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Cuenca News

Expat policyholders say insurance company has not paid claims, has broken coverage commitments

By Robert Bradley

Complaints against a health insurance company used by Cuenca expats are on the rise, with many policyholders complaining about poor service and claims that have gone months without being paid. Even when claims are paid, some say their checks have bounced.

Bellgenica policyholders say that hospitals have severed ties with the company.

Other policyholders of Bellgenica, which has offices in Cuenca, Guayaquil, Quito and Loja, report that health practitioners and health care facilities that were once part of Bellgenica’s network, and which they relied on, have severed ties with the insurer.

Several policyholders say that delays in payment have caused financial hardship.

Complaints about Bellgenica prompted a January 9 meeting at Cuenca’s Hotel Oro Verde between company management and policyholders. The announced purpose of the meeting was to allow the company to provide details of improvements it planned to make in its service and to address other policyholder concerns.

Instead, the discussion by company managers centered around the company’s failure to properly manage its own finances and employees  — a matter of little concern to the policyholders in attendance. Of special interest to this reporter was management’s opening statement that the press and social media coverage was an unwelcome distraction.

One frustrated policyholder, who asked not to be identified, said she has tried for months to get a claim paid. “I have an outstanding $110 reimbursement due since September 2017 for x-rays at Santa Inez Hospital,” she says. “I’ve made numerous trips to Bellgenica and have been promised the claim would be paid but five months later nothing has happened.” She adds that she knows others who have much larger unpaid claims.

Another customer, who also asked to remain anonymous, said he did, in fact, receive a reimbursement check but that it bounced when he tried to cash it. “It was only for $5.48 but the bank said there was no money in the Bellgenica account,” he said. “When I went to the Bellgenica office, the secretary at the front desk paid me out of her purse. I left thinking this was a lousy way to run an insurance company.”

The same customer says he joined the health plan based on the relationship Bellgenica said it had with high quality doctors, labs and hospitals. “I originally enrolled in Bellgenica because I was told by Mady (an employee of Bellgenica) that Hospital Del Rio was ‘on their plan’, and before enrolling I had used them for an exam and treatment and was highly impressed. So when I later needed medical procedures there Viviana (another Bellgenica employee) told me Del Rio was no longer associated with Bellgenica but that I could still use their services and file a reimbursement claim. Later, I found out that Santa Inez hospital had also severed relations with Bellgenica. Why was this not announced to policyholders? As clients we have a right to know where our medical providers are in relation with Bellgenica.”

Following the January meeting at the Oro Verde, CuencaHighLife and Cuenca Disptach secured an interview with representatives of Bellgenica on Wednesday, January 31, where we presented a list of questions of about the company’s operations. We were repeatedly assured the questions would be answered, translated into English, and emailed to this reporter by Friday, February 2.

The date came and went without a response. A second request for the list of questions went unanswered as well.

The questions we asked and for which we are still awaiting answers include: In the period from January 2016 through December 2017, what percentage of insurance claims were paid by Bellgenica within the 90-day period stipulated in the policies?; What percentage of claims remain unpaid beyond 90, 120, 180, and 240 days?; and, on what date will all claims be paid in full?

We also asked for the names of hospitals, doctors and other healthcare professionals and services that had once been associated with Bellgenica but no longer are.

As we await answers from Bellgenica, this reporter will continue to follow this story closely and report back to the expat community with the latest developments.

  • SpiffyHeart

    This is certainly disheartening. I just last week, probably while you were writing this….went into ER, then hospital, and to Emergency surgery to have a pacemaker implanted! Otherwise I have none of the “elderly” diseases, and co-morbities!

    I put everything on a Visa debit card! Now….I wait to be able to get cash from ATM machine, until February’s check.

    Bellgencia isn’t co-operating….and I can’t get out of apartment for at least another week.

    Count me in, on the brain storming stage of helping solve this expensive problem! We are STUCK! Can’t afford to have anything major done in the U.S. and I was told I could get a second opinion in Quito! But was too sick to make that long trip….hotel, expenses of highering someone to go with.

    • tocuencawithlove

      Sign up with IESS. 100% coverage for everything, including most medications, very reasonable rates for someone like me on a retirement Visa based on Social Security, which is my only source of income. Yes, there is a three-month initial waiting period, except for emergencies such as what you just experienced . My deepest sympathy, and I hope you recover fast and fully.

      • Craig Gardner

        Good for you. A person with a monthly income of say $3,000 monthly would pay way over $500.00 monthly to be covered under IESS. Cheap? I don’t think so.

        • Elly Maillet

          No this is an error. You still pay 72 or 75 dollars (just the one person). The 17% off of pension income was bever applied and is not about to be applied for a looong time.

