ORANJESTAD, Aruba — The AZV Overseas Medical Care process has received renewed attention after the Executive Body of AZV responded to public allegations involving Ricardo Croes, Fundacion SIKI and the medical treatment of an insured young person.
AZV said it became aware of a press conference during which Croes and Fundacion SIKI representative Jayburtt Dijkhoff strongly criticised the insurer’s handling of the case.
The organisation disputed the allegations but said it could not publicly respond with detailed clinical information because the matter concerns confidential patient data.
AZV Describes Its Handling of the Case
According to AZV, the insured person’s request was submitted on July 7, 2026, and received the required attention.
AZV stated that a treatment plan was proposed, the patient travelled to Colombia and later returned to Aruba, and the insured person was informed about which treatments could and could not be covered.
The insurer said the case was considered through evaluations involving Aruba’s oncology committee at Dr. Horacio E. Oduber Hospital, the Cross-Border Healthcare Committee and an oncology committee in Colombia.
These statements form part of AZV’s response and have not been independently confirmed through the patient’s confidential medical records.
Public Allegations Prompt Official Response
During the earlier press conference, Croes and Dijkhoff alleged that AZV’s decision placed the young patient’s life at risk.
They argued that an alternative treatment requested while the patient was in Colombia should have been considered instead of the treatment initially approved by AZV.
AZV rejected the characterisation of its conduct and published a broader explanation of the rules governing overseas medical care.
Because the medical file is private, the public information available does not establish the complete clinical reasoning of the doctors, committees or patient involved.
When Overseas Treatment May Be Approved
Aruba has several medical specialties, but some illnesses require expertise or treatment that is unavailable on the island.
In such cases, the patient’s treating specialist discusses the proposed treatment with the patient and submits a formal request to AZV.
Prior authorization is required before AZV will cover medical treatment abroad. AZV says the requested treatment must be medically necessary and unavailable in Aruba.
AZV’s statement also says that the treatment must fall within the insurance package and be considered an accepted treatment within the relevant medical specialty.
Treatments still considered experimental or primarily part of research are generally excluded from AZV coverage, according to the insurer.
Independent Committee Reviews Requests
Requests for overseas care are evaluated by the Commissie Grensoverschrijdende Zorg, commonly known as CGZ.
The committee assesses whether the requested treatment is medically necessary and whether it can be provided in Aruba.
After reviewing the request, CGZ gives its advice to AZV. AZV says it follows the committee’s recommendation in most cases.
For oncology cases, AZV said the patient’s situation must first be discussed by Aruba’s oncology committee before the request proceeds to CGZ.
This process is intended to ensure that cancer-treatment requests receive clinical evaluation from the appropriate specialists before a coverage decision is made.
What AZV Arranges After Approval
When overseas treatment is approved, AZV arranges the appointment with a contracted hospital and coordinates the patient’s travel and accommodation.
Coverage can include:
- Return airfare for the patient;
- Travel for one approved social companion;
- Hospital admission and approved medical procedures;
- Necessary tests connected to the authorized treatment;
- Accommodation through an AZV guarantee;
- A daily financial contribution toward the patient’s food expenses.
The destination and hospital are assigned through AZV’s overseas-care system. Aruba currently sends patients to destinations including Colombia, Curaçao, the Netherlands and the United States, depending on the approved care and available arrangements.
Urgency Determines Travel Arrangements
The time required to arrange treatment depends partly on the medical urgency and the availability of appointments at the overseas hospital.
Patients generally travel on commercial flights shortly before their first appointment.
When the patient’s medical condition makes ordinary travel unsafe or the situation is considered extremely urgent, an air ambulance may be arranged following medical assessment.
Treatment Changes Require Additional Approval
A patient’s condition can change after arriving abroad.
Additional tests may reveal another illness, complication or treatment requirement that was not included in the original approval.
In that situation, the overseas hospital must communicate with AZV and the treating specialist in Aruba. Additional authorization may be required before the new treatment can be paid from the AZV fund.
AZV says communication continues among the overseas hospital, the insurer and the patient’s Aruban specialist throughout the treatment period.
Approved Treatment Defines Initial Coverage
AZV explained that when an insured person accepts overseas care through its system, the authorization applies to the treatment plan approved before departure.
A different treatment proposed after arrival is not automatically covered simply because it is available at the overseas hospital.
The new request must be medically evaluated and must satisfy the applicable coverage criteria.
AZV said that if the insured person chooses not to undergo the approved treatment, arrangements may be made for the person to return to Aruba.
Patient Communication Remains Essential
The controversy demonstrates the importance of clear communication among patients, families, treating specialists and AZV.
Patients should understand:
- Which treatment has been requested;
- Which treatment AZV has approved;
- Why a requested alternative was accepted or denied;
- What expenses are covered;
- What happens if the medical plan changes abroad;
- How to request clarification or review.
AZV advises patients to ask their specialist for a copy of the overseas-treatment request so they can confirm what was submitted and when AZV received it.
Case Remains Medically Confidential
AZV’s public response provides an explanation of its general procedures but does not resolve the disagreement between the insurer and those representing the patient.
Croes and Fundacion SIKI have questioned whether the approved treatment served the patient’s best interests, while AZV maintains that the case received the required medical reviews and that the insured person was informed about available coverage.
Without access to the confidential medical evidence, neither position should be presented as conclusively proven.
The broader AZV Overseas Medical Care explanation confirms that prior authorization, medical necessity, available care in Aruba and insurance coverage all affect whether treatment abroad will be funded.
