ARS Universal medical insurance

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twallace56

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Jul 8, 2005
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To anyone who has or is thinking of purchasing Universal medical insurance.
In Oct last year(2009) my wife was rushed into hospital.
Although on arrival at the hospital it was discovered that they were not affiliated to Universal we were told that she was not stable enough to be moved to another hospital as the move could kill her. We were then told that the law in this country states that any hospital can be used in an emergency and the insurance company have to pay.
After two emergency operations in one week i approached Universal who refused to pay as they did not consider it an emergency.Even though the doctors at the hospital stated that it was, Universal were not interested.
During the operations, it was discovered that my wife had cancer so i asked Universal what their stance was on this?
"No problem", they replied. as we cover 80% of the treatment up to 250,000 pesos. I also told them that it was impossible for her to travel to Santiago for treatment as she was to ill. I also informed them that a doctor was willing to travel up from Santiago but we would have to pay for treatment up front.
Once again, "no problem amigo", Just get it sorted then come back.
After spending in excess of 1,000,000 pesos i went back to Universal.
"Sorry", i was told. "You should have taken your wife to Santiago"
After explaining again what they had told me(to the same person) they just said next time get a better policy as they do not re-emburse and there was no point me talking anymore.
The fact that we were sold our policies by the very people that i was talking to on their advice made no difference. Even though i was only trying to claim the 250,000 pesos that we were entitled to.
I would urge anyone with or thinking of using Universal to go to a different company as i,m sure they have done this to plenty of people out there.
Also if there,s anyone out there that knows of a good lawyer,( and not one of the usual ones who just want money and do nothing ) in the Puerto plata to Caberete area then please pass on their phone number and address.
Twallace56
 
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E

Eddy

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Jan 1, 2002
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Universal

Universal is crap and so is their coverage. At the store, we are changing to Humano. BTW for those living in Sosua, the new clinic, at least as of 2 weeks ago, do not take Unversal.
 
Robert

Robert

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Jan 2, 1999
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Sorry to here about your insurance issues, some of these companies are real sharks.

I myself have used ARS Humano for 3 years and never had a problem.
 
waytogo

waytogo

Moderator - North Coast Forum
Apr 3, 2009
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Santiago DR
Thank you for the up to date info. I am in the market for med ins and was considering Universal. Now I will go with ARS Humano. These are the kind of posts that are informative and helpful.
 
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Eddy

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Jan 1, 2002
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Robert said:
Sorry to here about your insurance issues, some of these companies are real sharks.

I myself have used ARS Humano for 3 years and never had a problem.
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Maybe DR1 could get a group together to offer Humano coverage for members. The more the cheaper. Of course you would have to pay at least 6 months in advance to weed out the loosers. Just another idea to make DR1 the really No.1. Oh boy I'm gonna get barred for this one. LOL. (Sorry Rob)
 
waytogo

waytogo

Moderator - North Coast Forum
Apr 3, 2009
6,407
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Santiago DR
Eddy said:
Maybe DR1 could get a group together to offer Humano coverage for members. The more the cheaper. Of course you would have to pay at least 6 months in advance to weed out the loosers. Just another idea to make DR1 the really No.1. Oh boy I'm gonna get barred for this one. LOL. (Sorry Rob)
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Actually, that sounds like a great idea, I would sign up right now.
 
Robert

Robert

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Jan 2, 1999
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Eddy said:
Maybe DR1 could get a group together to offer Humano coverage for members. The more the cheaper. Of course you would have to pay at least 6 months in advance to weed out the loosers. Just another idea to make DR1 the really No.1. Oh boy I'm gonna get barred for this one. LOL. (Sorry Rob)
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I'm all for it Eddy. I'll leave it in your capable hands to muster up a group of people.

If you need me to make a post a sticky or do something, let me know.
 
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mike l

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Sep 4, 2007
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Are ARS Universal and ARS Humano different plans from ARS or are they two different companies?
 
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mike l

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Sep 4, 2007
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Eddy said:
Maybe DR1 could get a group together to offer Humano coverage for members. The more the cheaper. Of course you would have to pay at least 6 months in advance to weed out the loosers. Just another idea to make DR1 the really No.1. Oh boy I'm gonna get barred for this one. LOL. (Sorry Rob)
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I just found out they are two different comnpanies and I will sign up and prepay but if this doesn't fly.

Who in the Sosua area sells ARS Humano coverage?
 
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whirleybird

Silver
Feb 27, 2006
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We are with ARS Monumental and, although not perfect, they have been good through our problems and I would not change.
 
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Eddy

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mike l said:
I just found out they are two different comnpanies and I will sign up and prepay but if this doesn't fly.

Who in the Sosua area sells ARS Humano coverage?
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I think most brokers handle Humano along with Universal and others. The monthly rates depend on the number of people in a group. I've been with Humano for several years and belong to a small group. Less than 10 so it costs me 1200.00 ea. per month for both my wife and myself. When the store changes over we will transfer from the group we are with now and as we will have more than 10 people, my rate will fall from 1200 to 850 per month. Either way I'm stuck with Humano because they are the only ones, I think, that don't cancel you when you hit 65/70 years old. That's me.
 