          • Ricki

            Not true they just haven’t caught up with you. They want over 21,6% for married couple. They told us in person and wanted our proof of income from social security. We went with Bellgenica, cheaper at $330/monthly. Six phones #’s from the internet, and business card and not one did anyone answer!! We are now going back on Medicare and moving out of Ecuador

            • Charlie

              You’ve been saying you’re moving out of Ecuador for a year now. When will you be going? What is the country-du-jour today? I’ve read Mexico and Colombia from you in other posts. Just wondering when and where you will be going.

              • $tillAlive

                If she is going back on Medicare, it seems that would imply she is moving back to the States. I really wish she would give Colombia a try first. The Facebook blogger and photographer “Al” is moving there soon.

                • Charlie

                  Frankly, I don’t care where she moves as long as it is ourt of Ecuador and soon. She is a whiner that we heard from multiple times a day when she was “forced” to pay more for her IESS insurance. Along the way, she revealed her approximate monthly income and lost any sympathy she may have had from her cries of hardship.

                  • 1Maineac1

                    She was never “forced” to pay more! It was a voluntary request to present your income to IESS. She chose to do that. Those of us who did not, and friends who are signing up now are still getting our original rate (higher by a few bucks due to increase in minimum wage this year). What IESS keeps spouting is not necessarily the truth….

                    • Charlie

                      Interesting that you have noted that I put the word “forced” in quotation marks yet you don’t seem to understand what that means. Words placed in such quotation marks are called “Scare Quotes”. Here is an explanation of them for you:

                      scare quote
                      PRONUNCIATION:
                      (SKAIR qwot)

                      MEANING:
                      noun: The quotation marks used to indicate that the quoted word or phrase is incorrect, nonstandard, or ironic.

                      ETYMOLOGY:
                      Coined by the philosopher G.E.M. Anscombe in 1956. The equivalent term in spoken communication is air quotes.

                      NOTES:
                      Scare quotes are used to indicate the writer’s disagreement or disapproval of the use of the term.
                      Example: Some consider Trump to be the “greatest” president ever.

                      USAGE:
                      “Caspar always thought of his ‘time machine’ thus, with scare quotes around it, since it was not really a machine, and Caspar did not believe in time.”
                      ______________________________________________________

                      If you read elsewhere on this thread, you will see that just as you have noted, I refused to be bluffed into going with the rest of the herd to Azogues. I continued to pay my usual $66 until this month when I was raised to ~$67 due to the increase in el basico that you reference.

                    • Michael Berger

                      I could not have stated it better!

              • Gia Santangelo

                Charlie…You are too funny! Don’t know you, but you’ve got a great sense of humor! 😉

                • Charlie

                  Gia, I can’t tell you how much I appreciate your words. Most people don’t get me nor my humor. I’ve always said that it takes intelligence to have a sense of humor and you seem to have one.

            • 1Maineac1

              Don’t believe what the Cuenca IESS says….. They made their own rules while the rest of Ecuador sat back and watched. New law (May or August or Never) affects “tourists” only….at this point.

          • tocuencawithlove

            No error! My premium went up last June from $66 to $194. However, this was because I am one of those (stupid?) honest people who went to the IESS office to report my true income. In hindsight, probably not so smart. I have had IESS coverage for over five years.

            • StillWatching

              It is admirable that you recognize your own error and take responsibility for it. I refused to follow the sheep and I am still paying $66 per month for my IESS coverage.

            • SpiffyHeart

              Oh…tocuencawithlove. Me too! I was feeling like I wanted to be honest, and Carry MY fair share! But the coffers have been hit hard….the perfect storm so to say. Let’s just ride it out! See which way the government finally goes….I still want to stay here….this home! Where I have history. My life!

            • Mark

              It looks like you got screwed. You might try closing your account and then opening a new one a month later at $66 per month. What have you got to lose?

            • Michael Berger

              What in your culture may be considered honest is considered stupid here in Ecuador.

          • SpiffyHeart

            The official date to begin this increase was postponed to May. We will see…..but don’t hold your breath

        • SpiffyHeart

          Craig, That’s why I bought Bellgencia in first place. If we can wait, and see if the 17.6% of income doesn’t ever really materialize…..in May, maybe I can hang on and continue with IESS. I used it 3 yrs ago, getting sick after my husband died.
          You see….this pacemaker could have been don at IESS, but the Ablation that was NECCESSARY before I plant! So…..private hospital.
          My SSA was short again this month, due to the LAST back payments for skipped Medicare premiums being taken out of check. (I know NOW about the form, proving I’m still alive now)

          You are right Craig Gardner! I used IESS when I got sick after husband died 3 yrs ago….and it was fine! I’ve just been concerned about something major happening…like this very thing! But when I found out what it would cost me out of pocket to go to States (which I couldn’t) with no supplementary Ins. It would have been about $43,000.00! So I guess, if one has TIME to plan, and can buy additional supplementary, one can still use the Medicare if forced to go back, due to not being able to cope living in my home/Cuenca!

