1- OUR HISTORY
TOP Health Insurance was created through the knowledge of many years of experience, by expert health media.
A market study bringing together a panel of subscribers, but also editors whose competence has been to study the various insurances on the French market for several years, made it possible to find the ideal partner to create TOP Santé assurance.
Our subscribers, but also their spouses, their children, their parents, have made proposals for services and guarantees that they wanted to include in an effective, transparent, useful and cheapest complementary health contract on the market.
2- OUR GUARANTEES
We based ourselves on existing criteria:
– The cost of reimbursement of general practitioners
– The cost of reimbursement of medical specialists as well as their excess fees
– The cost of reimbursement of hospitalization costs
– The cost of reimbursement of dental expenses
– The cost of reimbursement of optical expenses
– The cost of reimbursement of audioprosthetist fees
– The cost of reimbursement of drug costs not reimbursed by social security
– The cost of reimbursement of alternative medicine costs or to be like the physiotherapist, osteopath, kinesiologist, acupuncture, psychologist, etc.
3-OUR EXCLUSIVE SERVICES
We also asked our test group to tell us about their needs for additional services, in order to see how we could include them.
We then decided on two services which seemed to us to make sense with the needs of our readers but also the critical eye of our experts:
– The prepayment service: avoid advancing the costs, we set up a dematerialized bank card sent to your smartphone with an amount allowing you to pay the health professional not covered by social security in advance
– The post-hospitalization service at home: you must be hospitalized for at least 2 days, we take care of you after your hospitalization to avoid you staying in a hospital room, we transfer you home in a medical vehicle, we plan your care via specialized nurses and doctors at home, a medical bed if necessary, the delivery of medication, meals and if necessary, a household help and childcare at your disposal
This new enriched complementary health insurance is at the cutting edge of technology and will allow our community, but of course also beyond, to avoid as far as possible claiming reimbursements, the postponement or cancellation of health costs or expenses. equipment for lack of financial means, or even impacting their purchasing power with amounts to spend that would prevent them from living normally on a daily basis.
Also no more loneliness in the hospital with visits reserved for specific hours but no one to talk to outside these hours, everyday objects to pass the time inaccessible and an interminable wait for the authorization to leave.
So many constraints avoided with yet care and identical medical monitoring at home, as in the hospital
To give you in complete transparency, the credibility that we wish to bring to TOP Santé assurance is the alliance of a network of experts, with users concerned about their health, to create an insurance whose included services are explained. in complete transparency for a better use of it in your daily life.
So that health insurance is no longer perceived as a compulsory expense but as a useful service in terms of prevention, curative needs and medical support at the end of illness
4-OUR REINFORCEMENTS
Complementary health insurance could not be complete if we did not take into account the additional needs of our subscribers and future policyholders and, as some need much higher levels of guarantees, we had to build a completely modular and flexible offer, in according to individual needs.
We have therefore called “reinforcement” modules that everyone can add, or not, as they wish, to increase their level of insurance, to make it possible to distinguish in their family if the dental, optical/auditory need, their possibilities of being more often hospitalized or additional well-being comfort is necessary for his activity or linked to his personality.
TOP Santé assurances has of course understood the request made, by responding to a not insignificant imperative: that this reinforcement of reimbursements does not impact a purchasing power which is reduced from year to year, because health cannot be monetized, and the complementary health must in no case differentiate between those who have the means to treat themselves, and the most modest
We have therefore asked our partner to find an offer adapted to all needs, therefore a reinforcement of the guarantees high enough so that it is never disappointing, but also a price which will never exceed the maximum of what our subscribers could spend on more than the monthly rate of their mutual, i.e. 4€ per month of ceiling.
Achieving this feat was only possible thanks to the same reflection as for the creation of the offer: an association between experts in the insurance sector, in particular the technical direction of the insurer and its history of the many medical costs perpetuated for several years, with a study of the purchasing power of the French people and the amount allocated to health expenditure on a monthly basis.
