Global Excel Management GlobalExcel Medoc Went to hospital emergency for urgent care prior to calling Medoc. My claim was reduced by 30% as a result Sheerbrooke, Quebec
I have travel insurance that is managed by Medoc / GlobalExcel.
On my Medoc wallet card it says: "Keep this card with you while travelling. In case of a Travel/Medical Emergency, you or someone on your behalf MUST call the MEDOC Claims Assistance Centre prior to treatment or your coverage will be limited."
As it turns out, when they say prior, they mean PRIOR!
recently, I had a travel/medical emergency recently. I required urgent care and went straight to the hospital emergency and was admitted right away. Despite what my card said, I did not even consider calling Medoc / Global Excel and following the voice prompts to advise them of my predicament!
I notified them after the fact but within in a reasonable amount of time, filed a claim and approximately a month later I received a cheque in the mail. There was no cover letter and the cheque and stub was the only correspondence that I received on the matter.
There was an area on the cheque stub for remarks. In this area there was one simple line stating that "Reimbursement is being made up to the maximum benefit limit which is 70% of eligible expenses for failure to notify the Assistance Company prior to your treatment."
Certainly, this must have been a mistake or they had incorrect information. They must not have realized that this was an emergency . I would have recklessly endangered my own life by calling the insurance company prior to seeking urgent medical treatment.
I called Global Excel to ensure they understood my state of health prior to seeking urgent care. At first I was only offered the call centres embellishment as to why the claim was reduced by 30%.
The explanation given on the cheque stub may not have been well articulated and detailed but it certainly was clear. I was not prepared to accept a partial payment and pressed to have someone review the decision.
The case was passed back to Angela Sangster, the same case manager that adjudicated the claim in the first place. Hardly an independent review but I thought that when the circumstances of the situation were pointed out to Ms. Sangster she would realize the error and I would be awarded the balance of my claim. No such luck! Angela Sangster stood firm on the decision.
I am left with a cheque for 70% of the claimed amount with a clear and concise one line remark on the stub that serves as a warning for the future:
If I find myself in a similar situation, in need of urgent care and I
would like to have 100% of my emergency travel medical expenses covered, I
better call Medoc / Global Excel instead of 911!
Needless to say, I am pursuing the matter further!