<div class="portada"><div class="meta">Menteia · Seguro Sin Vueltas · October 2026 · Confidential</div>

# Business plan

**Seguro Sin Vueltas** — AI assistant on WhatsApp that guides patients with major medical insurance at no cost and routes them to in-network doctors and hospitals, backed by VITAE Asesores.</div>


## 1. Summary
Seguro Sin Vueltas is a free guidance service for patients: an AI agent on WhatsApp collects the basic details, reads the policy with computer vision, pre-qualifies the case and assigns it to a specialist advisor at VITAE, who guides the patient to doctors and hospitals in their insurer's network. Our own CRM gives advisors a prioritized queue, case files, live chat with takeover and KPIs.

> Use your health insurance without the runaround.

## 2. Problem
- 14.5 M Mexicans have private health insurance, but using it is a maze: hospital networks, deductibles, co-insurance, surgery scheduling, reimbursements.
- Patients arrive late or at the wrong hospital and end up paying out of pocket or abandoning the claim.
- Doctors and hospitals lose insured patients because nobody connects them with people who already have coverage.

## 3. Solution and product
- Single entry point on WhatsApp from the website or referral QR codes, tagged by source (patient, emergency, surgery, doctor, company).
- The AI agent collects data, reads the policy summary page (OCR) and transcribes voice notes; it never promises coverage or gives medical advice.
- Pre-qualification and automatic assignment to the available advisor with the lightest workload.
- Advisor CRM: prioritized queue, funnel, patient case file, live chat with 'take control', insurer-specific forms, SLAs.
- Network of partner doctors and hospitals with no membership fee; HR portal for companies.

### Technology
- Next.js 14 + TypeScript (websites and CRM); Supabase (Postgres with RLS, pgvector, Auth, Storage, 10 Edge Functions).
- Meta WhatsApp Cloud API; agent in n8n; OpenAI (GPT-4.1, vision, Whisper).
- DigitalOcean + Traefik/Docker, Cloudflare, Metabase, Resend.

## 4. Market
| Level | Annual size | How it is calculated |
| --- | --- | --- |
| TAM | US$29 M | 14.5 M people with major medical insurance × ~5% with a hospital event per year (~725k cases) × US$40 per routed case |
| SAM | US$11.6 M | Mexico City and State of Mexico (~40% of insured people) |
| SOM | US$300k | ~750 cases routed per month by month 24 (≈2.5% of SAM) + partner memberships |

**Supporting data:**
- Health insurance premiums 2024: ~US$8.5 B; loss ratio 74% (AMIS).
- More than 14.5 M people with major medical coverage (+4.4%).
- 71k registered insurance agents (Jun-2024).
- Claims paid in 2025: ~US$7.8 B (+19%).

*Market figures are estimates based on public sources; validate them before sending to institutional funds.*

## 5. Target customer
- Patients with major medical insurance (policyholders and family members) in Mexico City and the State of Mexico facing surgery, an emergency or medical tests.
- Specialist doctors and in-network hospitals looking for insured patients.
- HR departments at companies with a group policy (employee benefit).

## 6. Business model and pricing
Free for the patient. Revenue from a coordination fee charged to partner doctors and hospitals per attended case, a partner membership with visibility and tools, and a B2B program for companies with a group policy.

| Item | Price |
| --- | --- |
| Patient | Free |
| Coordination fee per attended case (partner) | US$25–60 |
| Partner doctor membership (profile, scheduling, CRM) | US$50 / month |
| HR program (companies) | US$1–2 per employee / month |

## 7. Go-to-market strategy
- Patients: health SEO and content + Meta and Google campaigns (with human approval of spend).
- Referrers with QR codes: medical offices, pharmacies, insurance agents.
- Network of partner doctors and hospitals in Mexico City/State of Mexico with no initial membership fee, recruited through vitaeasesores.com (portal for doctors and HR).
- Companies: HR as a B2B2C channel (wellness benefit for employees).