          I will keep paying insurance premiums until we see what happens here. I LIVE here, lost my husband, lost my little dog….here! This is where I want to be!

      • Sue

        We so agree. We have been very pleased with IESS.

      • SpiffyHeart

        Thank you! Love your handle :-). Love Cuenca!

  • Mark

    Bellgenica in Cuenca has been the beneficiary of Cuenca IESS charging 9-1 visa holders a 17.6% income tax for health insurance when strangely no other IESS office in Ecuador does this.

    That’s left a windfall for Bellgenica being the cheapest alternative in Cuenca for many who just want the cheapest policy to be in compliance with the law.

    • tocuencawithlove

      Well, you get what you pay for!

      • edgeof 2

        Yes ! Speaks to the need for universal single payer health insurance for all. Capitalism and profit and greed should not be involved when people’s health is at issue. This is the nature of it….and the USA tops the list of abusers to people with health care needs.

        • StillWatching

          Socialist garbage.

          • Bart

            Your Libertarian “free market” garbage is what killed manufacturing in the U.S.

            As for “free oil profits” (which nobody pays for), that can be used in part to supplement a vibrant health care system. Yep, Socialism, bring it on.

            • Michael Berger

              He’s not a Libertarian any more than Glen Beck or William Weld are Libertarians, he’s admitedly sucking off of the government tit and milking the I.E.S.S. for all it’s worth paying $68 a month!

    • Nicole

      Two weeks ago an Ecuadorian lady that works in Montanita asked me why only Cuenca IESS charges pensioners 17% of their income for inclusion. Word gets around.

      Her retired expat boyfriend pays IESS $66 a month through Libertad.

  • Charlie

    Looks like your claim reimbursement checks will soon be available in Miami at the Bellgenica owner’s estate. He lives next to the Isaias brothers. Good luck.

  • Magdalena

    Thank you for this article. i have been wondering why no one was talking openly about Bellgenica’s failure to pay claims (I have been waiting for three months for a $100 check). How can Bellgenica continue to want us to pay their premiums when they do not pay for claims. And they have put their staff in the very unfortunate position to tell us lies.

  • David Besonen

    Sounds like people should just cancel their policies with Bellgenica and hope for the best regarding any claims submitted.

    • SpiffyHeart

      But, if I cancel….what’s the chance of them following through on the claim? Shouldn’t I wait until I see the refund…then cancel?

  • chupacabra

    Stop paying their monthly premiums!

  • sueb4bs

    So, folks — enough ruminating —WHAT DO WE ENROLLED DO NEXT?

    • Larry

      Why not change insurance companies? I’ve been satisfied with Ecuadorian Health Group and there are several others that get pretty good reviews.

      • Craig Gardner

        How do we contact Ecuadorian Health Group?

        • Susan Burke March
        • Ken

          ttps://www.ehg.com.ec

          • Craig Gardner

            Thanks Ken. Will visit them tomorrow.

      • Bren

        Is there a rep number we can call for Ecoudor Health Group? We too have be ripped off by Bellgenica. We had to pay for my back surgery, hospital stay and meds. Seem to be worse than the U.S. it would have cost less.

    • Ken

      You extricate yourself from Bellgenica.
      You write off your losses.
      You find a stable alternative.
      You expect to pay more for a quality product.

      • Bart

        “You expect to pay more for a quality product” – Wrong. My ONLY interest in “health insurance” is to comply with the law mandating it.

        • Charlie

          I’m pretty sure that Ken’s advice was for intelligent people. You can obviously do as you please.

          • Bart

            Insurance is for little people like yourself. Some of us can afford to self insure.

            • Charlie

              You seem to presume to know my financial position. How is that?

        • Ricki

          It’s on hold the law until May.

      • Larry Von Eschen

        Correct.
        I hate to say I told ‘em so but for many months I’ve been telling folks not to purchase the subject product. After attending a few of their “informational” meetings, as a seasoned claims professional I could smell a rat. Nonetheless, folks didn’t listen and now they’re left holding the bag.

    • chupacabra

      If you are enrolled with Bellgenica first step is STOP paying their monthly premium!

    • Charlie

      Take the cue from your own screen name. Sue before you have to put up with more BBS———— Bellgenica Bullshit. There are several of us here on this board who have done just that.

    • Don’t pay the premiums and refuse to do so until you are paid. Won’t matter if they cancel you as they are doing you no good anyway. Cut off the pocket book gets the best results in this country and file a complaint with the Ministry of Health.

    • Margie

      We are paying more but went back to IESS. Not the first time, we have had problems with insurance. We regret ever leaving IESS.

