新西兰Southern Cross

在新西兰

我找Southern Cross 保险公司报销，因为我刚来这儿就买的这家保险。可是他们一直拖着我，不给我结果。一直说我给他们的资料不全，之后我就把我的医生的联系方式发给了他们，让他们去和我的医生要。可他们说这是我的义务，没办法我只好自己和医生要，然后把我能收集到的所有资料全给了他们。

之后他们给我回email说让我等三个工作日之后会给我回复。可是我没想到这一等就等了两月之久，中途我也经常发email催他们，并问他们为什么不给我结果，可他们总是用我的申请在审核中和再等三个工作日来搪塞我。而且还和我说我给的资料不全，他们在和我的医生联系，可我之前让他们联系我的医生时，他们拒绝了，现在却说在和我的医生联系。我真的是无言以对。更可气的是我苦苦等了两个


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同情楼主，这保险公司确实混蛋，但是半年生活费八百多刀，一年才一千七八，在新西兰这样能活吗？

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这是医生给的报告，当然也包括一些化验报告，但太长了，所以没有发：
History: Visitor. Came with her aunt. C/O Had only 1 menstrual period since coming to NZ on 5/7/17. She said her only menstrual period in NZ was in Nov 2017 when she had very slight vaginal spotting for 2 days only. No dysmenorrhoea.  
Has put on 5kg in weight past 6/12 - eating more meat and lack of exercise. 
Menarche 11 yr old. Menstrual periods have always been irregular varying from 1-3 months. However for 2-3 months prior to coming to NZ last year, her periods have been regular.

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这是保险公司给的报告：
You have claimed for medical expenses incurred due to a diagnosis of Polycystic Ovary Syndrome.


We understand from information supplied with your claim that you sought treatment with your GP, Dr Chan, due to Oligomenorrhoea and irregular menstrual cycle. You were then referred for an Ultrasound and lab tests for further investigation. Due to the results of these investigations you were diagnosed with Polycystic Ovary Syndrome.


In order to consider your claim, we initially referred to the following section of our policy wording;


If, as a result of an Unexpected Event, You require medical treatment during Your Journey, We will reimburse You for Actual and Reasonable Medical Expenses incurred, or We will confirm payment for a qualifying hospitalisation claim. You, or someone acting on Your behalf, must contact Southern Cross Emergency Assistance if You require hospitalisation or surgical treatment during Your Journey

 

(1.1 Medical & Evacuation, page 23)


Documentation submitted with your claim advised that since your menarche, your menstrual periods have always been irregular, varying from 1-3 months. Following the receival of this information, it was required that further clarification was needed from your GP, Dr Foong Yeen Chan, in relation to the diagnosis of Polycystic Ovary Syndrome and your medical history of Oligomenorrhoea and irregular menstrual cycle. The following question was presented to your GP;


    ‘In your opinion, on the balance of probabilities, is the diagnosis of Polycystic Ovaries related to the diagnosis of     Oligomenorrhoea and irregular menstrual cycle?’



Below is the response provided by your GP, Dr Foong Yeen Chan.


    ‘An presented with Oligomenorrhoea, Irregular Menstrual Cycle with prolonged periods of Amenorrhoea and her     Pelvic Ultrasound Scan on 15/01/2018 has shown Polycystic Ovaries.

    Although her Testosterone level is normal, she has two out of three diagnostic criteria based on the Rotterdam     diagnosis of Polycystic Ovary Syndrome. Hence she does qualify for the diagnosis of Polycystic Ovary Syndrome.

    In Polycystic Ovary Syndrome, patients have hormonal imbalance causing irregular menstrual cycles, oligomenorrhea,     amenorrhoea/anovulation.

    Hence in my opinion, on the balance of probabilities, her diagnosis of Polycystic Ovaries is related to the diagnosis of     Oligomenorrhoea and Irregular menstrual cycle.’






Under the policy;


    We will not pay for any claims under any section of this Policy arising directly or indirectly from Pre-Existing Conditions.


