SALUS SEGUROS DO NOT WASTE YOUR MONEY

Playing devil's advocate here but is there any chance you had some sort of pre-existing condition with your back? The scans and tests would have been diagnostic and it could be that the results of these scans showed up a pre-existing problem which your fall has exacerbated.

Has there been a diagnosis of osteoporosis with all the tests? If not, I feel for you as it sounds as if you have a fight on your hands when you least need it. I hope you have a positive outcome.

What Cheryl says would make sense, they carry out the scans and tests not just to assist you, but to also see if they can find any justifiable reason not to pay for further treatment. It would seem that they have discovered something which they believe will exonerate them, please ask them to explain to you what exactly they have discovered during the scans and tests  that justifiably leads them to the conclusion that it was pre existing. Wishing you all the best, but they must explain what has led them to this conclusion. Then you can take it further, or not. 

Hi Gabrielle,

I´m sorry to hear of your accident and the great difficulty you are now experiencing, I hope you can achieve resolution through the ombudsman.

You kindly shared the name of the insurance company denying your claim, but are you able to tell us the company name of the unhelpful agent, presumably through which you bought the policy?  Is Adolfo Lagunas the director of the insurance company, or the agent?

Kind regards,

Kim

It may be worth trying to ask for a Hoja de Reclamacions (Complaint Form) which all companies must have by law.  If you can't get one from them I understand you can go to your local OMIC who should be able to get you started.  There's better details about the Hoja link here

I'm not fully up on the matters, but it may be of help nevertheless.

Have you tried Citizens Advice they may be able to "signpost" you to somewhere who can help.

This is very sound advice. I had a similar problem with Salus as I had a fall and damaged my shoulder and rotator cuff. they agreed and paid for an operation to repair the torn rotator cuff and severed bicep, however this did not correct the injury and the surgeon recommended another op where he proposed to transfer muscles in my back to supplement severed deltoid muscles in my arm. The Salus company refused to pay for this and did not give a satisfactory reason for their refusal. I followed through the above complaints procedure and they sent me to a specialist in Valencia who recommended that I have reverse shoulder replacement surgery. They agreed to pay for this and I am now in recovery and already have 85% use of my arm and shoulder. So follow the complaints procedure above and don't give up.

Best regards

Jeff    

I love Spain but I find customer service is almost non existent.

Absolutely agree, irrespective of the company. But can vary depending on who you are, which is even worse!