Guardian Insurance MX

Insurance protection for the unexpected.

    Real claims scenarios

    HEALTH
    TOURIST AND RESIDENT AUTO

    Scenario 1: Pre-Authorization of a Medical Procedure - Direct Payment to Medical Facility

    April 12
    Client Contacted Guardian Insurance MX
    • Client contacted Guardian Claims Department to inform us of a necessary surgery and requested pre-authorization and for the insurance provider to pay the expenses directly to the facility.
    • Guardian Claims Department contacted the insurance company to inform them of this and to ask what documents we needed to provide.
    • The insurance company replied to Guardian Claims Department with the list of the necessary info to proceed with the pre-authorization of the procedure. This info included medical notes on the condition, the medical order from the doctor, the date and place of the procedure, and a medical fees breakdown (surgeon fees, anesthesiologist fees, assistant surgeon fees).
    April 27
    Client sent documents

    The client sent all documents that were requested to our Guardian Claims Department, but the expense breakdown was missing. We requested that from the client again.

    May 3
    Client sent us the expense breakdown
    • Client sent us the expense breakdown.
    • The insurance company requested further information (MRI and a medical report including info of the beginning of the medical issue, including date of first diagnosis, etc.).
    May 5
    Client submitted MRI

    Client submitted MRI and medical report, but it was missing a doctor’s signature and some other information, so we requested that from the client

    May 11
    Client sent medical report

    Client sent the complete medical report with the doctor’s signature and missing info

    May 13
    All information submitted

    With all information submitted, the insurance company sent the Guarantee of Payment Letter.

    May 13
    Client had successful surgery

    The client had successful surgery, which was paid directly to the facility by the insurance company.

    Total amount paid directly to hospital: $35,935.82 USD

    Total claim processing time: 33 days

    Scenario 2: Reimbursement after meeting deductible

    June 11

    Guardian Claims Department received the medical report, doctor’s prescription, and payment receipt from the client.

    June 14

    Guardian Claims Department sent the documents to the insurance company.

    June 21

    The insurance company replied confirming receipt of the documents.

    July 14

    The insurance company reimbursed the prescription medication expenses in full to the client.

    Total Amount Reimbursed to Client: $7,628 MXN ($382 USD)

    Total claim processing time: 33 days

    Scenario 3: Applying Expenses Toward the Annual Deductible

    August 17
    • Client suffered a minor accident and sent Guardian Claims Department the necessary documents, including payment receipts, itemized bills and medical records.
    • Guardian Claims Department sent that documentation to the insurance company.
    August 26

    The insurance company confirmed receipt of the documents.

    September 2

    The insurance company notified Guardian Claims Department that they are missing the hospital intake form. Guardian Claims Department contacted the client regarding this.

    September 8

    Client sent Guardian Claims Department the intake form, which was then forwarded to the insurance company.

    September 10

    The insurance company confirmed receipt of the intake form.

    September 13

    Claim is processed and applied towards the client deductible.

    Total Amount Applied Towards Annual Deductible: $2,867 USD

    Total claim processing time: 26 days

    Scenario 1: Collision insured at fault.

    January 26th
    at 2:52 pm
    • The insured contacted Guardian Claims Department. Informed of having an accident with a bus.
    • Guardian Claims department called the insured and requested a description of the event, his location, and other required information to proceed with making the report to the insurance company
    January 26th
    at 2:55 pm

    Guardian Claims department calls the insurance to inform them of the insured’s accident. The insurance company takes the information and creates the report number.

    January 26th
    at 3:08 pm

    The insurance company sends an adjuster to the insured location.

    January 26th
    at 3:43 pm

    Adjuster arrived at the insured location.

    January 27th

    Guardian claims department contacts the insured to ask about the resolution to his accident. Since the insured was at fault the adjuster gave a pass to the third party for his repairs and well to our insured.

    February 7th

    Insured visits Guardian insurance office and confirms having his car repaired without issues.

    Total time for an adjuster to arrive since the report was made: 35 min

    Scenario 2: Collision Insured affected.

    January 26th
    1:59 pm

    Insured contacts the Guardian Claims department through WhatsApp mentioning he was just in an accident.

    January 26th
    at 3:08 pm

    The insurance company sends an adjuster to the insured location.

    January 26th
    at 3:43 pm

    Adjuster arrived at the insured location.

    January 26th
    2:59 pm

    Adjuster arrives at the insured location.

    January 26th
    3:19 pm

    Adjuster makes an agreement with the third party which had to pay the costs of damages. The Insured receives an admission note for his vehicle to be paid without a deductible.

    February 9th

    Insured confirmed his vehicle had been repaired without issues.

    Total time for an adjuster to arrive since the report was made: 35 min