    (General Exclusions of this Policy Applying to All Sections, page 20)



Please note;


    Pre-Existing Condition: in relation to each person named on Your Certificate of Insurance, any medical or physical     conditions, (including congenital conditions, anomalies or defects but excluding congenital blindness and deafness),     symptoms or circumstances which You are aware of, or a reasonable person in Your circumstances ought to have     been aware of:


for which advice, care, treatment, medication or medical attention has been sought, given, or recommended; or

for which You are awaiting test results or further investigation, specialist treatment or specialist consultation; or

which have been diagnosed as a medical condition, or indicative of a medical conditions; or

which are of such a nature to require or which potentially may require medical attention; or

which are of such a nature as would have caused a prudent, reasonable person to seek medical attention.


        prior to Your Start Date of Insurance and regardless of whether or not a medical diagnosis has been made; or


which are not Covered Conditions; or

which have been excluded during the application process; or

for which You have chosen not to seek cover for, or do not tell Us about, at the time of completing Your application.


        (Definitions, page 14)



Under the terms and conditions of the International Student policy, we will not pay for any claims arising from Pre-Existing Conditions. Our definition of a Pre-Existing Condition includes any medical or physical symptoms which you were aware of, and for which are of such a nature to require or which potentially may require medical attention prior to Your Start Date of Insurance.


As you had the symptoms of Oligomenorrhoea and irregular periods, which is a symptom of Polycystic Ovary Syndrome, before you came to New Zealand, we consider this to be a Pre-Existing condition and we are unable to accept your claim on this occasion.


We are sorry we are unable to bring you better news.


We understand this may not be the outcome you were hoping for, however please know that we have carefully considered your claim according to the terms and conditions of the policy.

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请大家不要纠结于八百多的生活费。我住在我姑姑家，姑姑管我吃住方面。这八百块相当于我的零花钱，平时买买学习用品，学校活动或是同学生日礼物之类的。其实说真的我都没有八百零花钱，我每次学校活动捐钱，哪怕两块都要和我姑姑要。而且这个看病的钱都是我和我姑姑借的，要是要不回来，我真的不知道怎么办。姑姑帮了我太多了，我来这儿各种证件都是姑姑帮我弄的，我实在不行再欠她更多了
求好心人帮帮我，谢谢

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求好心人帮帮我，谢谢

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如有好的保险公司，请推荐一下，谢谢了

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不包preexisting的是这样的吧，你自己去问问insurance advisor

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你家gp都说很清楚了，你很有可能之前就有多囊卵巢综合症。而且我谷歌了下你那个医生采用的临床标准，胖不是临床多囊诊断标准，所以你不能以此来辩解。医生倒是可以说你之前月经就少于了9次一年很有可能那个时候就有多囊了。反正你以后注意吧，在和医生说的时候一定要注意，医生诊断都是主诉为主，你自己都说以前月经不调了，还能怎样

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谢谢你的回复

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我给你推荐一个好的保险公司吧，我朋友在那边做，即使不是从他那里买的保险，他一般也会愿意帮朋友解答一下的，你加我微信吧 grace56760262


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Lianlian88的建议很对，你买商业保险前一定要看preexisting 条款，很多都是不给报销的。而且和医生说话也要注意，除非你觉得你的病史会影响医生的诊断，你没必要说太多。另外体重之类的是你告诉医生增加了很多吗？如果你不说他也不知道你从前多重。另外家庭医生也要选择好的，水平和声誉相差很多。有些基本就是开处方，敷衍了事。但是我看你的家庭医生是满负责的。但是你大概对待商业保险报销经验不足。就当是吃亏买个教训，退一步想想你的疾病至少得到诊断了吧？有时候得失不能光看钱方面。保险不cover，做了很多检查，新西兰医疗真是良心价了，这如果在美国换算成纽币要5000起。

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找一个男人。

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得先去证明你这个症状不是来之前就有的
可能是来了这边水土不服??
这样才有可能claim回来
不然的话只能吃一蛰长一智了
去做点partime把钱一点点补回来吧 以后再找个好点的保险公司 问清楚条款 不要再吃亏了
good luck

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医生为什么不问你有没有保险？我几次检查医生都会问，CT一次800多，保险报了。

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Southern Cross很不错了其他的保险更加不咋样


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找专家出诊断报告，或者体检报告，证明在国内时没有多囊卵巢综合症