A medical cost that was too high would not have made it possible to cover all the health costs, and a cost of the amount of the insurance would not have allowed the insured to strengthen their guarantees for needs that may be one-off or permanent
Examples:
We have taken into account all categories of people to be able to respond to a majority of our subscribers, and the association of the base of the mutual with each reinforcement allows everyone to see themselves represented in the offer that we propose:
Example 1: A 25-year-old student who does not wear glasses, without orthodontics or specific dental needs, who only has a risk of hospitalization without any real follow-up, will be able to settle for a basic contract at €16.17 including tax per month
Example 2: A 37-year-old active woman, pregnant, who has no other need than the pleasure of relaxing by having a reinforcement of well-being with alternative medicines compatible with her lifestyle, can be satisfied with a contract with the well-being reinforcement at €42.87 including tax per month
Example 3: A 48-year-old business manager who wears glasses with a 42-year-old part-time woman who wants access to alternative medicine, with 2 children aged 10 and 14 who may need orthodontics can take a level 4 formula whose dental, optical and well-being reinforcement is already included at a price of €192.72 including tax per month
Example 4: A single 68-year-old retiree who needs multifocal glasses, dental crowns, talks with medical specialists who exceed fees and who are prescribed spa treatments can subscribe to a formula from the formula 2 with optical reinforcement for €106.78 including tax per month
These examples serve to show that regardless of the level of coverage desired, the age of the person wishing to subscribe, the family composition or the associated plan, there will always be a formula adapted to the needs of the insured, and the reinforcements will be available. of all, without exception.
5-OUR CUSTOMER SERVICE
The strength of the TOP SANTE assurance offer does not lie solely in the product and the levels of guarantee because, of course, they are important, but the execution of these guarantees must be irreproachable.
This involves customer service accessible over long time slots (by telephone, email, chatbot), responsiveness in the response to be provided to our policyholders, a definitive response from the first call, the implementation of a immediate advance payment of costs, third-party payment systematically made available, useful services set up for the insured if necessary and immediate assistance for the most urgent needs.
Customer service is operated by our partner who, thanks to his experience, will be able to take care of the request of the insured without a question form or too long a waiting period. The goal is to avoid successive calls from our policyholders, which reinforces the feeling of a bad customer experience and the desire to change mutual insurance.
We are on a permanent search for the improvement of our customer service, we are therefore very attached to your requests for improvement, your complaints or your requests for new products or services, we therefore set up a contact form @omniiz.fr which allows you to send us as many needs as insured persons, with the assurance of an answer as soon as the solution is found
6-TERMINATION OF YOUR MUTUAL
Do you want to change your health insurance but don’t know how to cancel your current health insurance to join us? We explain everything to you.
You have the possibility of terminating your mutual insurance via the infra-annual termination, introduced by law n° 2019-733 of July 14, 2019 for complementary health contracts and this is an effective measure after one year of commitment, and this without charge, justification or penalty
You have the possibility of terminating on your own as soon as you take out new health insurance, or of giving power to your new insurer so that it begins the process itself and relieves you of this often time-consuming administrative act.
This second solution is the most popular with our policyholders
7- MODEL LETTER OF TERMINATION
Full name
Address
Insurer’s name
Address
Registered letter with acknowledgment of receipt
The date),
Subject: Termination of health/mutual insurance contract no.….
Dear,
- Case n°1: Termination at maturity
I, the undersigned)….(full name)declares to terminate the above-mentioned health insurance contract at the end of….(expiry date of the contract)in accordance with the general conditions of the contract.
- Case n°2: Termination at maturity – Chatel Law
I, the undersigned)….(full name),declares to terminate the above-mentioned health insurance contract as of….(date)in accordance with the provisions of Article L. 113-15-1 of the Insurance Code, and following(check the reason invoked):
□the absence of information relating to the deadline for exercising the right to terminate the contract on the expiry notice received.
□ when the notice of expiry is sent less than 15 days before the expiry of the termination period of my contract (the postmark being taken as proof)
□the failure to send my expiry notice.
- Case no. 3: Infra-annual termination
I, the undersigned)….(full name),declares to terminate the above-mentioned health insurance contract on the date of….(desired date respecting a minimum period of one month)in accordance with the option offered by law no. 2019-733 of July 14, 2019.
- Case n°4: Other reasons for termination (refer to the general conditions for the reasons for termination)
I, the undersigned)….(full name), requests the termination of the above-mentioned health insurance contract, in accordance with the option offered by law and stipulated in the general conditions of the contract, due to…. (discuss the change: change in marital status, retirement, change in professional status, complete cessation of activity).
Thanking you in advance, please accept, Madam, Sir, my best regards.
Signature
8-REWARDED LOYALTY
Our subscribers, then now those who trust us by choosing our expertise through our insurance are more and more rewarded and can be offered the following advantages:
– A free subscription to any digital magazine
– A -50% subscription to any paper magazine
– Discounts if you equip yourself with at least 2 of our insurances
– Access to KiosqueMag for benefits throughout the year
For any information :