  • tim murphy

    bellgenica is becoming, or maybe it has always been, just like a us health insurance company; always changing the rules without telling it’s clients when they change the rules. my wife filed a claim for $42 back in october, 2017. the check arrived in november. she was never contacted by bellgenica that her check had arrived and we only discovered that the check was there when i went to file a claim for my hopital stay last week! that check sat in bellgenica’s office for over 2 months without anyone from bellgenica calling or e-mailing us that it was there! and now I had to spend a week chasing down paperwork to file my claim ( for my hospital stay and surgery ) that bellgenica will probably never pay. funny thing, bellgenica provided me with a list of items they require when filing a cliam, and electronic fractura’s from a pharmacy for prescriptions is NOT listed as a requirrement on the form provided by bellgenica, but i was told they are required when filing a claim. and getting an electronic factura from pharmacys isn’t an easy thing to do! as soon as the government drops the ridiculous requirement that us gringos have to pay for crappy health insurance, i’ll be dropping bellgenica! what a scam bellgenica is pulling on us all!

    • Charlie

      That’s nothin’ Tim. How about the people who had been paying their premiums through automatic bank withdrawal and Bellgenica stopped making those withdrawals without a word. When those people went for medical services and then submitted claims to Bellgenica, they were told their coverage had been dropped for non payment of premiums.

      You’ve heard of The Gang that Couldn’t Shoot Straight? Bellgenica is often the gang that can’t shoot at all and when they do shoot, they miss every time.

  • Ken

    It appears there are little or no government regulations for a health insurance company related to solvency ratios / the company’s financial heath.
    At least with IESS they have the backing of the state.
    It’s hard to be financially viable while selling the cheapest policy available in the country.
    Good insurance costs good money.
    If I had a Bellgenica, I’d be running for the exit.
    Quit paying premiums, write off your losses and find a stable alternative.
    You’ll likely never see those reimbursements you are owed. There is no $$ in that bank account.

  • Sara

    All the moving experts, facilitators and lawyers who have been pushing Bellgenica should also be held accountable for this fiasco. Obviously, they were getting some kind of kick-back. Maybe someone should compile a list.

    • Emily Lang

      Actually, it would be helpful to know the names of those who have been recommending Bellgenica. I’m planning to move to Ecuador and would like to avoid the movers and lawyers who did not do their due diligence in this case.

    • Ken

      Sara – Place blame on Bellgenica or on the buyers of the policies.
      On yourself if you are one.
      Ask all the right questions before buying a policy, including questions about the financial health of the insurance company you choose.
      Then be accountable for your choice.

  • Fernando

    VERY reliable word on the street is that Bellgenica will soon go belly up. I agree with the other comment that the expat “facilitators” who recommended them should be outed.

    • StillAlive#477

      Should we out or oust from Cuenca the expats who bought it without any help from facilitators?

    • Stan

      Explain to me how a company that apparently has no “out flow” (paying claims), only “income”, goes belly up.

      • Charlie

        You’re kidding, right? They just close their doors and move to Miami with the money they purloined.

  • William Keyes

    I have lived here for 8 years and have gone through several private insurers all of which failed so four years ago we joined IESS and have had all our medical needs covered for $110 a month. Now let me make this clear the so-called IESS rate increase was never any kind of official action by IESS so anyone who abandoned IESS for Begenica was over reacting. And while how you decide how who you want to cover your health care needs is your business it is indeed very unfortunate that the IESS system is condemned because it is a “public” system. Yes maybe the lines are long and you have to wait for some procedures if they are not an emergency but IMHO I believe the overall quality of the health care is just as good as what you would get at a private hospital. Case in point. Three years ago I had a heart attack went to Santa Ines ER was treated and had a stent put in released after 3 days but told I needed triple bypass within 3 months. The total hospital bill was $7600 which ultimately I paid out of pocket. A friend if mine got me on the public health care system (not IESS) and I went back to Santa Ines had triple bypass was in the hospital for 9 days and it only cost me a little over $100. Dr Diego Córdova did the surgery. Now I am under the care of Dr Karol Guzman an excellent doctor who works at the IESS hospital cardiological unit and go every three months for a check up at no cost. Guess who else works in that unit Dr Diego Córdova as well as Pablo Quichpe who put the stent in at Santa Ines. So at least in my case there is no reason for me to believe that the healthcare I received through the public system and IESS is any less quality than if it had all been done through private insurance. So my point here is not to trash Belgenica but to point out that it is unfair IMHO to assume that private insurance healthcare is better then IESS.

    • Josie

      So, what can we do about IESS charging 17.6% of Social Security benefits? Charging only expats in Cuenca is illegal. Do we sue IESS or person who calculated the increase?

      • Charlie

        Ever think of signing up somewhere else?

    • Charlie

      I agree completely, William. I have IESS and still pay $66 per month for coverage because I didn’t follow the herd of gullible gringos to Azogues to be shorn like sheep. Yes, for my own reasons I also had Bellgenica but I have a personal policy that dictates that if a person or a business lies to me, I will sever that relationship. I’ve been gone from Bellgenica for a long time. They are liars, from top to bottom.

