Health Insurance

Can the insurer increase the insurance premium without notice?
It is an almost normal habit in almost all insurance companies that the premiums of the contracted insurance products increase slightly at the moment of their updating.

Regardless of the type of insurance, including health insurance, and if you have already used their services, the increase in the premium may even be disproportionate.

In this post we indicate the cases in which it is possible to protest if the client believes it is necessary.

Cases in which to claim the increase in the insurance premium from the insurance company
In all, or almost all, Spanish homes, some insurance is available. There is an infinity of ranges, with an enormous diversity of insurances for all types of consumer profiles, and for all contingencies.

All these insurances are covered by a premium agreed with the same insurer, although it is normal that, after a few years, the rate will increase without prior consultation.

In this way, customers find themselves in the situation of having to assume a higher cost for maintaining an insurance policy. And, if already in a normal uncomfortable situation, it is more embarrassing during the economic crisis, since the vast majority of Spanish homes try to develop savings maneuvers in their day to day, without taking away the conservation of their insurance products.

The increase is legal in the case that the modification of the price is included in the contract subscribed by the insurer and the client.

In which cases can the insurance quota be increased?

The premium is increased with the customer’s acceptance.

The increase is legitimate when the change in premium is correctly included, in any particular case, in the contract signed between the customer and the insurer at the beginning of the contractual relationship.

With this hypothesis, customers have no defence because what has been agreed is taking place and, therefore, the premium increase will not require the customer’s acceptance.

What’s more, the insurance company doesn’t even have to warn you. There is no alternative but to accept the disbursement and, if you cannot afford it, you would have to wait a month before it expires to notify the insurance company of your desire to cancel the insurance.

The modification was not included in the contract

There is another situation, which offers greater protection to users and is that the variation of the quota was not included in the policy. You should read it carefully to detect any shortcomings for this reason. In this, the increase must be recorded in writing and accepted by the consumer, as stated in Article 5 of the Insurance Contract Law.

On the other hand, when the increase in the premium occurs at the time of renewal (a new period of guarantee begins), the insurance company must inform the customer of this increase 2 months prior to the termination of the policy.

Stethoscope on a printed sheet of paper

In such a situation, the customer may choose not to assume the premium increase, although the company may refuse an extension of the policy for the contiguous period of coverage.

Claims and Complaints
If the customer is not satisfied with the premium increase, how can we formalize or channel any claim or complaint? Firstly, through the customer service divisions of most insurance companies.

They receive and resolve requests susceptible to claims and complaints from policyholders, as long as they relate to their legally identified rights and interests.

These actions must be taken and decided within a period of no more than 60 days from their explanation in the corresponding departments of each company.

Also at the full disposal of policyholders, in our offices in Malaga and Cordoba, is the order for the Defence of the Client, which regulates the internal operation of claims and complaints, the activity and processes of the division of the defender of the client or attention to the client, in addition to the existing relations between the two.

Interested in a health insurance with reimbursement? Know its characteristics!
Many insurance companies offer various types of health policies that can be customized to meet your health needs.

Making the decision to take out a health policy is a very important step and depends on many aspects: you have to be clear about which insurance company you are going to choose and which type of medical policy is best suited for you.

Before taking out a policy, always compare and for that purpose, there is Previsión Médica, which makes its website available to you so that you can find out which policies are best for you and your health.

You should be aware that there are different types of policies and the most common are baremado and copayment, but there is another alternative: reimbursement. Today we tell you about the latter, in case you didn’t know them.

What does a health insurance reimbursement consist of?
They constitute a modality within health policies, which allow clients to access health centres and private doctors who want to pay the total amount of the visit, but later recovering part of the invoice, hence the reimbursement.

How do these insurances work?
When we take out a health policy, the insurer must provide you with a medical list, which includes a list of hospitals, centres and specialists that they offer and from which you can choose which one to go to. Reimbursement insurances have the alternative that you can choose the doctor you want to visit, even if he or she is outside of the medical group that the company offers you.

In this case, as a client, you can go to the professional of your choice, whether they are on the medical list offered by the insurance company or any other that you can decide at your own discretion. The insurer will cover the costs when the client requests reimbursement of the money paid for the consultation.

When the insured person visits a doctor, he or she has to pay for the service in advance, pays all the costs of the service and then asks for reimbursement.

The reimbursement will be based on what has been previously stipulated in the insurance.

You may find that some insurers only apply the reimbursement in certain coverages such as dental health or alternative medicine, in any case should be informed carefully and in advance to avoid an unpleasant surprise.

How is the reimbursement?
The reimbursement can be partial or total, depending on the company with which you contract the insurance, the reimbursements and coverages change. Also, the limits set in the health policy and the alternative of visiting the professionals of the medical team, or the opposite, have an influence.

The insurance companies normally establish a percentage of the reimbursed, however, the reimbursement is usually 80% and 90% of the expense.

The process is based on the delivery of invoices and a form where, after viewing, the reimbursement is made around no more than 20 days.

It is necessary to be attentive, because the insurers set a period of time, usually 7 days, to make the statement.

Taking out this kind of policies has some benefits and the main one is that you can customize the medical coverage to your needs, because many insurers leave some services out of the insurance.