Sifus-sifus sekalian,

Posted this in insurance talk, and no feedback from others...

I have a problem here with AIA and I would like to get some opinions from policy holders and insurance agents:-

I bought an medical insurance policy for my mother. My mother is kind of old, so the premium is quite expensive, of course before the policy was enforce, a medical screening was done and submitted for approval. 11 months down the road after the policy is enforce, a checkup revealed that my mother has contracted Hep-C.

So in order to do the claims for the treatment, my mom has to be hospitalized for one day and post hospitalization jabs can be claimed. The f*cking problem with the f*cking insurance company right now is:-
- it's been 6 bleeding months and the investigation is still 'going on'...as of now, the the underwritting process is still 'on going'

- the first batch of medical bills (3 months) has been submitted for claims, since I can't get confirmation on the first batch of bills, I wasn't able to do claims for the second batch because hospitalization is required

- I've chased my agent countless of times. She said: "wait, be patient" or..."this needs about 2 weeks to process". This lame excuses has been reused countless of times

- I've completely lost confident in this imbecile agent (who also sold me very lousy medical policy), and I decided to follow up the claim myself with the insurance company. (you just got to do everything yourself...initially, I submitted the claims to her and she said she'll settle for me, I think there's a lot of delaying on her end as well)

- as of lately, the investigator fax a document to my mom, wanting my mother to acknowledge and answered a few questions before proceeding with the underwritting and decison making process. I've fax the document on 2nd November and I was asked to for one week. So today I called in to enquire the status. The customer service clerk check system and told me that the fax document was scanned into the system 4th of Nov, and I need another one week to know the answer!

This
is
f*cking
ridiculous.

I'm very very sorry for the swearing because I'm in a terrible mood...okay guys, here are the questions:-
- If I want to make a complaint to AIA, where should I go? How should I go about? Or I pull MCA thing? (don't think the MCA thing will work though)
- Does it make a difference if I march into AIA HQ and make a big ruckus?
- Can I change my bloody agent?
- Can I lodge a complaint against my agent?

Thanks,
Totally Disappointed with AIA


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Added on November 12, 2010, 9:52 amAdditional details:-

Mom went to private hospital for treatment, SJMC. From the day I received the bill. I pass everything to the agent to settle it. But then again, she came to me a couple to get more details, there was historical medical report needed, which clinic went to in the past 5 years or something, etc etc.

From what I found out, Hep-C is something viral that stuck in the body for years...what the investigators are trying to prove now is that my mother contracted hep-c before the policy was bought (insurance doesn't cover pre-existing condition). So for worst case scenario, the investigator might call up clinics and hospital everywhere to get medical record or some sort of prove...which I think they did that, or else, how come the investigation took so long?? This is what agent stated this as a "special case".

As far as I remember, my mother's previous blood test and check ups are all okay (If there was a problem, doctor could have advise or something). Even before the policy was bought, AIA request my mother to do a medical checkup with panel clinic to get report. The panel clinic diagnosis and checkup was simple. No blood test.

Another thing why I'm so pissed off is that, since I've been following up with both my agent and AIA customer care personnel. Both them give me different story every time I ask for claim status. From this incident, I have this stinking feeling that my agent is inexperience at all at doing claim and handling cases. My perception here is that the why would customer care personnel lie?

So sick and fed up.

It has been six months, I tried very hard to pay for the treatment on my own, with claim department delaying the claim for the first batch, I can't claim for the second batch. What has been paid, paid. What I need to know whether AIA can approve the claim or not.

If they are not, I need a very valid reason why. If the investigators can indeed prove that my mom contracted hep-c before she got the policy, fine. Which, I think they can't find any prove yet...I believe the only thing they can speculate that my mother contracted Hep-C years ago was a 'Raised GGT' values found in year 2006 medical report. From what I research, raised GGT is just an indicator of liver damage and it is not valid measurement for Hep-C diagnosis. And if there was raised GGT is a blood report last 2006, the doctor could have probe further. What I afraid the most is whether the investigators are working with speculative facts to reject the claim.

If they are in the 'underwritting' process, make it fast (6 months ler, macha, a typical company/bank/kedai runcit out there probably has already run 2 quarter financial report ler).


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Added on November 18, 2010, 3:52 pmAfter long waiting and delayed lame excuses from my imbecile agent, I manage to find out status of my mom's claim. I manage to get insider info from my brother-in-law's agent (from GE, he know the guys working in AIA claim dept.) to probe and get the answer from claim department.

The claim is REJECTED.

THANK F*CK YOU VERY MUCH, AIA. AFTER LETTING ME WAIT FOR 6 MONTHS.

From what the claim department said, they reject the claim because of the Raised GGT levels found in the blood test that was done in 2006. From what I research, raised GGT is not a definite indicator of hepatitis, but an indicator of liver damage (they are a couple of reasons that cause this).

I will chase for an official reply from AIA AND I'm going to go for appeal. If there was a problem with my mother's blood test 4 years ago, the doc could have probe further that time.

My guest is correct when they are working on speculative facts to reject my mother's claim. This AIA is the MOST F*CKED UP insurance company that I've come across...SAME GOES FOR THIS AGENT 'FRIEND' OF MINE.

bro, if let say someone change/upgrade their medical card plan after 1 year, GE will still decline the GL for investigation purpose?

Hi Exp Zero,

Thank you for your reply. Really appreciate it.

