Someone approached me for help. He bought an integrated Shield plan and went for an expensive operation in a private hospital costing $60,000.
He had checked with the insurance agent and was assured that the operation would be fully covered. He had the integrated plan and the rider that covers the co-payment.
After discharge, he submitted the hospital bill for reimbusrement. The bill was rejected on the grounds that the policy had lapsed and when he reinstated the policy, he did not declare that he had approached the polyclinic for some medical checkup.
The case was quite complicated. There were many letters and documents for me to read.
I agreed to help the claimant as his sister diligently organized all the documents for me to review. She also helped me to draft the appeal letter.
Without the sister's help, I would have to spend many hours to understand the issues and to draft the letter of appeal.
I have turned down other requests for help because the the person asking for help was too lazy to do his part of the work. He gave confusing and inadequate information to me, and would have required me to spend many hours of my time.
If they had approached a lawyer, they would have to pay more than $1,000 in legal fees, as lawyers charged $300 for each hour, or maybe more.
Here is the lesson. If you expect someone to help you, you must do your part of the work to organise the information so that the person who is helping you do not have to spend too much time. You have to respect his time.
He had checked with the insurance agent and was assured that the operation would be fully covered. He had the integrated plan and the rider that covers the co-payment.
After discharge, he submitted the hospital bill for reimbusrement. The bill was rejected on the grounds that the policy had lapsed and when he reinstated the policy, he did not declare that he had approached the polyclinic for some medical checkup.
The case was quite complicated. There were many letters and documents for me to read.
I agreed to help the claimant as his sister diligently organized all the documents for me to review. She also helped me to draft the appeal letter.
Without the sister's help, I would have to spend many hours to understand the issues and to draft the letter of appeal.
I have turned down other requests for help because the the person asking for help was too lazy to do his part of the work. He gave confusing and inadequate information to me, and would have required me to spend many hours of my time.
If they had approached a lawyer, they would have to pay more than $1,000 in legal fees, as lawyers charged $300 for each hour, or maybe more.
Here is the lesson. If you expect someone to help you, you must do your part of the work to organise the information so that the person who is helping you do not have to spend too much time. You have to respect his time.
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