Published On: Thu, Oct 9th, 2014

Curaçaoans are not at risk when traveling with a travel insurance of Guardian Group

Fatum CuracaoWILLEMSTAD – Recently an article appeared in the media about the travel insurance coverage at Guardian Group. In this article, Mr. Richard Pols indicates that the people of Curaçao are at risk when traveling with a travel insurance from the Guardian Group. Pols is a lawyer in Curaçao and handles cases of personal injury and insurance cases against commercial insurers.

Pols was approached by a client who had a heart attack while on vacation in Suriname. He had gone on a trip with a travel insurance of the Guardian Group, formerly Fatum, with the most expensive coverage for medical expenses.

At the close of the insurance, the employee at Guardian explained to client “that he is insured for medical expenses and everything that is not covered by the Social Insurance Bank (SVB) will be paid by the Guardian.”

After the heart attack, Guardian told the worried partner of the traveler, who was in Curacao, to pay for all the hospital expenses and that they will be reimbursed. The partner then traveled to Suriname to assist her husband.

According to Pols after returning to Curaçao and after all the hospital bills were paid by credit card, Guardian suddenly said that they will not pay anything to the client.

In a reaction to Mr. Pols' article Guardian stated that they sold, until recently, travel insurance, which also provides coverage for expenses in case of an acute illness and or injury. However, this is an additional coverage above the primary health insurance of the customer. Also, this coverage is subject to a maximum amount, after all, it is a travel insurance and not a health insurance.

The situation is that the primary health insurance does not cover expenses made abroad. Guardian Group indicates, both orally and in an appendix, at the inception of the insurance, what the insurance covers in the case of costs related to acute illness or accident abroad. It is explicitly stated that it is a secondary coverage and that its precondition is that a customer should have a primary medical insurance. Guardian Group thus provides a secondary coverage. In short, Guardian Group will only reimburse medical expenses abroad if the primary health insurance - with regard to the basic SVB insurance - has already paid a portion of the medical expenses abroad.

What can be expected from a professional insurer therefore was exactly what the Guardian Group has done, even in the case Mr. Pols refers to. According to Guardian Group, they have duly informed the customer of the policy, the insurance and the appendage of the travel insurance, which again stated the conditions under which there is coverage in case of acute illness or accident.

To summarize Guardian Group wants to distinguish three periods:

The period before the introduction of the BVZ. It is explicitly mentioned in the policy conditions that travel insurance is a secondary insurance related to acute illness and or injury and with the precondition that the customer must have primary health insurance.

The period after the introduction of the BVZ to 1-09-2014, Guardian Group provides its customers with an appendix, when taking out travel insurance, again to remind what the terms of the coverage in case of acute illness and or accident abroad.

The period after 1-09-2014. Guardian Group launched a new travel insurance, according to the market need. This product provides coverage for medical expenses in case of acute illness and accidents abroad, with a certain maximum. If the customer has his health insurance covering medical costs for acute illness and accidents abroad, the coverage specified in the insurance is then secondary. For customers who have health insurance at the SVB (and therefore have no international coverage for medical expenses in case of acute illness or accident), this coverage is primary.

In view of the above, Guardian Group therefore cannot agree with the allegations of Mr. Pols, that Guardian Group Fatum knowingly sells an insurance product that is no good. Through the Appendix to the former insurance product as well as by oral presentation, Guardian Group has informed customers explicitly and transparently of coverage in case of an acute illness and or accident abroad. Guardian Group has thus fulfilled a basic principle of information in a proper and transparent manner, which is expected from a professional organization.

Mr. Pols have also felt obliged to give a warning that with a travel insurance at Guardian Group you are not insured. “Thus we can say that our travel insurance product fully conforms to cover costs in the event of an acute illness or accident abroad, both in case of primary foreign coverage and no coverage abroad.

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