Ingosstrakh Released Information Statement on Complaints
OREANDA-NEWS. February 25, 2010. Lately negative opinions and complaints have been published on the Internet from the daughter of Aleksey Kalabin, a client of Ingosstrakh OJSIC who was bitten by a snake in
First of all, we are glad that Mr. A. Kalabin was dismissed from
As was earlier publicly announced, Ingosstrakh will perform all its obligations and will pay the client's medical care expenses in accordance with the travel insurance policy.
The internal investigation revealed that many complaints stated on the Internet by the victim's daughter are groundless. All settlements with the clinic were duly performed and the documents were sent promptly.
In the course of the said investigation the comments of the service company which cooperates with Ingosstrakh were collected, the telephone calls of the victim's representative were heard, the communication operator's printouts of the SC's outgoing calls, copies of letters and faxes to the clinic and to the SC's local partners were obtained.
To protect our goodwill, built up in the course of 60 years by several generations of employees, and because we appreciate the opinion of each of our customers and partners, we believe it is necessary to publish the results of the investigation on the company's site.
The employees of our company and of the service center sincerely feel with Aleksey Kalabin, his relatives and friends in connection with this accident. And we did all that was in our power to help our client, so that he could recover as soon as possible.
Ingosstrakh always performed, and will perform, all its obligations to the clients and will never remain indifferent to their destiny and health. We thank each one of the several millions of our clients who trust and choose our company purchasing the travel insurance polices.
From the materials of the internal investigation on the insured event
1. According to the evidence available to the company, on February 1 (i.e. on the third day after the event) the SC in
In the previous days, January 30 and 31, calls from the insured's relatives to the 24-hour call center of the service company were recorded. The callers could not provide complete information on the client's location, in which hospital he was, and where the fax with the guarantee letter was to be sent. Unfortunately the feedback was somewhat hindered, and the operator informed the client's representatives about this by telephone.
2. Note that hospitals do not have the right to deny medical care, especially urgent, due to the absence of a guarantee letter. Tourists may even not be ensured, and more to this, if they are ready to immediately pay for medical care. The hospital staff did not request the guarantee letter neither from the insurance company nor from the SC. No medical report is required for the submission of this document. The guarantee letter was sent to the hospital before the receipt of the medical report.
3. According to the medical reports received from the hospital, since January 30 the victim was in the intensive therapy department under constant medical control (connected to the monitors). The decision to perform a transfusion was made only by the attending doctor, based on the patient's objective conditions. Kalabin was cured in accordance with the local doctors' prescriptions. Ingosstrakh is not entitled to object to the treatment provided in the hospital, to interfere with the process, as our company is not a medical institution. The doctor and the medical institution are fully responsible for the treatment provided.
4. The company has evidences of the outgoing calls provided by the communication operator. Calls to the insured were made on January 30 at 5:42, 5:43; 9:34; on January 31 at 15:06; 15:09; 15:41; 15:51 16:59; on February 1 at 18:38, 18:57 (
5. On January 30 at 04:07, during a telephone conversation with the client's representative, the SC operator, taking into consideration the victim's serious conditions, made the only correct decision: to follow all the instructions of the medical staff of the hospital at Mataram Island. Although the SC had no contractual relations with the hospital, the guarantee of payment for all the medical services provided to the insured by the hospital was sent on the same day. However, according to the information received, the hospital on
6. From January 30 up to now neither the
7. For a better understanding of the situation, we would like to explain the following. The insured item under travel insurance are the property items related to expenses incurred during the insured's permanence in the foreign country in connection with the necessity to receive medical care and other services specified in the insurance contract. The Insurer compensates the expenses within the insured amount specified in the contract.
For the convenience of tourists traveling abroad who do not know the laws, traditions, language of the foreign country, insurance companies enter into agreements with assistance companies (service centers), which, in their turn, arrange for the necessary assistance on a 24-hour basis. These companies have entered into agreements with medical institutions, transportation companies, local agents etc., which allows them to organize services on a non-cash basis (i.e. free for the insured). For this scheme to work successfully, the client has to timely contact the 24-hour call center: before seeking assistance in a medical institution or from a doctor. If, due to certain circumstances, the client, on his/her own, contacted a medical institution, the SC cannot always solve payment issues and reach an agreement on provision of services to the insured in another clinic. Not all medical institutions are ready to work on a non-cash basis, especially with foreign companies. In these cases the clients shall pay the expenses on their own, collect all confirming documents and request a refund to the insurance company after their return. Moreover, according to the Insurance Regulations, if it is not possible to contact the SC, the clients shall, on their own, contact a medical institution and then obtain a refund.
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