  • Bartley D’Alfonso

    1.
    “El Comprador Tenga Cuidado” in Spanish means “Buyer
    Beware”. In May of 2016 I enrolled as a new Bellgenica client,
    with $145/monthly premiums. About a year and a half later in September 2017 (17 months later?) they “updated” my policy
    with a new contract number, and increased my premiums $20 monthly (a 14% increase) to $165 / monthly premiums. The next day they called me and said I also owed 5 months of back-charges starting back from May 2017, and owed $100 (5 months x $20 = $100). I objected in that it was their fault they did not tell me that my policy needed to be “renewed” every twelve months, and I refused to pay the $100 back charge. Viviana threatened that they would cancel
    my policy and coverage, so I paid the $100 extra. Next week I shall cancel my Bellgenica “membership”! Customer Service is a term that Bellgenica either is ignorant of, or refuses to follow.

  • chupacabra

    If your credit card is through a US bank you can ask your bank for a charge back.

  • Jimmy G

    I get a kick hearing folks bitch about paying $300 and $500 a month for IESS. I know things are cheaper in Ecuador but these folks would be paying at least $1,500 back in the US for the same coverage. Most of my expat friends got grandfathered into IESS and pay $80 or so a month — what a sweetheart deal that is!

    • Charlie

      You have smart friends and your analysis is right on. People forget that IESS is 100% coverage, not the 80% uncoverage that Bellgenica and virtually all U.S. policies offer. I had a good laugh at the guy above who complained that IESS would cost over $300/month for a person whose monthly income is ~$3,000.

      Of course cheap Canadians and some Europeans who have been told (and some have believed) that they were receiving “free” medical care in their own country of origin aren’t smart enough to figure out that their taxes were paying for that medical care and it certainly wasn’t as inexpensive as IESS

      • Judita Jessica Kosorinec

        Sorry but you are wrong. I don’t pay any taxes in my European country and my monthly 100% coverage is only €30.

        • Charlie

          How silly. YOU may not pay any taxes in your European country but somebody has to pay for free-loaders like yourself. There is no such thing as a free lunch. If somewhere, at some time, somebody gets something for “free”, somewhere at some time some other person has to pay for it. Unless, of course, you believe in the tooth-fairy.

          • Bart

            How do free oil profits fit into your equation of someone having to pay for it? Try not to blow a gasket coming up with an answer.

            • Charlie

              Bart, before celebrating your self envisioned triumph, you will have to give me more REAL information, not hypotheticals. You do realize, of course, that there are no European countries like Judita comes from that have “free” oil profits.

          • Judita Jessica Kosorinec

            Everybody in our country pays no more than €30. I am retired and my income is not taxable. Our property tax is only 18 euro a year and if you have baby you can stay home for 2 years and you get paid to take care of your children. Some countries actually do care abot their citizens, Sir. I guess this time your humor is not as funny as you thought.

            • StillWatching

              Why don’t you tell us what your country is so we can research it ourselves and find all the holes in your posts?

              If it is so great in your country, why are you in Ecuador?

              • Judita Jessica Kosorinec

                Hmmm- Yeah, I think not. The thought of Negative Gringos like yourself starting to research how to retire and ruin another country is terrifying . What I am going to do instead is put GP and CH in the Spam. I am not in EC anymore so no need to loose energy on negativity.

  • john

    Confiamed is an alternative. 072806711

    • Charlie

      A bad one, depending where you buy it. Stay away from Seguralmeida Agency. They’re as bad as Bellgenica. Well, almost.

    • Judita Jessica Kosorinec

      Confiamed pays 0.00 on your claims. I had them for a year and was always told that this procedure that I had is not covered.
      Don’t get them – they lie to you just like Belgenica.

      • Charlie

        That was my experience when I had Confiamed as well.

  • Joe Durr

    I suggest that as many Gringos as possible go to the office in Cuenca and protests with signs as many days as it may take to change what is going on. This is what they are afraid of. Handling complaints the same old same old way will not move the ball forward.

    • Charlie

      Gringos? Why? Are gringos the only people that have been abused by Bellgenica? I’m not a gringo (I think) but can I go, too? What time will I see you there, Joe? Oh, you mean this is something other people should do, but not yourself. Got it.

  • Charlie

    Training? You’re kidding, right? They are all fed lies from ownership and upper management and that is their training.

  • Elly Maillet

    Frankly this does not surprise me… Another insurance company here found excuses not to pay… I have now found an international insurance that does pay for my medical needs including much of my dental work.

    • Confiamed?

