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Let’s take a look at the case of Rafael Casco Monjaras, an AXA Seguros policyholder, who is in a legal battle against the insurer after it refused to cover his hospitalization expenses, despite having a major medical expenses policy for 75 million pesos. Casco accuses AXA of fraud and has filed a formal complaint with Condusef.
Despite having complied with all the obligations established in the policy, including the payment of the corresponding premiums for four years, AXA Seguros argues that there is a pre-existing condition that justifies the denial of coverage. However, Casco maintains that this pre-existing condition was duly declared and that the insurer authorized the issuance of the policy, including additional coverage for pre-existing conditions.
Faced with this situation, Casco has decided to take legal action. With the support of an insurance specialist lawyer, he has filed a complaint with Condusef. She has also made her story public in order to alert other policyholders about AXA Seguros’ practices and prevent more people from falling victim to similar situations.
If you find yourself facing a denial of payment from your insurer, it is important that you know your rights and take the following actions:
If it is proven that AXA Seguros acted in bad faith by refusing to cover Casco’s medical expenses, the insurer could face the following consequences:
The case of Rafael Casco highlights the importance of not giving in to the big insurance companies and of turning to experts to receive the support and advice necessary to defend one’s situation. It also highlights the need for the competent authorities to monitor compliance with the obligations of the insurance companies and protect the rights of consumers.
If you or a family member or acquaintance finds themselves in a situation similar to that of Mr. Casco, contact LEX & CO. Our team of expert insurance lawyers will gladly provide you with legal advice and representation to obtain a resolution in your favor. Write to us at the contact form, let us know your case and learn the art of winning with LEX & CO!
Carlos Figueroa Rodríguez, attorney at law at Lex & Co. He has more than 10 years of experience in specialized cases involving insurance claims and medical malpractice. He is a graduate of the Universidad Anáhuac and has a Master’s Degree in Constitutional Law and Amparo from the National Bar Association. He also has a Doctorate in Juridical Sciences from the UCI Mexico. Professional license 6577215.
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