But why the SOP is not being made aware to the client? It is never mentioned in the policy or by the agent that cases within 1 year time will require stupid 2 to 3 months investigation. Why it is never mentioned to the client? It is not even in GE policy. If they have mentioned that, I have made a better decision not taking this stupid insurance that do investigation for 2 to 3 months. This is a medical necessity and waiting for 3 months is really not rational at all.

And why I need to pay first when I'm having the medical card? I should be enjoying the GL benefit, unless there is a valid reason like for example my mother case falls into any of the exclusions. That I really can accept.

But now there any giving excuses like they are no sure, and there is not enough information. What in supposed to do if there is not enough information? I have forwarded all the documents given by the doctor. So now GE except clients to do research and find out information regarding the illness before admission to the hospital. What the hell? When they are selling, none of this were mentioned either by the agent or in the policy.

Really, based on my experience, GE is being unethical and biased. They don't really care about their client. Their so called SOP sucks, and client is not even made aware of that. Please don't choose GE, if you want your life really assured.

I really want to terminate my mom's and my policy with the company. Just tat I want my money back,  but the stupid company dowaan to give back my money. I mean I never have claimed nything from them, so it is fair enough for me to get me back my money, but this the company said can't give. Blood suckers. Wants people money, but not giving them wat they deserve.

Truely agree. I also piss off with GE agent. If there is any reputable insurance company that allow customer to purchase insurance via online, i'm very very much interested and terminate my lousy insurance policy!

Example is fundsupermart to allow customer to buy unit trust via online and bypass unit trust agent!

End of the day, Great Eastern is lousy insurance company. What do you expect from Singaporean company? They all just want to take your premium but not pay when you claim. So many people I know complain about the same thing with Great Eastern.

I think last time even their staff also complained and had street protest and demonstrations outside their HQ in Jalan Ampang? Any company where the staff have picket demos and complaints can't be good. MAS last time also the same and look at it now.

better wait for the investigation result.

if the result is not in ur favor then only terminate

I have never believe in any part of the insurance selling which basically say that a medical card will get you admitted into a private hospital.

The most tangible entrance fees for admission that a private hospital look to is credit-card or cold hard cash. Insurance medical card really is second rated.

Besides, I heard that it is common practice that private hospital bump up the charges when they deal with insurance claim vs a cash paying customer. This could also draw down the insurance claim limit faster than necessary.

TS, in your case, you could always pay first for the private hospital, and claim back later. If you have beyond reasonable doubt that it is not an existing pre-condition, GE cannot deny you your claim down the road. You could always decide on cancelling the insurance AFTER the claim if GE did not serve your needs and expectation.

ExpZero you are not telling the entire story, especially for your own Great Eastern company. The protest I am referring to is the one involving Menara Great Eastern on Jalan Ampang and you deflect to Miri???

This is just showing everyone how a Great Eastern agent works, not telling the entire story and selective in sharing information.

Enough said, you have just shown everyone that your actions is the same as what your Great Eastern company do to its policyholders.

Hi Exp Zero,

Thank you for your reply. Really appreciate it.

But why the SOP is not being made aware to the client? It is never mentioned in the policy or by the agent that cases within 1 year time will require stupid 2 to 3 months investigation. Why it is never mentioned to the client? It is not even in GE policy. If they have mentioned that, I have made a better decision not taking this stupid insurance that do investigation for 2 to 3 months. This is a medical necessity and waiting for 3 months is really not rational at all.

And why I need to pay first when I'm having the medical card? I should be enjoying the GL benefit, unless there is a valid reason like for example my mother case falls into any of the exclusions. That I really can accept.

But now there any giving excuses like they are no sure, and there is not enough information. What in supposed to do if there is not enough information? I have forwarded all the documents given by the doctor. So now GE except clients to do research and find out information regarding the illness before admission to the hospital. What the hell? When they are selling, none of this were mentioned either by the agent or in the policy.

Really, based on my experience, GE is being unethical and biased. They don't really care about their client. Their so called SOP sucks, and client is not even made aware of that. Please don't choose GE, if you want your life really assured.

I really want to terminate my mom's and my policy with the company. Just tat I want my money back,  but the stupid company dowaan to give back my money. I mean I never have claimed nything from them, so it is fair enough for me to get me back my money, but this the company said can't give. Blood suckers. Wants people money, but not giving them wat they deserve.

Great eastern medical card is "As charged" or "As charged subject to reasonable medical fee" ?

How to find the price of the medical cost for the GE as charged price list?

Truely agree. I also piss off with GE agent. If there is any reputable insurance company that allow customer to purchase insurance via online, i'm very very much interested and terminate my lousy insurance policy!

Example is fundsupermart to allow customer to buy unit trust via online and bypass unit trust agent!

Some Insurance Companies have Bancassurance Partnerships with Banks, meaning u can buy selected Insurance Products at Banks, and sometimes, the products are priced lower compared to Agent products

Great Eastern - partners OCBC
Prudential - partners Stan Chart and UOB
AIA - Partners Public Bank (due to former agreement with ING)
Tokio Marine - Partners RHB Bank
Sun Life - Partners CIMB

Bank owned Insurance Compaies

Etiqa - Maybank
HLA - Hong Leong
AmLife - AmBank
AXA Afin - Affin Bank

I am having similar situation recently. In the midst of appealing now.
GE declined my claim with reasons which is not acceptable.

In short:
--> the time they approach, anything CAN CAN CAN.
--> the time we need claim, they will decline with all kind of funny funny reasons to leceh us.