      • Charlie

        I can’t speak for Confiamed now, but when I had coverage with them, it was pretty bad. This was made worse by the agency that sold the policy, Seguralmeida. Confiamed was bad, Seguralmeida was even worse.

    • Mignon Scott

      Why do people who find good solutions never also post the details?????

  • Richard Schuckman

    Bellgenica will answer few, if any of CuencaHighLife’s questions. As anyone who has been here for a while (like a week) can tell you, explaining the problem often passes for a solution.

    • Charlie

      Brilliant, succinct explanation. You nailed it.

  • George

    Thanks Robert for a very informative and well written article. But I view the issue from a different perspective. The problem lays with the Ecuadorian government. I have been told by Ecuadorians that the new healthcare law was implemented because of the tremendous influx of expats from countries like Venezuela, Cuba and the like. But these are not the Expats who are buying the insurance. It is Expats like you and I who are. In Ecuador you have four options when it comes to healthcare. The first is to buy private insurance. The second is to enroll in IESS. Third is to pay out of pocket and the fourth is to use Salud Publica (Public Health). The first three options are self-explanatory. Many Expats are very healthy and don’t care to pay for healthcare. That should be their right. I personally have had health issues or the years I have lived here and have chosen to pay out of pocket. I’m fortunate to be one of those Expats who can afford to do so. If you want totally free healthcare, then Salud Pubilca maybe the answer. The one problem is that you need to speak fluent Spanish( or at least very good Spanish) to maneuver through the process. This is where I see the real problem from the governments view point. This free healthcare is available to anyone. This is the one healthcare alternative that puts the greatest strain on the governments purse stings. I doubt that there are many Expats that have used Salud Publica. It’s really meant for the poor of Ecuador but does provide realatively good healthcare. If non citizens are availing themselves of this completely free healthcare, then in my opinion, what the government should have done was to pass a law stipulating that only citizens are allowed to use this free healthcare system. This law requiring all Expats to carry health insurance is ridiculous and I don’t really understand its original intent.

    When Ecuadorians want to be heard, on any subject, they protest. Hundreds, if not thousands fill the streets around Parque Calderon. Then the government starts to address their issues. Why don’t Expats do the same? I think partly because the Expat community is not organized. I think it would benefit all Expats, who are here legally, to come together as one and elect a council who can represent us as a whole. We should then protest, as Ecuadorians do, to have our concerns addressed. This path I fear is unattainable as we are, as I see it, a very fractured community. I’ve read about the many people who are frustrated by current system and available choices in order to comply with the law. There is an old saying, “When you don’t like the rules, change them”. That, as Expats, is what we should be concentrating on.

    • Charlie

      There are more logical holes in your suggestions than Swiss Cheese. I won’t take the time to debunk them all, but perhaps others might. If not, that’s great too, because it means that either people didn’t bother reading your post or they just found it so devoid of value that they dismissed it themselves. People like you that depend on getting others to change or do something you can’t or won’t do for yourself are a drag on society.

      There is one point you make that I will address, however. You wrote this: ” Many Expats are very healthy and don’t care to pay for healthcare.”

      While you may find some healthy expats, in general, expats are older, less healthy, over weight, drink more alcohol and arrive in Ecuador with long standing underlying health issues. This is a high-risk pool of people that should cost more to insure. Ecuadorian insurance companies are learning that the hard way. There have been several companies that rushed to insure expats and have gone by he wayside as a result of not understanding these facts. FOPS and the infamous “Bjorn” group reflect this reality.

      Aw, heck, I might as well take one second to point out another of the many flaws in your post. You write this: “Third is to pay out of pocket” When you write that, it reflects a total lack of understanding of the requirements of the new law mandating universal healthcare coverage.

      • Ricki

        Mandate is on hold, till May.

  • Joe Tana

    Here is a copy of an email I got from Bellgencia just a month ago and they told me that They are still with Hopital Rio
    I asked what changes they have made. Here was their answer. Everything is the same way, if you go to a doctor in our network you cancel 20% and leave our network we reimburse 80%, we continue with Hospital del Rio, Monte Sinai. Calidad medical integral.
    So can someone tell me are they lying about Hospital Rio?

    • Hugh Prather

      Go try it. They do not accept. I was just there this past Thursday. No more relationship with Bellgencia.

  • Charlie

    As I read these comments, I have to wonder where all the people who praised Mady Gonzales and Viviana are and who extolled the virtues of Bellgenica. Yes, those people had valid positive experiences but some of them used those experiences to try to discredit or dismiss those of us who were lonely voices in the wind in exposing Bellgenica’s abuses. Just as my negative experiences didn’t negate their positive experiences, their positive experiences shouldn’t have been used to try to dismiss our negative experiences.

  • Joe Tana

    Can you at CuencaHighlife setup a meeting with other international insurance companies who have offices in Cuenca or Ecuador and let us set up Policies so we can cancel Bellgebcia , I’m sure all your readers would appreciate it if you could do this. It seems like we are wasting our time and money with Bellgencia.

