I have encounter a special case lately.
A friend of mine got his insurance claim rejected. He went to clinic due to a very bad headache, and the doctor actually wrote a letter and refer him to hospital.
In the hospital, he went for some scan, and then admitted to hospital.
During admission, he wanna use his medical card but the GL was declined.
After that, he received a letter from the company notifying that they cannot pay the medical bill on his behalf basically they think the issue can be resolved without being hospitalized.
I've heard that when a policy is new, like 2 years, company sometimes will decline GL first, but they will pay once they investigate and confirm the case is genuine.
And in this case, my friend case was totally being rejected. But my question is he got the refer letter from doctor (clinic) to get hospitalized in the first place. It is a professional advice from a doctor for him to get hospitalized. I think it is a very good proof that he need urgent and higher level attention than usual headache case but his case got rejected totally......
So far, I've encounter some case where my own clients was hospitalized but all went through smoothly. I have never encounter any case where the GL is declined, thus I'm not sure is this considered normal?
Plus, it is from another company, so it is a little it hard for me to follow up this case. My friend agent based in another state and she seems like not willing to take the effort to help my friend. haiz..... she directly ask him to use company medical card and ask him to forget about this matter as he is entitled to claim from the company medical benefit.
My fren has lost his confidence in insurance now..... to him now it is not the issue whether or not he can claim the medical bill back but if this card is so useless to him, there's no point for him to continue paying for it.
What do u guys think? Do you think this case is a norm in the industry? coz I myself do not feel it is justice for the company to reject my friend's case.
This post has been edited by frosteer: Apr 18 2015, 07:23 PM