Thursday, October 22, 2015

Rejected insurance claim - insurer finally pay

Recently, I was approached to help an elderly lady who was covered under a Shield plan for private hospital. She was treated in a private hospital for colon cancer. The total bill was $300,000. The insurance company rejected the claim as she did not disclose that she was being treated for diabetes when she upgraded the plan a year earlier.

I helped the daughter of the policyholder to prepare a report on this matter. It was submitted to the insurance company, and copied to the regulator.

After a few months, the insurance company changed its mind and agreed to settle the claim. It seemed that the agent was not thorough in asking the policyholder on her medical condition when helping to complete the upgrading form.

I have been approached on many cases of rejection of an insurance claim on flimsy grounds. I help the consumers to present their case for the insurance company to review their decision. If it is still rejected, the case material can be used to lodge a complaint with FiDREC.

If you are interested to consult me, register here.


Anonymous said...

Consumers must not be fooled that insurance companies are interested in your financial life. They are in the business to make money out of you.
They are betting with you that you will not make a claim . And if there is a claim they will finds ways and excuses not to pay you , until bopian then they pay you.
Same with insurance agents they too are only interested in closing you because without closing you they will not get commission. How to close you? They manipulate you and coach you to fill the form so that you are a 'standard life' and so pass underwriting without a hitch.Then they can see the money flying into their bank account, isn't it? How many of these cases have been exposed?
The truth is you are dealing with dishonest agents. They see you they see commission, nothing else. Helping you? How? when they are not qualified? Aren't they dishonest ? Claiming to be competent when they are not is dishonesty, right?
When they say they can do and that ask them how?

Anonymous said...

Mr.Tan, why not lodge those cases that you found very shoddily done to MAS and have both the agent and company censured and disciplined for misconduct.
Kudos to you....for caring for those aggrieved consumers who have no idea who to turn to. Justice seems out of their reach. Many fear getting justice is expensive and therefore those scumbag agents got away scotch free to continue to con and cheat their victims.
There is a big case coming up for trail in February 2016 and i I hope it is landmark case for hauling up many more.
Thank you for championing the cause of the unwary victims of insurance agents and the insurers.

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