  • Dave

    They completely misrepresented their insurance benefits to me and never paid any of my claims. They to drastically improve their offerings or get out of the business.

    • Charlie

      I don’t think you’re going to have to wait long for them to go out of business.

  • edgeof 2

    Universal single payer health care for all everywhere on the planet.

    • Charlie

      As long as you move to Kolob and want universal health care there, I support your idea.

  • Like most companies and agencies in Ecuador, it will depend on who you talk to as to what you are told. Assume none of it is fact-based or correct and they make it up as they go so to appease you at the time.

    • Charlie

      You have articulated an important aspect of Ecuadorian culture quite well. This nails it: “…they make it up as they go so to appease you at the time.”

    • Acbig1

      Lol. And I can’t help but think about a recent comment made that said Ecuador wasn’t a “third world country”. You gotta be kidding me.

  • Ricki

    Pension visas they want 17.6% and 3.1% from spouse, for IESS, in Cuenca. It was just announced, on Cuenca Highlife the manditory insurance is on hold till May.

    • 1Maineac1

      Not true….it is only in Cuenca! They do not ask to see your income. I just had a friend sign up and she did not have to present her income!

  • Cathy

    I was told (by Bellgenica) that Viviana no longer works there

  • Paula Zina

    As newcomers to Cuenca 5 years ago, we enrolled in a private Insurance policy with Salud, ran by a gringo. We religiously paid our dues, but never had to use the services. One day a friend told me that the company has been out of existence for a year, we were never notified, while we kept on paying. Naiveté, and stupidity comes to mind. We then enrolled in IEES, $66 for my husband, and $13.16 for me. We have never used the services, and probably never will. We have kept our private physicians for all our medical needs. They have been excellent recommendations by friends and family over the years. Yes more expensive than maybe with IEES, but definitely a lot more reasonable than in the USA. A good Ecuadorian physician friend once told me: the choices are to have an operation performed in a garage, or in a high end operating room in a hospital. Ecuadorian humor I suppose, explaining the difference in cost and convenience.

  • Charlie

    Yes, I knew that roomer that lived with your grandfather. Rumor has it that he was a lecherous old soul.

  • Jeff Salz

    With all do respect to those who have suffered… as a very recent graduate of the Bellgenica/Hospital del Rio alliance (I was released a matter of days ago after a four day/three night stay) allow me to say: My experience with both Bellgenica and Hospital del Rio was impeccable!

    Although it took about four hours for the paperwork to be processed… while I waited in my hospital room all suited up, bags packed and ready to go – when the bill DID arrived… Bellgenica had delivered as promised, covering a clean 80% of my total costs.

    Thanks to Mady Gonzalez, my agent. And to Christian Flores of Bellgenica customer service who responded to my initial email within minutes and had a doctor to my door in under 45 minutes, as promised… and has been beyond helpful every step of the way.

    Again… not to undermine or discredit anyone else’s experience… but this was mine… and less than a week ago!

    Best Wishes to All…

    • Charlie

      Jeff, I’m glad your experience with both Hospital Del Rio and Bellgenica was a positive one for you. I hope your medical outcome is a complete success as well.

      That said, I hope you will appreciate the perspective that with all the current furor over their lack of service and delayed claims payments, you don’t really think that Bellgenica would dare give clients with current claims, their usual run-around, do you? They know they’re under public scrutiny and will do anything in their power not to further sully their name, FOR NOW. Having seen their lies and deceit first hand, I don’t have any faith that your experience will be the Bellgenica norm going forward.

  • Andrew

    I never could understand Belinica’s business model. In insurance you aggregate your pool of people so although you lose on the claims you make money to cover and a profit on the non claimers. They seemed to be taking on a lot of claimers without the corresponding non claimers. Without a big pool of existing good clients it’s a recipe for disaster. Maybe they thought we’ll make it up with the numbers. I went to IESS several times to understand the horrific new premium. I was about to sign up when Tom Butynski said let them come to mm you. So we have continued under the old amount. The IESS troubles stem from a 2015 Correa decision to let all the EC’s over 65 who had not paid in , into the system. Then the government borrowed $4 billion out of the IESS system to balance the oil revenue starved budget. I’ve heard that private doctors have not been paid for three years. Without a massive cash infusion I don’t see how it can go on. The quality of care I have received has been excellent. I think we keep lurching from one thing to another as we do in Ecuador. There are several guru’s now wanting to charge people to go in and beat the IESS computer system. Thereby reducing their premiums. If you are going to do that then make sure you show the minimum income of $800. Don’t reduce it down to $400 as some idiot did.

