Insurance Claim

March 5, 2006 | 11 Comments   

How come when someone sells insurance to you, they can absolutely be like an angel? Bowing to all your wishes and never saying “No”. The opposite of this is when you try to claim, the customer service officer can really give you a hard time. Don’t ever buy insurance from XIX Company (*name changed, but you get the idea*) because the claim department officers are very unprofessional and the claims policy is ridiculous.

One day my hubby was telling me that my PIL is whining because he cannot claim his hospital bill from the insurance company. You know, elderly people treasure every sen very valuably. He was trying to claim from his company insurance policy because he had the accident when he was working. Apparently he has submitted all his hospital bills to the insurance agent. After a few months, the insurance rejected his claim because of a missing deposit receipt. You know, you have to make a deposit before you can admit to the private hospital, in case you cannot pay.

It is absolutely ridiculous right, in a logical manner that the claim was rejected even though the true copy of the hospital bill is in tact but the deposit receipt is missing. The agent asked PIL to go back to the hospital to issue another but the hospital will never issue another receipt, the best they can do is to certify a copy. The insurance company refuse to accept certify copy. PIL was so upset because he went to the hospital a couple of times. Everyday he complained to us.

I decided to help him out, made a call to the claims department. No one have a definite answer to the claims. The officer asked me to write a letter to appeal. The manager said there is no guarantee the appeal will go through, it depends on the committee.

Me: Why is the deposit receipt so important when you have the actual hospital bill?
Mgr: It is our company policy. *policy to give the customer a hard time* Furthermore, it will prevent the customer to claim from other insurance company.
Me: I am a having a hard time just to claim with the original actual hospital bill from your company. Do you think other insurance company will let me claim using a deposit receipt???!!!
Mgr: *speechless for a few seconds* Please submit an appeal letter.

What a disappointment? I wanted to complain them to Bank Negara. Anyway, I thought of giving the company a chance, draft out an appeal letter for my PIL to sign and send. After a month later, PIL whine again because no news from them. I decided call.

Me: I have sent the letter of appeal a month ago.
Officer: We didn’t receive anything, the computer showed no record. *Excuses*
Me: Can I fax the letter to you?

She gave me the fax number and I faxed it in. After a few more weeks, I called in to check the status else they will probably sit on it. With claims, you have to call in every now and follow through, give them a hard time too.

Officer: The cheque has been issued and has been send to the Penang branch on Feb 12.
Me: My PIL has not heard from the Penang branch.
Officer: You just have to wait for them to call you.
Me: Can I call them?
Officer: If you want, I cannot stop you.
Me: *How RUDE!!!* :wall:

My PIL received the cheque after calling the Penang branch agent. The cheque was RM160 less than the original amount. In the letter, they put “out of goodwill that they have approved the claim” Good will my foot!! :shoot:

Anyway, the whining stops.

*Note, by the way, if any of you have trouble claiming with your insurance company after dealing with them and still negative, you can bring your case to Bank Negara.
Website: http://www.bankinginfo.com.my/index.php?ch=19&pg=31*