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[综合讨论] Southern Cross [复制链接]

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楼主
发表于 2018-3-29 18:31:51 |显示全部楼层 |倒序浏览 微信分享
本帖最后由 早餐吃面包 于 2021-12-11 21:32 编辑



我找Southern Cross 保险公司报销,因为我刚来这儿就买的这家保险。可是他们一直拖着我,不给我结果。一直说我给他们的资料不全,之后我就把我的医生的联系方式发给了他们,让他们去和我的医生要。可他们说这是我的义务,没办法我只好自己和医生要,然后把我能收集到的所有资料全给了他们。

之后他们给我回email说让我等三个工作日之后会给我回复。可是我没想到这一等就等了两月之久,中途我也经常发email催他们,并问他们为什么不给我结果,可他们总是用我的申请在审核中和再等三个工作日来搪塞我。而且还和我说我给的资料不全,他们在和我的医生联系,可我之前让他们联系我的医生时,他们拒绝了,现在却说在和我的医生联系。我真的是无言以对。更可气的是我苦苦等了两个

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沙发
发表于 2018-3-29 18:45:48 |显示全部楼层 微信分享
这是医生给的报告,当然也包括一些化验报告,但太长了,所以没有发:
History: Visitor. Came with her aunt. C/O Had only 1 menstrual period since coming to NZ on 5/7/17. She said her only menstrual period in NZ was in Nov 2017 when she had very slight vaginal spotting for 2 days only. No dysmenorrhoea.  
Has put on 5kg in weight past 6/12 - eating more meat and lack of exercise. 
Menarche 11 yr old. Menstrual periods have always been irregular varying from 1-3 months. However for 2-3 months prior to coming to NZ last year, her periods have been regular. 

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板凳
发表于 2018-3-29 18:48:21 |显示全部楼层 微信分享
这是保险公司给的报告:
You have claimed for medical expenses incurred due to a diagnosis of Polycystic Ovary Syndrome.


We understand from information supplied with your claim that you sought treatment with your GP, Dr Chan, due to Oligomenorrhoea and irregular menstrual cycle. You were then referred for an Ultrasound and lab tests for further investigation. Due to the results of these investigations you were diagnosed with Polycystic Ovary Syndrome.


In order to consider your claim, we initially referred to the following section of our policy wording;


If, as a result of an Unexpected Event, You require medical treatment during Your Journey, We will reimburse You for Actual and Reasonable Medical Expenses incurred, or We will confirm payment for a qualifying hospitalisation claim. You, or someone acting on Your behalf, must contact Southern Cross Emergency Assistance if You require hospitalisation or surgical treatment during Your Journey

 

(1.1 Medical & Evacuation, page 23)


Documentation submitted with your claim advised that since your menarche, your menstrual periods have always been irregular, varying from 1-3 months. Following the receival of this information, it was required that further clarification was needed from your GP, Dr Foong Yeen Chan, in relation to the diagnosis of Polycystic Ovary Syndrome and your medical history of Oligomenorrhoea and irregular menstrual cycle. The following question was presented to your GP;


    ‘In your opinion, on the balance of probabilities, is the diagnosis of Polycystic Ovaries related to the diagnosis of     Oligomenorrhoea and irregular menstrual cycle?’



Below is the response provided by your GP, Dr Foong Yeen Chan.


    ‘An presented with Oligomenorrhoea, Irregular Menstrual Cycle with prolonged periods of Amenorrhoea and her     Pelvic Ultrasound Scan on 15/01/2018 has shown Polycystic Ovaries.

    Although her Testosterone level is normal, she has two out of three diagnostic criteria based on the Rotterdam     diagnosis of Polycystic Ovary Syndrome. Hence she does qualify for the diagnosis of Polycystic Ovary Syndrome.

    In Polycystic Ovary Syndrome, patients have hormonal imbalance causing irregular menstrual cycles, oligomenorrhea,     amenorrhoea/anovulation.

    Hence in my opinion, on the balance of probabilities, her diagnosis of Polycystic Ovaries is related to the diagnosis of     Oligomenorrhoea and Irregular menstrual cycle.’






Under the policy;


    We will not pay for any claims under any section of this Policy arising directly or indirectly from Pre-Existing Conditions.


    (General Exclusions of this Policy Applying to All Sections, page 20)



Please note;


    Pre-Existing Condition: in relation to each person named on Your Certificate of Insurance, any medical or physical     conditions, (including congenital conditions, anomalies or defects but excluding congenital blindness and deafness),     symptoms or circumstances which You are aware of, or a reasonable person in Your circumstances ought to have     been aware of:


for which advice, care, treatment, medication or medical attention has been sought, given, or recommended; or

for which You are awaiting test results or further investigation, specialist treatment or specialist consultation; or

which have been diagnosed as a medical condition, or indicative of a medical conditions; or

which are of such a nature to require or which potentially may require medical attention; or

which are of such a nature as would have caused a prudent, reasonable person to seek medical attention.


        prior to Your Start Date of Insurance and regardless of whether or not a medical diagnosis has been made; or


which are not Covered Conditions; or

which have been excluded during the application process; or

for which You have chosen not to seek cover for, or do not tell Us about, at the time of completing Your application.


        (Definitions, page 14)



Under the terms and conditions of the International Student policy, we will not pay for any claims arising from Pre-Existing Conditions. Our definition of a Pre-Existing Condition includes any medical or physical symptoms which you were aware of, and for which are of such a nature to require or which potentially may require medical attention prior to Your Start Date of Insurance.


As you had the symptoms of Oligomenorrhoea and irregular periods, which is a symptom of Polycystic Ovary Syndrome, before you came to New Zealand, we consider this to be a Pre-Existing condition and we are unable to accept your claim on this occasion.


We are sorry we are unable to bring you better news.


We understand this may not be the outcome you were hoping for, however please know that we have carefully considered your claim according to the terms and conditions of the policy.

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地板
发表于 2018-3-29 19:06:30 |显示全部楼层 微信分享
请大家不要纠结于八百多的生活费。我住在我姑姑家,姑姑管我吃住方面。这八百块相当于我的零花钱,平时买买学习用品,学校活动或是同学生日礼物之类的。其实说真的我都没有八百零花钱,我每次学校活动捐钱,哪怕两块都要和我姑姑要。而且这个看病的钱都是我和我姑姑借的,要是要不回来,我真的不知道怎么办。姑姑帮了我太多了,我来这儿各种证件都是姑姑帮我弄的,我实在不行再欠她更多了
求好心人帮帮我,谢谢

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5#分享本帖地址
发表于 2018-3-29 19:11:50 |显示全部楼层 微信分享
求好心人帮帮我,谢谢

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6#分享本帖地址
发表于 2018-3-29 19:12:22 |显示全部楼层 微信分享
如有好的保险公司,请推荐一下,谢谢了

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7#分享本帖地址
发表于 2018-3-30 19:51:24 |显示全部楼层 微信分享
lianlian88 发表于 2018-3-29 23:23
你家gp都说很清楚了,你很有可能之前就有多囊卵巢综合症。而且我谷歌了下你那个医生采用的临床标准,胖不是 ...

谢谢你的回复

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