  • Bartley D’Alfonso

    Please allow me to add another complaint about Bellgenica:
    their lack of respecting clients’ right to privacy. While inside their Cuenca office, they made me “update” or “renew” my one-year policy (hitting me with a 14% increase in
    paying monthly premiums), they asked me to verbally list and explain all of my medical history, including current medications.
    This was a question-and-answer interview, while another elderly couple was sitting next to me (mistakenly enrolling as new Bellgenica clients), and they were also describing their medical history and prescription medications. I could easily overhear them, and I am hearing impaired, and no doubt they in turn could also overhear my medical history. It was uncomfortable and embarrassing that these simultaneous invasions of medical privacy were allowed. Such conversations should be
    allowed. Such conversations should be done inside a private office, and NOT inside their reception lobby, for everyone else to
    overhear. Also: if “pre-existing conditions are completely covered” as they promise, why do we need to reveal them in the first place?!
    Hmmm. By the way, many thanks to all of you who have shared
    your war stories about this inefficient company, which helps me to finally cancel my membership and stay with I.E.S.S. coverage, even at their higher rates.

  • edgeof 2

    …..where is the Ibarra office they promised?

  • edgeof 2

    “ good morning Viet Nam ! “ 🙂

  • Kenneth A. Merena Ph.D.

    Wow, looks like this thread has kept a lot of people busy over the weekend. The thing that I notice right off is that until someone opened the flood gates and had the courage to post complaints about Bellgenica a while back, all we used to hear were the effusive complements of the shills praising Bellgenica and some of their employees. As I have said many times, I never doubted the experience that those people were reporting, but it was anecdotal evidence that carried little weight. Now, it seems that the preponderance of evidence has shifted and people have become emboldened to post their negative tales and outright horror stories I guess that’s just the way herds work.

    For myself, my experience with Bellgenica has been sufficiently bad that I have brought legal action against them. I knew it was time to stop simply complaining when I had been lied to by three levels of management at the company. First, Mady Gonzales at the sales level did so publicly and you can read those lies here:

    http://www.gringopost.com/2017/02/belgenica-health-insurance.html#disqus_thread

    If you take the time to go to that thread you will see that this is not a he-said-she-said battle, it is Mady convicting herself with her own words which she posted publicly. That thread ended last July and not a penny of the claim for $2,600 has been paid to this date.

    Next up was Piedad Pantoja, who was introduced to me as the General Manager of Bellgenica in Quito. I had a meeting with her on August 9, 2017 at which she informed me she was unaware of my unpaid claims and conversations with Mady Gonzales and asked that I send her copies of my written communications with Bellgenica Employees. I did that the very next day. Sra. Pantoja told me she would get back to me immediately but here we are, six months later and I have yet to hear from Sra. Pantoja or anyone else regarding the material I sent her.

    Next, I attended the January meeting with at the Oro Verde in which the main address was from the owner of Bellgenica, an arrogant man that had the temerity to tell all those present that we didn’t have the right to take our complaints public in the media. To me, that was laughable because what he told us we should have done was to take our complaints directly to Bellgenica representatives. Based on what we all heard at the meeting, that is what many of us had done and it resulted in no action whatsoever from the company to pay claims and improve customer service.

    After that meeting I spoke directly with the owner and he told me he had never heard of my case, but he promised he would look into it and get back to me immediately. I know that as ex-pats, many people have come to accept that in Ecuadorian culture, “immediately” has a different meaning from the one we may be used to. Some fresh off the boat expats even think this is cute. I’m way beyond that rose colored glasses stage.

    It is now a full month later and I still haven’t heard from the owner or anyone else from Bellgenica. Finally, I threw in the towel and have engaged Fabian Pozo, a principal in the Law Firm of Gottifredi Pozo. Since Fabian began representing me, he has reached out to Bellgenica several times and like many of the rest of us, he has been fed promises that have been broken. We are now taking direct action against Bellgenica as we realize that Bellgenica hasn’t and won’t operate in good faith.

    Kenneth A. Merena, Ph.D.

  • Terri Drake

    Amazing that Bellgencia is quick to take your money but not quick to pay the claims. I am still owed $107, which I was told would be available last Friday. Not so, reimbursement is now three months. Cristian Flores told me to email her witjany questions or problems. Surprise, surprise, the email is nondeliverable.
    Unfortunately, we are locked in for one year under their contract. We are going to speak with our attorney to see if we have any recourse or can cancel the contract without jepordizing our Visas.

    • Ricki

      We cancelled at the office and have a letter why we did! “No customer services or working phones” Also, took back our authorization to debit our card. We paid in cash and have that receipt too.

      • Terri Drake

        Thank you Ricki. We have Tricare Overseas and the only reason we got Bellgencia was because we could not get proof that Tricare is good in Ecuador, even though it is, and is paid for by the U.S. Government for Military and those on Disability due to war related injuries, which is my spouse, and were told that Ecuadorian Insurance is now the requirement.