the ER, CT scan, and some basic blood and urine tests ended up costing about $10,000. Hospital contacted Atlas insurance directly, but we also had to send some manual claims and letter with explanation of the emergency. The bottom line was that Atlas America insurance covered their share of expenses, which we would like to acknowledge. The overall experience with the support of your team was excellent, and we will keep using your services and recommending them to others.
Thank you,
Stela

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mak2677     12/15/2014 14:08 PM
 


Stela:

We also have Atlas America & they denied our claim (MIL had kidney stone pain & needed to have it removed by surgery since it was stuck in ureter.) stating its a pre-existing condition. Can you please clarify the following,
1. Did you claim that your mother had kidney stone on any insurance document?
2. If so, did you show any prior treatment received?
3. Was your claim originally declined ?

Please let us know how you went about disputing it, if you did?

Thanks
Mahesh

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insubuy     12/19/2014 16:53 PM
 


Mahesh,
As we discussed over the phone, this was clearly a pre-existing condition and not covered expense.

This person's both in-laws were in the US for around 6 weeks, and he didn't buy any insurance. He bought insurance only for mother-in-law past the mid night and attempted to use the insurance either the same day or the next day for such medical issue. Even though his father-in-law was here too, he bought only for mother-in-law. And he claims that this issue happened to start on the same day, incidentally.

Unfortunately, when people end up waiting to buy the insurance until after they already have pain or symptoms and are ready to seek medical care, there is no insurance company that can afford to cover such anticipated and pure loss. Insurance is for future unforeseen events that may occur after the effective date of the policy. Not just this plan but any other plan from any other company would have declined this case as well.

We at Insubuy, as a broker, are more than willing to help if people are having genuine problems with legitimate claims. However, this falls outside of that and unfortunately, we are unable to help on this.

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