Kære Heydar,
Vi beklager dybt din utilfredshed med vores dækningspolitik. Vores mål er altid at levere en forsikringsløsning, der lever op til vores kunders forventninger.
Din tandforsikring via din arbejdsgiver har nogle specifikke vilkår. Forsikringen dækker typisk de fleste tandbehandlinger uanset tændernes tilstand på tegningstidspunktet. Dette inkluderer blandt andet plastbehandlinger, rodbehandlinger, paradentosebehandlinger, kirurgi, diverse røntgenbilleder og bidskinner, som alle er dækket fra tegningsdatoen og frem uden forbehold. Dog er der visse krav, der skal opfyldes for at få dækning for protetiske behandlinger såsom kroner, broer og implantater, hvilket er klart defineret i vores forsikringsbetingelser. Disse betingelser blev sendt til dig sammen med din police ved forsikringens start og ved seneste fornyelse.
I den ordning din arbejdsgiver har valgt, dækker forsikringen ikke tænder med revner eller fyldninger i tre flader eller mere. Ifølge punkt 6.2 i forsikringsbetingelserne dækker forsikringen heller ikke følgende behandlinger:
• Allerede diagnosticerede, igangværende, planlagte
eller anbefalede protetiske behandlinger (krone,
bro, implantat eller lign.)
• Rodbehandlede tænder uden krone samt tænder
med revner eller fyldninger i tre flader eller mere.
Vores afgørelse er baseret på journalnotater og tilhørende røntgenbilleder for at vurdere tandens historik.
Vi forstår, at dette kan være skuffende nyheder, og vi har sympati for din situation. Vores primære ansvar er at overholde de vilkår og betingelser, der er skitseret i vores forsikringspolicer, for at sikre retfærdighed for alle policeholdere.
Afslutningsvis undrer vi os over, at du fraråder denne forsikring. Det er ikke et særlig godt råd at give andre. Vi hjælper rigtig mange danskere hver eneste dag og assisterer i øjeblikket mellem 5.000 og 6.000 danskere hver måned.
Med venlig hilsen
Dansk Tandforsikring
Dear Heydar,
We sincerely regret your dissatisfaction with our coverage policy. Our goal is always to provide an insurance solution that meets our customers' expectations.
Your dental insurance through your employer has specific terms. The insurance typically covers most dental treatments regardless of the condition of the teeth at the time of enrollment. This includes, among other things, fillings, root canals, periodontal treatments, surgeries, various X-rays, and bite guards, all of which are covered from the date of enrollment onwards without reservation. However, there are certain requirements that must be met to obtain coverage for prosthetic treatments such as crowns, bridges, and implants, which are clearly defined in our insurance terms. These terms were sent to you along with your policy at the start of the insurance and upon the most recent renewal.
Your employer has chosen an insurance that does not cover teeth with cracks or fillings on three surfaces or more. According to section 6.2 of the insurance terms, the insurance also does not cover the following treatments:
• Already diagnosed, ongoing, planned, or recommended prosthetic treatments (crown, bridge, implant, etc.)
• Root-filled teeth without a crown, as well as teeth with cracks or fillings on three surfaces or more.
Our decision is based on journal notes and accompanying X-rays to assess the history of the tooth.
We understand that this may be disappointing news, and we sympathize with your situation.
Our primary responsibility is to comply with the terms and conditions outlined in our insurance policies to ensure fairness for all policyholders.
In conclusion, we are puzzled by your recommendation against this insurance. It is not particularly good advice to give to others. We help many customers every single day and currently assist between 5,000 and 6,000 customers each month.
Best regards,
Dansk Tandforsikring