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Eddy

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Robert said:
I'm all for it Eddy. I'll leave it in your capable hands to muster up a group of people.

If you need me to make a post a sticky or do something, let me know.
Click to expand...

I suggest it be a DR1 venture and handled by your office. You have the staff and means to collect ie "Pay Pall" etc. I don't think people would mind if they had to pay a small service charge and that would generate a little income.
 
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rubio_higuey

Gold
Feb 7, 2007
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Eddy, group and individual coverage has no really big difference in premiums - maybe 100 to 200 pesos per month, depending on a plan. It might be viable for you to arrange for a group, and then go maybe via Franco & Acra. You will get some discounts, but the discounts are not that big. Also, for DR1 to just break even on cost (time, manhours, resources) they would dedicate to such project themselves directly, they would have to charge a sufficiently high membership fee, and that could possibly negate any savings (because there are little) the member would gain by going via such group.
 
Robert

Robert

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Jan 2, 1999
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Eddy said:
I suggest it be a DR1 venture and handled by your office. You have the staff and means to collect ie "Pay Pall" etc. I don't think people would mind if they had to pay a small service charge and that would generate a little income.
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I have done this before Eddy, not a fun task, this is why I suggested you :)

People commit via email, PM's etc, but when it comes to the payment part, that's when the fun and chasing starts.

As I said, I'm happy help promote it on the board and assit someone that takes the job on.
 
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Eddy

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Robert said:
I have done this before Eddy, not a fun task, this is why I suggested you :)

People commit via email, PM's etc, but when it comes to the payment part, that's when the fun and chasing starts.

As I said, I'm happy help promote it on the board and assit someone that takes the job on.
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I'm sure you're right. As for me doing it, impossible. Between the work at the store and travelling back & forth to Canada, have no time. We have a group and it's part of the salary package so no need to hunt down people for payment. The buisiness pays for everybody. Forming a group is just a way that people could get insurance at a decent rate. But as you say collecting everyone on time coud be difficult.
 
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cocoloco63

New member
Mar 23, 2008
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I even checked last week with the people from CMC ins Sosua, but till then there has never been signed a contract by Universal to state that CMC is an affiliate, despite promises by Universal that the contract would be signed by January 1st 2010. I think it is good to have a hospital that is capable to deal with all kind of medical problems ans it is a shame that not every insurance company has a contract with them yet. Service is good, you don't have to wait to long and you don't have to drive for at least an hour all the time. Since we have our medical insurance with Unversal and we don't want to go all the way to Puerto Plata in case we need a doctor, we will definitely change our medical insurance. Reading about all the problems Terry and his wife are having I would advice everybody to just change in case you are having your medical insurance with Universal, let them feel they are so wrong.........
 
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mike l

Silver
Sep 4, 2007
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I have ARS Universial and have yet to use it.

I sent this thread to the person who sold me the policy and here is the positive response

Hi Mike, It appears it is as I told you, they do not understand the coverage. They obviously bought Optimo 2000 which does not allow for any reimbursement if you do not use their affiliated clinics. You will recall that was why I encouraged you to take the better plan. Yes, they do cover for emergency and I find it strange that they did not cover for this client, I submit claims all the time with no problem. My guess is that the poor people were mislead by the clinic to believe that she could not be moved, I have seen the local clinics be very unscrupulous and dishonest just to make a buck. Whenever someone tells you something that is outside of their standard operating practice it is important to get it IN WRITING, it is too easy to misunderstand particularly when you don't speak the same language. The new clinic should be affiliated any day now. I will forward the link to Universal and I will think about reporting something.
 
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twallace56

New member
Jul 8, 2005
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mike l said:
I have ARS Universial and have yet to use it.

I sent this thread to the person who sold me the policy and here is the positive response

Hi Mike, It appears it is as I told you, they do not understand the coverage. They obviously bought Optimo 2000 which does not allow for any reimbursement if you do not use their affiliated clinics. You will recall that was why I encouraged you to take the better plan. Yes, they do cover for emergency and I find it strange that they did not cover for this client, I submit claims all the time with no problem. My guess is that the poor people were mislead by the clinic to believe that she could not be moved, I have seen the local clinics be very unscrupulous and dishonest just to make a buck. Whenever someone tells you something that is outside of their standard operating practice it is important to get it IN WRITING, it is too easy to misunderstand particularly when you don't speak the same language. The new clinic should be affiliated any day now. I will forward the link to Universal and I will think about reporting something.
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I can assure everyone that when my wife was taking to hospital it was a real emergency and we did understand what was going on.
The fact that she even made it to the hospital without dying was luck in itself as she had a very large tumour in her stomach (due to the cancer) which burst on the operating table. Had it been in the car then i was told that she probally had minutes to live. It may also be worth mentioning that two weeks previous, (and the month before that) she had a check up in Bournigal hospital(Universal affiliated) who diagnosed it as fibosis and was told that it was only minor problem which would be sorted with a few injections.
Universal even phoned up the clinic whilst i was there and were told of the emergency but the staff in head office decided that they new better so refused to pay.
I,ve sent Universal an email about this but as yet they refuse to reply.
 
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