health insurance

sabra

New member
Jun 16, 2007
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Hello, I submit an information ofmy girl-friend, maybe it is important for some of you:

"Attention to all who are insured with the insurance MONUMENTAL.
Check instantly whether you really have an insurance coverage.
Unfortunately I have had a terrible experience. On Friday I went to pay regularly my health insurance but the nice lady in the office in Puerto Plata told to me that this is not possible. My question: 'why? The answer: 'You arenot registered anymore'. She wanted to see my insurance card and called the main office. There I was told that I havn?t paid for more than one year. Fortunately, I was able to submit my payment receipts. Then I went to the main office, hopeful that the matter would be resolved with showing all my payment documents.
But nothing happend, go on dreaming. The answer was, they need to check where the money is, and as long as that is not cleared up, I would not have insurance and cannot pay. Notice: I have documents with the orginal heading of monumental and stamps that I paid. But it doesn?t matter that I really paid, the money is gone and he insurance too, super. :confused:
Today I got only the information, in case the nice employee from monumental brings the money I would be
insured again and could go on with paying. hahahah the joke of the year.
Not that the insurance will do something.
If you have this insurance > better you control, whether you are actually insured or if the nice staff took your
money for anything else > because that is your problem and not the problem of the insurance company.
really nice behaviour, isn't it?"
:cry:
 

ctrob

Silver
Nov 9, 2006
5,267
386
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So you didn't have any medical claims during that year that someone was stealing your payments? If you would have had claims they would have been denied. Can't you just reinstate the plan and have health insurance going forward?
 

PJT

Silver
Jan 8, 2002
3,271
35
48
This is one for the legal forum. You do have recourse especially if you have the paid receipts, at minimum you can threaten to bring suit to the Monumental Office. Visit the local fiscal for a consult, it won't cost you anything but time.

Any other posters have a suggestion ?


Regards,

PJT
 

Riva_31

Bronze
Apr 1, 2013
2,155
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I think first you have to wait at least 2 weeks, and keep safe your payments with the stamp, if they dont give you answer tell them that you will go to Superintendencia de Seguros in Santo Domingo and will make a complain to Monumental.
 

sabra

New member
Jun 16, 2007
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Thank's for your answers up to now. As it is not my case (my girl friend has this problems) I will ask her
in the early afternoon for more details. Now she is at work.
 

sabra

New member
Jun 16, 2007
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So you didn't have any medical claims during that year that someone was stealing your payments? If you would have had claims they would have been denied. Can't you just reinstate the plan and have health insurance going forward?
Just now I spoke by phone with my girlfriend. She didn't have medical claims during that year.

Reinstating the plan just would be possible in case the girl in the "collecting-office" will bring now all the money she collected from my girlfriend and didn't forward to the
headquarter of Monumental, as my friend was told.
:rolleyes:
 

caribmike

Gold
Jul 9, 2009
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I can't believe they would hold your gf responsible for the thievery of one of their own employees or brokers. I mean she has the receives and that should be good enough.

Anyway, why she don't just sign with another health insurance, Monumental seems not that much of a good choice after hearing this story...
 

Riva_31

Bronze
Apr 1, 2013
2,155
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Another thing, if she is working and you are under her medical insuance as Union Libre that is the same as a husband you dont need to pay nothing, they just have to add you under her policy, and its Human Resouce department that can do that. If this is the casa then she has to go to nearest DIDA office and explain the case, if is like that monumental will have to give you back all the money you paid.
 

sabra

New member
Jun 16, 2007
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I can't believe they would hold your gf responsible for the thievery of one of their own employees or brokers. I mean she has the receives and that should be good enough.

Anyway, why she don't just sign with another health insurance, Monumental seems not that much of a good choice after hearing this story...
Caribikmike, meanwhile I've heard that this happend in case of other insurance companies as well.
Depends from the INTERMEDIARIOS, this agencies, offices, where you pay regularly. Some of them didn't forward the money, the insurance didn't know from this.
P. example, I pay here in Cabarete to a lady in such an Intermediario. Up to now no problems.
But I am visiting regulary the Doc here, in case there would be no insurance coverage this would be known inmediately.
 

sabra

New member
Jun 16, 2007
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Thank's for you tips, Riva_31. I am german lady and have my own insurance.
But I will keep in mind your tip in case any friends are in the situation.
 

Riva_31

Bronze
Apr 1, 2013
2,155
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Thank's for you tips, Riva_31. I am german lady and have my own insurance.
But I will keep in mind your tip in case any friends are in the situation.
Yes, not too much people nows that DIDA exist to help you and protect you, but in your case as you have your own insurance is time to start to think to change and pick up ARS Palic, Humano, Constitucion, are the bigest and Im sure those thing dont happend with them.
 

sabra

New member
Jun 16, 2007
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Yes, not too much people nows that DIDA exist to help you and protect you, but in your case as you have your own insurance is time to start to think to change and pick up ARS Palic, Humano, Constitucion, are the bigest and Im sure those thing dont happend with them.
Riva_31, this problems with monumental happend to a friend of mine, as well a german lady, living and working here since
years. I am working with Palic (before Humano), with both companies no problems up to now.
But , as i wrote, it may depend on the INTERMEDIARIO-offices, where lot of people are paying, to avoid the way to
the headquartes of the insurance-companies. Some of this Intermediarios had been working into "their own pocket".
 
Apr 13, 2011
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I have heard of a similar situation, but for a car loan - the payments had been made every month at the bank. But after about 4 months, someone came to make a collection or repossess the car. The receipts were shown, but it was necessary to go to the bank. The said that non of the payments were in their system. It was believed that an employee stole the money (and may have done so with several other accounts as well). The bank said that it was still the responsibility of the car owner to get caught up on the monthly payments or lose the car because no payments for four months were officially recorded in their system - which basically meant paying twice... They were saying if the person, the former employee, ever paid after criminal charges, then the money would get reimbursed to the clients accounts, which everyone knew was never going to happen. So - no, they did not take responsibility for their employee who had stolen money.
I thought this was just a one time thing - so it is really interesting to find out that a similar scam happened/is happening with an insurance company - and that the insurance company is reacting the same way, by asking the customer to pay again to become current.
 

Criss Colon

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Jan 2, 2002
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yahoomail.com
NEVER pay at "Brokers"!!!!
Too MANY instances of them keeping your money.
Pay at the main office.
It that's not possible,set up to pay by phone with a credit card.
I have done that for YEARS!
They give you a validation code that says you have paid.
My "Banreservas CC now sends me an email as soon as the charge is made, with who, what,where, and how much, I was charged.
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