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We are thinking of switching our medical insurance cover from Groupe Mutuel to ASSURA. Anyone have any experience with this Insurance company? We had trouble with Groupe Mutuel this year and want to change; however, don't want to end up with a worse one. We could make a saving of 2000 chf a year if we go with ASSURA but again won't be a saving if they are not good. Thanks
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Out of interest, why are you considering this option?
I had medical cover with ASSURA through NVC (Basel) and had a lot of issues in the 1st 4 months of residency.
(1) The broker took our brief for medical & dental cover but ultimately extracted themselves from the support loop so effectively just taking whatever reward was on offer for signing us up - disappointing;
(2) I think were under the impression that if you pay good money, you get good service - we did not - at least by old UK standards! An no obvious course for redress or arbitration (i.e. Consumer service act/trading standards);
(3) I broke a tooth, told NVC who said go to a dentist, I did. The dentist patched me up & said that I needs (a) an implant @3500CHF best option, or (b) a crown @ 2500CHF good but not best option. I told the broker who told ASSURA who insisted that I go get some X-rays so they could assess, which I did. They dragged this out for over 2 months despite my requests for info I was kept in the dark and quite ignorant. Eventually I was told that my policy had a 2500CHF reserve which I must pay (annually) 1st before the payout (less 10%) on any claim !!! And get this, they said they would not cover the extra 1000CHF for an implant anyway because the tooth had been filled previously (outrageously, this assumes that the impact on my tooth would not have broken it anyway had the tooth been untouched. I mean it could have been rotten but unfilled - my dentist agreed that it was a fob off). So effectivley the dental cover was practically useless. I would have to have perfect teeth and need nothing short of major work on 2 or more teeth to deliver any value. The broker effectivley shrugged their shoulders and rolled their eyes exclaiming "this is the SWISS way" and stopped returning my communications. ASSURA will only communicate with me in German (very difficult, especially on technical issues) and I have not been made aware by any party of a translation service or English speaking customer support! The dentist billed me for the X-rays that resulted only by the request of ASSURA who declined to cover this otherwise redundant detail (BEWARE!). So I had to pay extra for ASSURA ‘s administration - insult to injury.
(4) Also, I fell of my bike cutting my eye and severely bruising some ribs & shoulder. NVC & ASSURA were informed. So, I took myself to the hospital (no ambulance) and got some stitches, X-ray & shoulder scan + consultation. Excellent hospital service! Then I got a bill directly from the hospital. Of course it's been paid but I've had no instruction/advice from NVC or ASSURA to claim anything back.
The irony is that insurance is compulsory but as you can see, in my experience it is just another overhead as despite suffering circumstances that we typically take out insurance to cover (compulsory or not) I have not seen any value from the broker or the insurer. Indeed, there involvement in my misfortune has served only to add delay, cost and frustration. But I suppose that "this is the SWISS way" and if I want to live here I just have to accept it - the joke is on me then?
I now live in France and have a cross-boarder policy and an English speaking broker I can TRUST which gives me greater flexibility. My advice would be :
(a) don’t assume that the broker has a clue or gives a crap
(b) assume that the insurer will throw as much resource at wriggling out of a pay-out as they will to deliver on their (perceived) commitment to your WELL BEING.
(c) Try to understand (before you commit) at what point (deducting excess costs etc) and in what scenarios (typical to your anticipated requirements) the policy will deliver a pay-out or any value to you. This way you will not feel like a door mat when the answers come to your questions.
(d) There is a big difference between TRUST in context of friendship and TRUST in context of a commercial transaction so be sure to bring your commercial head to the table and don't expect any sympathy cards.
FINALLY. On a funny but relevant side note. When my broker NVC was measuring my statistics they actually fudged the figures to make the premium more reasonable. This brings into question the metrics upon which premiums and other stuff are justified.
I'm 6foot 1 inch, I play rugby & train every week (+ gym), I am solid with little (<10%) fat and lots of muscle, I'm also (as my mum says) heavy boned - I have a solid frame! I am a FIT lad & I was due to be 40 the month after arrival which in itself affects you insurance premium - globally! According to the insures metrics I am SEVERELY OBESE - what! So the guy at NVC says we’ll need to massage these figures, and so he does. I guess at this stage I should have realised that the whole fiasco was not really about me and my WELL BEING eh?
Good luck with ASSURA - think positive and I'm sure it will all be fine in the end (maybe?).