## 8. Competition and positioning
| Alternative | What it offers | Our advantage |
| --- | --- | --- |
| Traditional insurance agent | Sells the policy, offers little follow-up | 24/7 support when using it |
| Insurer's call center | Paperwork, not guidance | Advisor on the patient's side |
| Doctor directories (Doctoralia) | Search and book | Connects based on your policy's network |
| Reimbursement handlers | After-the-fact paperwork | Guidance before, during and after |

## 9. Defensible advantages
- AI does the heavy lifting (data capture, policy OCR, prioritization); a human expert makes the sensitive decisions.
- Health guardrails: no coverage promises, no medical advice, closed list of insurers, human in the loop.
- Free for the patient: revenue comes from the partner network and companies, not from the sick.
- Our own CRM with role-based security (RLS): each advisor sees only their own cases.

## 10. Traction
- Platform in production (pilot) since July 2026: website, WhatsApp agent and advisor CRM.
- Operated by VITAE Asesores (vitaeasesores.com), its corporate brand: a network of partner doctors and HR teams with free advisory, tools and a CRM to follow up on every case.
- Real case metrics still to be documented (test data was wiped in Jul–Sep).

## 11. Team
| Partner | Role | Stake in Menteia |
| --- | --- | --- |
| Rafael Herrera | CEO / CFO | 33.3% |
| Vladimir Díaz | CTO | 33.3% |
| Francisco D'Angelo | Head of Legal and Compliance | 33.3% |

**Hires funded by the round:**
- Full-stack developer — from month 1
- Customer success / implementation — from month 1
- Growth / digital marketing — from month 3
- B2B account executive — from month 4
- Support / operations — from month 6

## 12. Financial projection (24 months)
| Quarter | Revenue | Expenses | Net cash flow | Cumulative cash flow |
| --- | --- | --- | --- | --- |
| Q1 | US$1,400 | US$35,738 | US$-34,338 | US$-34,338 |
| Q2 | US$7,841 | US$56,048 | US$-48,208 | US$-82,545 |
| Q3 | US$13,003 | US$59,859 | US$-46,856 | US$-129,402 |
| Q4 | US$19,682 | US$60,021 | US$-40,339 | US$-169,741 |
| Q5 | US$28,667 | US$60,183 | US$-31,516 | US$-201,257 |
| Q6 | US$41,162 | US$60,345 | US$-19,183 | US$-220,440 |
| Q7 | US$58,992 | US$60,507 | US$-1,515 | US$-221,955 |
| Q8 | US$84,938 | US$60,669 | US$24,269 | US$-197,686 |

- Monthly recurring revenue (MRR) at month 24: **US$31,850** (ARR US$382,202)
- Total 24-month spend: **US$453,371**; cumulative revenue: **US$255,684**
- Projected monthly breakeven: **month 21**

**Revenue assumptions:**
- No revenue in the first 2 months (partner signing and compliance).
- Routed cases: 40/month in month 3, growing 15% monthly: ~750 cases/month by month 24.
- Average coordination fee: US$35 per case attended by a partner.
- Partners with membership: 10 in month 4, +5 per month (US$50/month).

## 13. The round
- Amount: **US$500,000** for **25%** (pre-money US$1,500,000, post-money US$2,000,000).
- Use of funds detailed in *06_Modelo_Financiero_y_Ronda* (financial model and round).

## 14. Risks and mitigation
| Risk | Mitigation |
| --- | --- |
| Health data (sensitive, LFPDPPP) | Privacy notice and express consent; RLS; legal review before scaling |
| Routing fee model (medical ethics, conflicts of interest) | Transparent coordination fee, no exclusivity; the patient chooses; legal review |
| Unsupported marketing claims | Remove 'thousands of cases' and illustrative testimonials until real data exists |
| Dependence on external n8n and a single server | Move the agent to our own redundant infrastructure |
| Expensive patient acquisition | Referral and company channels; human approval of ad spend |