The abridged version is that my wife needed some time-critical surgery and the hospital we chose to have the surgery at requested payment in advance (we don't have German health insurance and they do not trust an American insurance company to pay). Per their policy, our insurance provider was unwilling to pay in advance and suggested we use International SOS to arrange for payment since "International SOS has relationships with hospitals throughout Germany". International SOS's solution was to send my wife to Frankfurt for her surgery at a hospital that is 3+ hours away by train and doesn't have her doctor. I told them that this was unacceptable and asked that they come up with a more reasonable solution. They never called me back.

In the end, we bit the bullet, paid for the surgery ourselves, and are hoping that our insurance will actually pay what they are supposed to.

I had a bad experience with International SOS; others here have had positive experiences and I hope that yours will be positive as well.